In a sports medicine practice, the doctor or surgeon probably sees more patients with knee injuries than injuries to any other body part. Often a knee injury, like an ACL tear or patellar tendon rupture, results from a traumatic event. Other conditions result from overuse. Essentially mild stresses build up over time and lead to injuries.
In this article, I share some of the most common overuse knee injuries that athletes and active people face.
Overuse injury #1: Iliotibial band (IT band) syndrome
IT band syndrome often bothers joggers and other running athletes. The iliotibial band is a band of tissue along the lateral (side away from the midline of the body) side of the thigh and knee. It can become inflamed as it rubs against a bony prominence on the outside of the knee. Some people notice a snapping sensation on the outside of the knee as well. This problem rarely needs surgery. Ice, activity modification, stretching and physical therapy usually help athletes overcome IT band syndrome and return to exercise.
Overuse injury #2: Patellofemoral pain syndrome
Patellofemoral pain syndrome is one of the most common knee problems, affecting athletes and sedentary people alike. 25% of the population experiences this knee injury at some point. Studies suggest that close to 40% of the patients seen in sports medicine clinics for knee complaints have patellofemoral pain. It is common in adolescents, especially high school athletes.
Patellofemoral pain syndrome is a cause of pain in the front of the knee. You might have pain sitting with your knee bent for long periods of time. Going up and down stairs can hurt. You might notice a grinding or popping sensation when you bend your knee. Most patients do not need surgery. Working with a physical therapist and/or performing a home exercise program can help you overcome this problem.
Overuse injury #3: Patellar tendinitis
The patellar tendon connects the patella (kneecap) to the tibia (shin bone). It helps you extend your knee. If you play a jumping or running sport, you might be at risk for overuse of the patellar tendon. You can develop patellar tendinitis or inflammation of the tendon. Usually you will not need surgery. Rest, anti-inflammatory medications, activity modification, and physical therapy can help you eliminate the pain.
Occasionally, adults with pain in the front of the knee develop tendinosis of the patellar tendon. A small area of degeneration develops within the tendon rather than inflammation. You might still avoid surgery, but the recovery can be slower.
Overuse injury #4: Quadriceps tendinitis
Quadriceps tendinitis is less common than tendinitis of the patellar tendon. You can develop tendon issues with the quadriceps tendon above the patella. Treatment options for this knee injury are similar to those of the patellar tendon.
Overuse injury #5: Pes anserine bursitis (also called pes bursitis)
Pes bursitis is an inflammation of the bursa, or fluid-filled sac, overlying the insertions of the hamstring tendons on the medial (side closest to the midline) side of the knee. You will likely have pain or swelling on the inside of your knee just below the joint line with activity. Treatment includes rest, activity modification, ice, physical therapy, and occasionally cortisone injections.
Overuse injury #6: Tibial plateau stress fracture
Stress fractures of the knee are not as common as they are in the lower leg, ankle and foot. The tibial plateau is the top part of the tibia at the knee. A runner can suffer a stress fracture in this area and face aggravating knee pain. Like most stress fractures, this one results from an increase in training or not enough time to rest. You will feel the pain in a small area in the bone just below the joint line. You might notice increasing pain during running that takes longer to go away. Treatment involves limiting impact on that area. Doctors usually advise patients to stop training until the fracture heals.
It can be a good idea to see a doctor or orthopedic surgeon soon after pain from a knee injury develops. Most of these overuse knee injuries do not need surgery if you haven’t had pain for long. Rest, activity modification, physical therapy and other treatments can usually eliminate your pain and allow you to work back to sports and exercise.
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