Signs that you may have suffered an acute knee injury:

• You fell awkwardly or were struck by something.
• You heard a pop or snap at the time of the incident.
• You noticed immediate swelling or bruising around the knee.
• You were unable to walk or weight bear on your injured leg without support.
• You are unable to fully straighten or bend your knee.
• Your knee unexpectedly gives way under load.

What is an acute injury?

Acute injuries arise from a single incident, eg/ a fall or a tackle (Note: there are frequently biomechanical factors that predispose one to an acute injury eg/ habitual poor hip motion increases one’s risk of a knee injury).
Acute injuries will have a sudden onset involving a degree of swelling and with time the pain intensity decreases. In contrast, chronic knee injuries arise from years of minor injuries that come about from poor movement patterns and poor posture placing uneven or accelerated wear and tear on the body.

This article will focus on the basic ideas of acute knee injury; covering common injuries, prevention and management from an Osteopathic perspective.

Acute knee pain

The knee joint is a complicated and commonly injured joint. The knee consists of number of articulating surfaces, each being supported by a combination of muscles and ligaments.

Common injuries

Acute sharp knee pain can occur in a variety of movements for example:falling down stairs, awkwardly changing direction in a game of netball or being tackled in a contact sport. Most acute knee injuries involve soft tissue damage implicating a combination of the following structures:

• Ligament (connects bone to bone): LCL, ACL, PCL, MCL
• Tendon (connects muscle to bone): hamstring, quadriceps, gastrocs
• Menisci (a type of cartilage): Lateral meniscus, medial meniscus
• Other: fat pad, bursa

Fractures and dislocations can also happen to the knee but these are rare and usually require a more significant force.

Prevention

Of course, injuries are never fun and are best to be avoided altogether. The following factors can be managed to decrease the risk of acute knee injury:

1. Ankle and hip mobility and strength.

The actions of the ankle and hip are very important for knee health due to the flow on effects up and down the kinetic chain.

2. Maintaining a healthy weight.

Less body weight generally means less challenging forces for the knee to withstand. However, keep in mind that lighter is not always better, more (potentially heavy) muscle mass in the area can help to stabilise the knee joint (or any other joint for that matter) reducing the likelihood of injury. Which leads me to my next point.

3. Structurally balanced muscular development around the knee joint.

Ensuring that you develop the muscles immediately surrounding the knee in a balanced manner can ensure the forces through the knee are distributed broadly rather than overloading one particular area or direction. For instance making sure that the muscles at the back of the joint (hamstrings) are well developed relative to the front of the joint (quadriceps), or that the muscles controlling the inside of your knee (medial quadriceps) are well developed relative to the muscles on the outside of your knee (lateral quadriceps). In the same vein, sometimes it’s preferable to redistribute those forces away from the knee joint altogether, which brings us back to point number 1, in particular the development and function of the glutes can have a substantial effect on the health of the knees.

Management

Initial treatment for acute knee pain

Management for acute knee pain usually includes:

Rest, ice, compression, elevation, pain management, and appropriate referral. Seeking professional advice is extremely important as an Osteopath will be able provide you with the appropriate management.

Osteopathic management for acute knee pain

Management of knee pain will largely be patient and injury dependent. Following the initial management, rehabilitation exercises and hands on treatment will be an important component of the recovery journey.

During a consultation with an Osteopath we will:

• Provide you with a working diagnosis and management plan for both short and long term.
• Reduce some of the pain and swelling resulting from the injury.
• Kick start the healing process with a combination of hands on techniques, rehab and advise to help you safely return to your regular activities. 
• Send for an Xray or MRI scans or see that you are referred to an appropriate medical specialist if required.
• Looking beyond the area giving you pain, Osteopaths work holistically to also help identify predisposing factors to your injury and address any negative long term compensations that your injury may cause.

Beyond hands on treatment and rehabilitation exercises

When the body goes into a healing mode we need to fuel the process with a nutritious diet and keep the brain in a constructive mindset. 

• A positive and realistic mindset towards recovery will help fuel the healing process. Coping with an injury can be a mental challenge, it can be extra tough if the rehabilitation process is long and lonely. This is why we emphasize the importance of a positive and realistic mindset in conjunction with professional guidance throughout the physical rehabilitation to help keep you focused throughout the recovery phase.
• Reducing systemic stress by controlling other stresses in your life (to the extent that you can) can help to free up resources for your body to devote to the healing process. (check out our article here)
• Eating healthy wholesome foods and balancing your macro and micro nutrients will give your body the best opportunity to heal. If you would like some help in constructing an optimal diet to aid healing come in and have a free 20 minute chat to our Nutritionist Annalise (To make a booking click here) 

Final thoughts

Managing acute injuries in an intelligent and timely manner is important for avoiding reinjury and preventing the development of a chronic issue. Getting advice from an Osteopath will help the recovery process by giving you an understanding of your injury and creating a realistic management plan that aligns with your goals. In addition to developing a rehabilitation plan, your practitioner can help reduce pain and swelling with hands on treatment and, if necessary, send you for scans or guide you to another appropriate medical professional.

Injury prevention would be optimal, which is why we provide classes at The A Life to develop strength and mobility, “prehab” can help to avoid many injuries altogether. However if you do find yourself injured, being smart with your initial and long term management can make a world of difference to both physical and mental health following the injury.   

Written by our Osteopath Fauntine Lariba. 

To make an appointment with Fauntine online click here.  She sees patients in the clinic on Mondays, Tuesdays & Thursdays.  

Resources:

ClinicalKey. (2019). Retrieved from https://www.clinicalkey.com.au/#!/content/clinical_overview/67-s2.0-9e7111a2-15f2-41a8-af0c-328ad5da488a

Gage, B., McIlvain, N., Collins, C., Fields, S., & Comstock, R. (2019). Epidemiology of 6.6 million knee injuries presenting to United States emergency departments from 1999 through 2008. – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22506941