Knee Injuries

There is a large misconception which reflects a mindset suggesting only athletes involved in contact sports are susceptible to knee injuries. More accurately, non-contact injuries make up a significant percentage, i.e. 11-25% of knee pathology in athletes in general and runners specifically. Injuries may range from overuse syndromes leading to patellar tendonitis (“jumper’s knee”), medial/lateral retinacular (next to the kneecap) or plica (discomfort next to the kneecap) patellar (kneecap) tracking abnormalities. In most cases the variables which create these problems are often related to overuse, i.e. long training throughout the season or too aggressive training early in the season, lack of flexibility, decreased strength, poor proprioception (awareness of body position while in space or while landing from a jump), poor foot mechanics and leg length discrepancies. Additionally, it must be understood that idiopathic (unknown) knee pain may be a referred or radicular pattern with originating pathology in the hip or lumber (lower back) regions

SYMPTOMS:  Regional or specific knee pain often occurring without a specific causative event. The pain cycle generally increases paralleling work load. The pain cycle may diminish with rest but if the variable is not determined, the pain returns when running commences again. Effusion (swelling) often is not present and rarely is there an ecchymotic (discoloration) response. For the runner, they notice times are slower and the soreness/pain pattern during and post running increases. The pain may be global or specific to a region. There may be identifiable crepitus (snapping, popping and/or grinding. Changes in training regimen and/or terrain, new or aging shoes and failure to have lower extremity biomechanics evaluated are some but certainly not all of the variables leading to knee pain

MANAGEMENT  Waiting for the symptoms to subside  and self diagnosing must be avoided. The first step is to seek help from a physician trained in sports medicine physician with a solid background in running biomechanics and the pathology associated with them. The physician and the sports medicine team will assess the clinical picture and develop a treatment plan of care which may include but not limited to:

Diagnostic imagining as appropriate.

Biomechanical evaluation of the lumbar, hip and lower extremity complexes to check strength, flexibility, leg length and foot/ankle mechanics

Medication, prescription or over the counter

Referral to physical therapy or athletic training to assist with the above and implement the plan of care as prescribed

Fabrication of orthotic devise to control improper foot/ankle biomechanical deficits

Review, and if appropriate, revise the training regimen

For an immediate referral to our sports medicine team, call the 24 hour sports medicine hotline @419.262.1556 or burton.rogers@utoledo.edu

Burton L. Rogers, Jr. Ed.D., MBA, ATC, PTA

Administrative Director, Sports Medicine Division, Orthopedics

The University of Toledo Medical Center

Dowling Hall-Morse Center

3000 Arlington Avenue