Knee

*If you are experiencing persistent pain, diminished function, loss of strength, range of motion, and/or sensation, BCPT recommends that you contact your physician, as a serious underlying physical condition may be present.

Ligament Sprains

A sprain is an injury to a ligament that results from excessive stress that damages the ligament fibers. The amount of damage is dependent on the amount of stress and can vary from microtrauma without loss of ligament function (first degree sprain), to a complete separation or rupture with functional instability (third degree). A first or second degree strain may heal completely with proper support, protection, and rest complemented by physical therapy activities which encourage healing. A third degree sprain often requires surgical correction or reconstruction to restore joint stability.

Anterior Cruciate Ligament (ACL) Reconstruction

The ACL is one of the primary stabilizers of the knee joint and is most commonly injured when an external rotation force is applied to the knee while the foot is firmly planted on the ground. ACL tears are often non-contact injuries and occur with deceleration, as when a running back plants his foot to make a cut and avoid being tackled. Injury to the ACL can be accompanied by meniscal (cartilage) and/or other ligamentous tears, specifically the medial collateral ligament (MCL). Reconstructive surgery is often necessary after an ACL rupture to restore joint stability. After reconstruction, the physical therapist plays a major role in the restoration of joint motion and surrounding musculature strength, helping the patient/athlete return to full function/competition.

Meniscal Injury

The menisci are cartilage structures located in the knee joint which act as shock-absorbing and load-distributing structures during weight bearing activity. Tears to the menisci involve some form of knee joint twisting, often with a fixed foot. Symptoms of meniscal injuries include swelling, lateral or medial joint pain and tenderness, joint locking, popping, or limitations in normal range of motion. The meniscus has a notoriously poor blood supply and therefore healing rates without surgical intervention are low. the object of repair is to retain as much meniscal tissue as possible. Physical therapy after surgical intervention helps to regain full range of motion, strength, and independent function.

Chondromalacia Patellae

Chondromalacia patellae is a term applied to any disorder involving general retro patellar (behind the kneecap) pain. It is an overuse syndrome that stems from altered patellar alignment and biomechanics and leads to degeneration of the cartilage underneath the patella. Treatment depends on the amount of pain and misalignment present, but can vary from symptomatic modalities, muscle strengthening, patellar taping or bracing to improve patella tracking, to surgical intervention to improve the alignment and biomechanical forces place on the patella.

Patellar Tendinitis (Jumper's Knee)

Patellar Tendinitis is an overuse injury caused by excessive loading of the quadriceps muscle and its corresponding tendon. It involves pain located below the patella (kneecap), exacerbated with running and jumping activity, often treated with symptomatic modalities, rest, and gradual return to activity. In treating patellar tendonitis, it is important that a full evaluation of the involved lower extremity takes place, since tendinitis may be caused by faulty foot or hip mechanics.

References: Norkin, CC and Levangie, PK: Joint Structure and Function, A Comprehensive Analysis Magee, DJ: Orthopedic Physical Assessment Richardson, JK and Iglarsh ZA: Clinical Orthopaedic Physical Therapy