Sunday, February 8, 2015

Knee Pain? Join the Club!

Knee pain is by far the most common issue I see in my sports medicine practice.  In children and adolescents, pain may be the result of acute trauma or repetitive overuse.  And sometimes, it’s both.  An athlete may be nursing a chronic injury that becomes more severe due to a traumatic event.  Now the athlete has worsening pain, swelling, instability, and stiffness.  That’s usually when they come in to see me.

There are several causes for knee pain in young athletes.  We’ll start with the most common—patellofemoral pain syndrome.  “Patella” is another word for kneecap.  This condition results from inflammation and irritation of the back of the patella as it moves over the front of the knee joint.  If the alignment of the patella is off just a little due to muscle weakness, inflexibility, and to variations in knee anatomy, it will become painful with running, jumping, an
d climbing activities.

The patella tendon in the front of the knee, which connects the patella to the tibia (shinbone), can also get irritated.  This results in patella tendonitis and difficulty with running and jumping.  If the growth plate where the patella tendon attaches to the bone gets pulled on too much, it can cause a common condition known as Osgood-Schlatter disease.  Undoubtedly, someone on your team has suffered from this condition.  Maybe even you or your child!

The knee also has several ligaments that can be sprained or torn.  We’ve talked about ACL tears before, so today we’ll mention another very commonly injured structure—the medial collateral ligament, or MCL.  This ligament lives on the inside part of the knee and usually gets sprained when an athlete is hit on the outside of the knee.  This forces the knee inward and stretches the ligament.  Thankfully, most MCL sprains can be treated without surgery.

Kneecaps can also be injured traumatically, resulting in a dislocation or partial dislocation.  This can occur from a collision or a forceful twist of the knee during a noncontact cut on the field.  The patella will actually move off of the front of the knee to the outside.  It usually causes a pop, and is sometimes followed by another pop if the patella moves back to its normal position.

All of these injuries and conditions are common in sports and cause difficulty with playing and practicing.  Most of the time, they resolve with rest and rehabilitation exercises.  However, any injuries that causes a visible deformity or causes an athlete to be unable to put weight on the leg should trigger a trip to the doctor.  Most other situations will improve within 2-3 days with rest, ice, and elevation.  If the problem persists longer than that, pay your friendly sports medicine physician a visit.