Knee injury: Most common types of knee injuries and tips to prevent them

Health experts list some common knee injuries and share ways to prevent them to avoid discomfort, long-term damage to your knees and save you pain and damage

Knee injuries can be painful and disruptive to daily life as they can seriously impact your life by preventing you from doing physical activities or even walking around hence, having knee problems is no joke! Understanding common knee injuries and how to prevent them can help you avoid discomfort, long-term damage to your knees and save you pain and damage.

Knee injury: Most common types of knee injuries and tips to prevent them (Photo by Terry Shultz P.T. on Unsplash)

In an interview with HT Lifestyle, Dr Nataraj HM, Head of Orthopaedics, Robotic Surgery and Sports Surgeon at Belenus Champion Hospital in Bangalore's Sarjapur Road, suggested to keep your leg muscles strong, increase activity intensity gradually, stay at a healthy weight and practice proper alignment during physical activity to prevent knee injuries. He revealed some common knee injuries and recommended tips to prevent them:

1. ACL Tear: An ACL (Anterior Cruciate Ligament) tear is a common knee injury that occurs when the ligament that connects the thigh bone to the shin bone is damaged or torn. It is often caused by sudden twisting or direct impact to the knee. To prevent ACL tears, it's essential to maintain strong leg muscles and practice proper jumping and landing techniques during physical activities.
2. Meniscus Tear: The meniscus is a rubbery cushion that sits between the thigh bone and shin bone. A meniscus tear can occur due to sudden twisting or impact to the knee. To prevent meniscus tears, it's essential to maintain a healthy weight and avoid activities that put undue stress on the knee joint, such as running on hard surfaces.
3. Patellar Tendinitis: Patellar tendinitis is an overuse injury that occurs when the tendon that connects the kneecap to the shinbone becomes inflamed. To prevent patellar tendinitis, it's essential to gradually increase the intensity of physical activities and avoid activities that involve repetitive jumping or running.
4. Patellofemoral Pain Syndrome: Patellofemoral pain syndrome is a condition that occurs when the cartilage under the kneecap becomes inflamed. It's often caused by overuse or incorrect alignment of the knee joint. To prevent patellofemoral pain syndrome, it's essential to maintain a healthy weight, practice proper alignment during physical activities, and avoid activities that put undue stress on the knee joint.
5. IT Band Syndrome: IT band syndrome is a condition that occurs when the IT band, a thick band of tissue that runs from the hip to the knee, becomes inflamed. It's often caused by overuse or incorrect alignment of the knee joint. To prevent IT band syndrome, it's essential to maintain a healthy weight, practice proper alignment during physical activities, and avoid activities that put undue stress on the knee joint.

Adding to the list of common knee injuries, Dr Anil R Patil, Consultant Orthopedics and Sports Medicine Specialist at SPARSH Hospital shared -

