Knee injuries are common in sports like football, rugby, tennis, hockey, netball, basketball
and squash. Generally speaking, contact sports or any sport that involve a pivoting manoeuvre
or a sudden change of direction or going down onto your knees can lead to knee injuries.
The most important thing is to understand how knee injuries occur and to work on strengthening
the muscles and the ligaments around your knee to prevent injury.
The most frequent knee injuries that I come across are usually either sprains of the ligament
or soft tissue damage to either the cartilage or the tendons around the knee. Sprains are
usually injuries to the ligaments where the ligament is stretched or sometimes partially
torn. It affects the strength of the ligament. As opposed to strains, which is a tear or
a stretching of the muscle that can cause pain around the knee. The second type of injury
is the injury in the inside of the knee joint; where you can have a sprain of the, for example,
the cruciate ligament, the anterior cruciate ligament or at the end of the spectrum it
can be completely torn. So, a complete rupture of the anterior cruciate ligament. Other injuries
include meniscal tears. So, tears to the cartilage or to the lining of the joint. So, tears in
the cartilage itself can be caused by different types of injuries, mainly again impacts or
contact sports as well.
First of all, it's very important to maintain a healthy weight and healthy diet to prevent
recurrent knee injuries and overall injuries to the whole of your body. The higher the
weight or the higher the BMI, more likelihood that you will suffer with an injury to the
knee when you exercise. Number two: it is very important to stretch and exercise your
muscles to pre-empt them before exercising to warm them up and also to stretch in the
end to cool the muscles down after the exercise to prevent injury. This provides preconditioning
when you exercise before the exercise to try and pre-empt the muscle, get it ready, or
shall we say turn on the engine and then when you're cooling down after you finished your
exercise, it's very important to stretch the muscles again in order to prevent after exercise
pain and aches that might come after exercise. Number three: wearing the right clothing and
the right shoes and the right supportive supports does help in preventing knee injury, especially
shoe wear where you ideally want to wear a fitted shoe that fits with your gait that
prevents injuries, but also knee supports or knee guards which are fairly commonly worn
by sports players like rugby players, hockey players. These also help to decrease the incidents,
but not completely prevent it when you are playing sports. The fourth element in prevention
of knee injuries is to exercise also the rest of your body to maintain the strength of your
core muscles around your spine and your hips, your gluteal muscles, your back muscles or
your spinal muscles, your hamstrings and the muscles that support the back of your knee.
These are very important to maintain these in good shape to prevent injury. The fifth
element is to try and avoid kneeling or bending down when you're playing sports, and if you
are going to kneel, don't kneel on a hard surface. Wear a knee guard if need be when
you're kneeling. This will also help to prevent further knee injuries and then finally if
you do have aches or strains or if it's aching or if it doesn't feel right, please stop,
wait until the knee recovers, give your knee a chance to recover before going back to exercise
and if there's any concern of a persisting pain, seek help.
Women are more likely to suffer certain types of knee injuries. The commonest of which is
anterior cruciate ligament injury; which is a common sporting injury when one of the ligaments
inside the knee that plays an integral or important part in the stability of the knee
gets injured. There are three grades for this injury. Could be just a grade one where there's
a sprain, which is usually managed conservatively or a grade two where there's a partial tear
or a grade three where it's completely torn. The reason behind this is related to certain
elements such as hormonal imbalance specifically around certain times where there is a hormonal
imbalance that happens during the month for example, it can lead to predisposition to
a knee injury. Some evidences pointed to the fact that patients, the female patients who
are taking the contraceptive pill because they maintain their oestrogen levels at a
specific level due to the regularity of the tablets that prevents knee injuries because
of the sort of plateau or the stagnant presence of the hormones in the bloodstream. Other
issues that relate to that or sometimes the weakness and the muscle. It doesn't apply
to all females, but generally speaking more and more women have weaker muscles than men.
The way that women generally land when they jump, they tend to land with the knees in
slightly. Sometimes they tend to hyperextend their knees and that can predispose them to
develop knee injuries as well and this is very important from the point of view of conditioning
to try and pre-empt or prevent this by learning how to jump and land with your hips flexed,
your knees flexed and your ankles flexed to try and prevent the injury.
The most serious types of knee injuries are usually the multi ligament injuries or fractures
or dislocations that happen around the knee. These are usually what we call high energy
traumas and they cause significant trauma not only to soft tissue structures, but they
can also lead to associated fractures or breaking of the bones around the knee either inside
the joint or outside of the joint. These serious injuries usually require surgical reconstruction.
So that means that they require surgery to put things back to where they should be. That
may involve may be one or more than one operation to restore the function of the knee. It is
important to correct any intra-articular abnormality. So that means the joint inside, the surface
of the joint has to be reduced to an anatomical position, so that means there shouldn't be
any discrepancies in the surface of the joint. The ligaments that provide stability to the
knee are fairly important to restore and that involves the posterior cruciate ligament,
the anterior cruciate, the posterolateral corner of the knee and the collateral ligaments
which surround the knee. These are very important to make sure that they are intact. Otherwise,
the patient will have long-term instability and that can lead to long term problems. Dislocations
can be associated with severe injuries that can affect not only the ligaments but also
the vascular supply to the leg and these are emergencies that have to be reduced and restored immediately.