Sports Injuries of the Knee

             

The knee is commonly injured in contact and non-contact sports.  The principles of good clinical assessment and care apply for all knee injuries, regardless of the cause, however in sportsmen and women special considerations apply, particularly the main objective is to return to sport, hopefully at the same level as at the time of the injury.  This requires a careful assessment of the nature of the injury and a clear plan of treatment, including rehabilitation, which will lead to a successful return to sport.  This requires close collaboration with the team doctor and particularly the physiotherapist who are looking after the individual.   Early diagnosis of the nature and severity of the injury and is much more effectively achieved if the injury is assessed in the first few days, rather than weeks after the accident.  The diagnosis can usually be established by a careful clinical assessment, but often further investigations are required, including X-rays and, in particular, MRI scanning of the knee. 

MRI scans are particularly useful at assessing soft tissue injuries to the ligaments, tendons and menisci within the knee, as well as assessing damage to the joint surface, where “bruising” of the bone beneath the joint surface may be seen.  Bone bruises are particularly common in knee ligament injuries.

Following this assessment, a clear plan of management is discussed, including surgical treatment.  Post-operative rehabilitation and staged return to normal activities, including sport, are all clearly defined.

If surgery is required, basic surgical principles are adhered to, which apply regardless of how the individual suffered an injury, whether this is in sport or during other activities.   Many sports related injuries to the knee will be treated by arthroscopic surgery, which shortens the recovery time after surgery and allows rehabilitation to start sooner.  A period of protected weight bearing may be required, using crutches, and even a degree of immobilisation or splinting of the knee in a brace can also be required. 

The physiotherapist will become involved immediately after the operation, advising on care of the knee to reduce swelling and bruising, by using ice and early exercises to re-establish muscle function.  Early attendance as an out-patient at physiotherapy clinics to commence exercises will be required, but it is very important that the individual adheres to the exercise programme and performs these exercises on a regular basis at home, and attends the physiotherapist for further assessment and advice. 

I have over 25 years experience in management of sports injuries, with a particular interest in rugby injuries. I am fortunate that Spire Murrayfield Hospital (www.spirehealthcare.com/Edinburgh) is equipped with excellent facilities for sports rehabilitation, with highly experienced and skilful physiotherapists who specialise in rehabilitation of the knee and regularly treat sportsmen and women at all levels.