Knee
The knee is heavily loaded in sports and everyday activities. Rehabilitation aims to restore stability and strength.
Anterior cruciate ligament injury
Anterior cruciate ligament (ACL) rupture is one of the most common and serious knee injuries, especially in athletes who participate in sports that involve sudden changes in direction, jumping, or turning (e.g., football, basketball, skiing).
Causes of rupture:
• Sports injuries (turning with a fixed foot, landing with incorrect technique)
• Sudden deceleration or change of direction
• Direct impact to the knee (less common)
• Muscle imbalance, gluteal/hamstring weakness, poor technique
Symptoms:
• Sudden “crack” or “break” at the moment of injury
• Acute pain and immediate swelling (within hours)
• Feeling of instability or “give-away” knee
• Difficulty walking or supporting the foot
Posterior cruciate ligament injury
Posterior cruciate ligament (PCL) rupture is less common than anterior cruciate ligament rupture, but it is a serious knee injury. The PCL is a key ligament for knee stability, especially during posterior displacement of the tibia.
Causes of PCL tear:
• Direct blow to the shin while the knee is bent (e.g., crashing the knee into the dashboard – “dashboard injury”)
• Falling on a bent knee
• Hyperextension of the knee
• Sports injuries (e.g. rugby, football, skiing)
Symptoms:
• Pain deep in or behind the knee
• Swelling, usually mild compared to an ACL tear
• Instability or a feeling that the knee is “giving way” backwards
• Difficulty going downhill or up stairs
Meniscus injuries/Meniscus tear
A meniscus tear is one of the most common knee injuries, which can result from trauma or degenerative changes due to aging. The meniscus is the cartilage disc located within the knee joint, acting as a shock absorber and helping to stabilize the joint.
Causes:
• Acute injuries: Usually when bending the knee with the foot fixed on the ground, such as in sports (football, basketball, rugby)
• Degenerative changes: Age-related tears, where the meniscus becomes more vulnerable over time
• Abnormal movements or injuries: Such as in violent flips or jumps
Symptoms:
• Pain on the inside or outside of the knee, depending on the location of the tear
• Swelling and bleeding (usually within 24 hours)
• Feeling of blockage or “sticking” of the knee during movement
• Difficulty extending or bending the knee
• Feeling of instability or "gap" in the knee
• Rarely, tingling or numbness (in cases where the rupture affects the nerves)
Cartilage lesions
Cartilage damage in the knee involves changes in the articular cartilage, which covers the surfaces of the bones within the knee joint. Cartilage allows for smooth movement of the joint, while absorbing shock and reducing friction between the bones.
Causes of Cartilage Damage to the Knee:
1. Injuries:
• Direct injuries (e.g. fall, accident, severe impact)
• Injuries during rotation or changes of direction (such as in football or basketball)
2. Degenerative Changes:
Osteoarthritis: The wear and tear of cartilage over time due to aging or other factors such as overuse or previous injuries.
3. Anatomical abnormalities:
E.g. patellar deviation, bone asymmetries, chronic stress that affects the cartilage.
Symptoms of Cartilage Damage:
• Knee pain, which worsens with activities that increase pressure on the joint (e.g., going uphill, sitting for a long time)
• Swelling and feeling of "fullness" in the joint
• Instability or “locking” of the knee during movement
• Difficulty moving the knee (especially when extending or bending)
• Sometimes, a grinding sound or "rattling" when moving the knee
Patellar dislocation/Dislocation
Patellar dislocation is a serious traumatic condition that involves the loss of the normal position of the patella (or kneecap), when it moves out of its groove in the femur. Typically, the dislocation occurs outward (laterally), although it can also occur inward in rare cases.
Causes of Patellar Dislocation:
• Direct injury or blow to the knee.
• Strabismus or rotation of the knee while the foot is fixed on the ground (common in sports such as football, basketball, dance).
• Anatomical abnormalities of the patella or femoral groove, such as patellar dysplasia, which makes the patella less stable.
• Weak or weak muscles around the knee, especially the quadriceps, which reduce the ability to stabilize the patella.
• Crooked movements or turns of the knee under load or at an angle.
Symptoms of Patellar Dislocation:
• Sudden, severe pain in the knee area, usually on the front or outer side.
• Feeling of deformity or abnormality in the patella area (the patella is usually visibly displaced or "crooked").
• Swelling and bruising around the knee.
• Feeling of instability or inability to move the knee normally.
• Inability to straighten or bend the knee.
• Sometimes, vibrations or sounds during movement.
Bone edema/bone bruise
Bone edema is a microtraumatic bone injury, also known as bone bruise or subchondral edema, that often occurs in the knee after injury or overuse. It is an accumulation of fluid within the bone marrow, usually after a blow, fall, or twisting injury.
What is Bone Swelling?;
• It is a microtrauma to the cancellous bone, without an obvious fracture.
• The bone "splinters" internally, resulting in bleeding or inflammation in the marrow, without a crack in the bone's cortex.
• It usually occurs in the femur, patella, or tibia (especially on the medial or lateral condyle of the thigh).
Causes:
• Knee injuries (fall, direct blow, rotational injury)
• Sports activities with sudden braking/turning
• Concurrent damage to injuries such as:
o Anterior cruciate ligament (ACL) tear
o Meniscus tear
o Patellar dislocation
• Overuse or repetitive strain injuries (especially in runners or athletes)
Symptoms:
• Deep, diffuse knee pain, especially when walking or standing
• Pressure sensitivity
• Swelling in the joint
• Feeling of stiffness or limited mobility
• Pain persists for weeks, often without visible signs on X-ray