Whether you play sport socially or professionally, a knee injury can put you out of action. Physiotherapists provide expert advice and treatment to speed up recovery and get you active again following knee injury or surgery.

Types of knee injuries

Acute injuries result from a sudden trauma, such as an awkward fall, collision, or twist of the knee joint. Overuse injuries result from continuous activity or overload, such as running, jumping, cycling, weight training, or bush walking. These start gradually and usually relate to a range of factors such as structural or biomechanical problems, training methods, footwear, technique, or running style.

Acute injuries

The ligaments and menisci (cartilage) of the knee may be injured. Ligaments stabilise or strengthen joints. Over-stretching can cause tears to the ligament resulting in pain, swelling, loss of movement, and instability. The menisci also provide stability to the knee joint. They are mostly torn during weight-bearing activities that involve twisting and turning. A torn meniscus results in pain, swelling, and locking or catching of the joint. Many injuries may be successfully treated without surgery by physiotherapy treatment and supervised rehabilitation. If damage is severe, surgery may be required. Physiotherapists work closely with medical practitioners, sports physicians, and orthopaedic surgeons to assist recover and rehabilitation.

Overuse injuries

These are much more common than acute injuries, and usually affect the patello-femoral joint or patella tendon; if left untreated, they often get progressively worse. Early diagnosis and treatment may result in a quick recovery and less pain.

Patello-femoral syndrome

Patello-femoral syndrome may occur from squatting or stair climbing.

Patella tendinopathy

The patella tendon joints the thigh muscle to the leg bone. Injury to this tendon may be known as ‘jumper knee’ because it commonly occurs with repeated jumping and landing activities (Basketball, netball, volleyball etc).

Physiotherapy treatment is essential to reduce the pain and disability associated with overuse knee injuries. In addition, physiotherapists are well trained to address the potential aggravating factors that may have contributed to the development of the overuse injury.

How to reduce the chance and severity of knee injuries

  • Warm up before exercise
  • Cool down after exercise
  • Build up your exercise programme by gradually increasing the frequency, duration, and intensity
  • Don’t work through pain
  • Maintain good general fitness and lower body strength and flexibility (especially calves, quadriceps, and hamstrings)
  • Practise standing on one leg to improve your balance and leg muscle strength
  • Skiers: get a qualified ski technician to check your binding settings (binding must be set to weight and skill level)

When to return to work or sport

Your physiotherapist will discuss the injury with you and estimate the time it will take to recover. This will vary from weeks to months depending on the severity of the injury. The pain and swelling associated with an acute injury subsides much faster than the time it takes for the ligaments and muscles to regain normal strength. Returning to work or sport too early may delay healing and prolong recovery. Your physiotherapist can teach you how to tape your knee or fit you with a knee brace if required. Your physiotherapist can help you to plan alternative ways to maintain your fitness and muscle strength while you are recovering from your knee injury.

What to do after a sprain

As soon as possible, and for 72 hours after an injury, use the RICE method: rest, ice, compression, and elevation.

  • Rest, take it easy, and only move within your limit of pain
  • Ice as soon as possible, and for 20 minutes every two hours, apply ice or a frozen gel pack wrapped in a damp towel to control bleeding and pain, and reduce secondary tissue damage
  • Compression bandage the knee firmly and include 5cm above and below the joint to help control swelling
  • Elevate your leg higher than the level of your heart to reduce swelling.

For the first 48 hours, avoid any of the HARM factors: heat, alcohol, running, and massage.

How physiotherapy can help

Your physiotherapist will examine your knee to determine the type, extent, and cause of your injury, and can order an x-ray or refer you to a doctor if needed. Early treatment will reduce any pain or swelling. Special techniques called mobilisation may help to increase the movement of your knee joint (if required), improving your recovery. Your physiotherapist will teach you exercises to improve the strength of the knee and other lower leg muscles to enhance your recovery and help prevent further injuries.

Rehabilitation

Recovery can start very early after an injury. Physiotherapy rehabilitation techniques will help reduce the time that your knee is painful and movement is restricted so that you can get back to work and sport quicker. Rehabilitation also facilitates a good quality ligament repair and the return of normal muscle and nerve function.