The ABCs of Knees

By | July 27, 2014

In 2007, the Australian Institute of Health and Welfare published a study showing that 38.7% of all touch football injuries presenting to hospital were knee injuries. Changing direction at speed, side-stepping, jumping and landing can all cause damage to the structures of the knee if they are uncontrolled or performed with excessive forces.

So if you were to hurt your knee playing Touch Rugby League, how do you know when it requires attention? If your knee has swollen, particularly with a specific mechanism of injury, if your knee is limiting your walking, if there is difficulty bending or straightening or if it is clicking, popping or cracking, a visit to a healthcare professional is advised.

When you present to the physiotherapist with a fresh knee injury there are a few standard questions that you can expect to be asked. Your responses to these queries will dictate the most appropriate management.

1. Mechanism of your injury

How did it happen? Did someone or something land on your leg or did the injury occur during a step or landing from a jump? If your leg was in contact with the ground and bearing the weight of the body through it, there is a greater likelihood of structural damage within the knee. If the knee was twisting one way or another it is important to note the direction of movement as this will indicate which structures took the brunt of the impact.

 2. Snap, Crackle and Pop?

Did you hear anything when you injured your knee? A rupture of ligaments in the knee can often be accompanied by the sensation or even sound of a snap or pop. Clicking or catching can also indicate damage to other structures within the knee including cartilage and bony surfaces.

3. Swelling

Is there any swelling? Structures in the knee with a high level of blood supply will cause more rapid swelling. The amount of swelling and its location are also factors that your physiotherapist will take into consideration. Keep in mind that a tear of the cartilage in the knee can become increasingly stiff and swollen over a matter of days.

4. Investigations

A set of rules developed in Ottawa,Canada is widely used by therapists to determine whether an acute knee injury requires immediate imaging (Stiell et al., 1996). These rules suggest that anyone who fits any of the following criteria should seek immediate investigation:

  • Over the age of 55
  • Has isolated tenderness over the Patella (kneecap)
  • Pain over the head of the fibula (bone on the outside of the shank)
  • Unable to flex the knee to a right angle
  • Unable to take weight through the leg for 4 steps immediately post injury or in the emergency department

5. Range of motion

As discussed above, a lack of knee bend is a concerning feature of a knee injury, as is an inability to fully straighten the knee. This requires a thorough assessment and treatment to prevent any further injury occurring as a result of poor biomechanics

Hopefully these simple guidelines will allow you, or any of your teammates, to make a well informed decision regarding the management of your knee injury, should you sustain one during this season. If your injury fits any of the above descriptions  it would be advisable to have it assessed by an appropriately trained health professional as soon as possible.

As always, feel free to contact us with any concerns!

Kind Regards,

Ollie Codd

Allsports Physiotherapist – Jindalee Clinic

E-Mail: olliec@allsportsphysio.com.au

Phone: 3279 3752

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