1. Osteoarthritis: The most common injury we hear about is the osteoarthritis of the knee i.e the wear and tear of the knee or age-related degeneration of the knee. This is seen in the age groups of 50 and above and more commonly in the age group of 60- 70. There are no real factors that influence the onset of this disease. Usually, the most important factor is genetics, and other factors such as high-impact activities like running, jumping or old injuries could affect wear and tear of the knee. Osteoarthritis is one of the most common problems which could eventually lead to a need for knee replacement surgery. It affects mobility and creates a lot of pain. This problem is seen in the elderly.
2. Patellofemoral Pain: Another extreme is, knee pain in the young. Nowadays, we see a lot of youngsters experience pain while sitting for long or while climbing stairs, they feel the need to stretch out often. This is called Patellofemoral pain (the joint between the thigh bone and the kneecap is called the patellofemoral joint). This is the most common cause for knee pain in youngsters under the age of 40. The reasons for this knee pain are multifactorial and not because the bone has worn off. It could be because of flat feet, weak thigh muscles and hip muscles, and a lot of sitting throughout the day. All of these factors lead to patellofemoral pain or knee pain in youngsters. Proper assessment of the reason and lifestyle of the patient is important in order to get rid of such pain.
3. Jumper’s knee: Also known as Patellar Tendonitis. This can be called the tennis elbow of the knee. This is a muscular or tendon problem wherein, the soft tissue or the elastic band that attaches the kneecap to the leg bone, gets stretched beyond a limit or it gets injured. It is very commonly seen in people involved in impact activities like running, jumping, skipping, and dancing.
4. Sports injury: Sports injuries to the knee are sustained by twisting injuries. Injuries to the knee, contrary to popular belief that injury happens if you hit your knee on the floor or if you tore or broke something, it is usually a twisting or an indirect injury wherein the foot is planted on the ground and the body weight twists on top of the knee leading to a knee injury or a ligament injury. It is not possible to get a ligament injury by directly hitting your knee on the floor. Ligaments are elastic bands that hold the knee together like the hinges of a door. Ligaments hold the knee together for movement in a way how hinges hold the door. When the body twists, these ligaments stretch beyond limit which leads to a tear. This can result in severe pain, swelling and inability to walk. With time the pain and swelling comes down and the only symptom of this ligament injury would be instability of the knee or a giving away sensation of the knee (buckles) while trying to pivot and move. This is the most common symptom and buckling happens only once in a while and is often neglected or pushed to the back of the mind. When it is too late, the abnormal movement leads to the wear and tear of the cartilage of the knee or arthritis. Thus, the neglected ligament injury could lead to osteoarthritis.

Advising preventive tips for Osteoarthritis, he emphasised -

• Weight loss: Osteoarthritis, like mentioned earlier,the most influential factor is genetics. Genetics is a big thing we cannot change. Modifiable factors are weight. Weight loss will lead to decreased pressure in the knee joint and will lead to less pain.
• Walking: Fitness plays a big role in arthritis. Usually people stop walking due to pain but never stop walking irrespective of arthritis.
• Avoid ground level activities: Once you develop knee arthritis, you should avoid ground level activities like sitting cross legged, squatting and avoid climbing stairs.
• Lifestyle changes: Once you develop arthritis, the importing thing before surgery is lifestyle modification.

Advising preventive measures for Patellofemoral pain, he said, “The most important thing is to avoid sitting for long hours. If it is inevitable, look for proper chairs. The height of the chair is extremely important i.e the angle between your thigh and your leg should not exceed 90 degrees. Make it a point to get up frequently and stretch out your legs and make time for strengthening of the knee joints and the leg muscles.”

Advising preventive measures for sports injuries, he insisted upon -

• Proper warm up and proper stretching (sport injuries): The ligaments support the knee but it is also the muscles around the knee that support the ligament. If the muscles are not strong, ligaments have to work alone and they tend to give away if they don’t have any support. Proper stretching, strength training, plyometrics, wearing proper shoes and following proper techniques such as landing on the ground, dodging and tackling are also very important to prevent ligament injury. Also, proper nutrition is also extremely important.

When to see a doctor?

• For Osteoarthritis - Dr Anil R Patil siad, “If you need a painkiller everyday or if your social life is affected and performing day-to-day activities is also becoming a task due to knee pain, then it is time to see a doctor. Doctors may suggest analgesic, physiotherapy, injections and lastly if required, a knee replacement.”
• For sports injury - Dr Anil R Patil recommended that the first thing to do immediately after an injury is, rest.

RICE-

R- Rest

I- Ice pack application

C- Compression

E- Elevation

He said, “You should not massage the leg right after an injury. It should be rested and there should be no movement of the limb. Ice pack application is very important, not a hot water pack. For compression, use a crepe bandage or compression bandages to reduce the swelling and keep your leg elevated above the heart level to avoid swelling. If the pain is persistent or there is a deformity due to which you can’t walk or your leg gives away or buckles, then it means that you might have a complete ligament injury.”

He concluded, “You might need a scan to confirm. An X-ray does not diagnose ligament injury, you would require an MRI scan. Once the doctor confirms the ligament injury, treatment depends on the grade of the injury (grade 1,2 or 3). Grade 1 and 2 injuries just require rest and physiotherapy. Grade 3 injury depending on the symptoms and may require a key hole or an arthroscopic surgery to fix the ligaments.”