Whether you're an athlete recovering from a sports incident or a patient recovering from an unfortunate fall, knee injuries can be extremely debilitating and painful. Mobility and daily activities become limited due to pain and internal damage in the knee. To prevent these types of injuries from happening, we would like to offer some important insight about knee injuries and how you can prevent them. We spoke to Rebecca Thomann, North Hills Hospital's Joint Replacement Program Coordinator and a physical therapist, to find out more about knee injury diagnosis, treatment and care.

What are the most common knee injuries?
They include:

  • Strains of various ligaments around the knee including Anterior cruciate ligament (ACL), Posterior Cruciate Ligament (PCL), Lateral Collateral (LCL), Medical Collateral (MCL).
  • Tears of various ligaments around the knee including ACL, PCL, LCL, MCL
  • Meniscus tears (lateral and/or medial) or torn cartilage in the knee
  • Patellar (knee cap) dislocations
  • Fractures
  • Patella femoral syndrome (pain on the inside of the knee and below the kneecap)
  • IT band friction syndrome (pain on the outside of the knee)

Who experiences the most common knee injuries?
Knee injuries occur at all ages. Generally, osteoarthritis type knee injuries occur most often in older populations. High school and College aged females are most likely to sustain an ACL tear (ligament in the knee). Eighty percent of knee injuries result from torn ACLs (which is a tear in a ligament found in the knee). One in 3,000 people will face an ACL tear in their lifetime. Those who play sports that include cutting and other fast changes in direction have an increased risk for knee injuries. These sports include soccer, basketball, volleyball, and tennis.  Also sports with high levels of contact such as football increase the risk of knee injury.

When do you know your knee injury is serious?
If your knee isn't functioning as it should, be sure to seek medical treatment. Serious knee damage is likely when people:

  • Can't put weight on the knee
  • Struggle with their knees giving out or locking
  • Can't climb stairs without experiencing pain
  • Do not have a full knee range of motion

How do you treat knee injuries?
Injured knees need to be rested to reduce swelling, along with the following:

  • Protection
  • Rest
  • Ice
  • Compression
  • Elevation
  • Modalities
  • Medicine
  • Support

Other treatment options include prescribed medication, physical therapy and surgery. For those struggling with osteoarthritis, some alternate knee treatment options would include:

  • Physical therapy (often including aquatics)
  • Injections from a physician
  • Minimally invasive arthroscopic knee surgery
  • Total knee replacement (followed by several weeks of physical therapy)

When is surgery needed to treat a knee injury?
Knee injuries must be considered on a case-by-case basis to determine whether they should be treated with physical therapy, surgery or a combination of both. Surgery is always the last resort and may not be the best treatment for the specific injury. Physical therapy can help the knee build more strength, which takes pressure off injured ligaments, cartilage, or bone. Therapy can also help retrain muscles to ensure proper firing of the muscles and aid in the symmetry of muscle forces allowing decreased strain to the tendons and ligaments.

Ligament tears are considered for surgery more often in younger patients but, even then, may only be considered if physical therapy has not improved their condition.

Cartilage tears are often treated with arthroscopic surgery to clear away floating debris or help improve the knee's function. Physical therapy typically follows to help rebuild muscles around the knee for maximized support.

Breaks may require surgery if pins are needed to keep bones in place during the healing process. Otherwise, using the self-treatments above, followed by physical therapy, is beneficial.

Older patients with knee conditions due to osteoarthritis may be good candidates for arthroscopy or joint replacement surgery. These are considered on a case-by-case basis and only if all other treatment options have been exhausted.

How can I prevent knee injury?
Our expert suggests the following tips to avoid unnecessary pain and damage from knee injury:

  • Train for the activity you plan to do.
  • Cross train, which includes strength training, stretching, core training, and proprioception activities. IF participating in cutting sports, you should include plyometrics in your cross training routine.
  • When training, watch your alignment carefully. Your feet, knees, hips and shoulders should line up.
  • If you are a long-distance runner, watch how fast you increase your mileage. It should increase no more than 10% a week.
  • If you have pain, stop what you are doing.
  • Stay active and make physical fitness a priority.
  • Ask for advice! North Hills Hospital's physical therapists can train you in injury prevention or help you get started on an exercise program that is right for you.
  • If you are in a high-risk sport for ACL tears, such as soccer, basketball, volleyball, or football, we have a therapist certified in an ACL tear prevention program that is backed by research (Sportsmetics).
  • We are a certified Joint Replacement Hospital by JACHO.

North Hills Hospital provides the Northeast Tarrant County community top-notch therapy services to assist patients on an inpatient and outpatient basis. We offer physical therapy, occupational therapy, speech / swallowing therapy, and wound care. To find out more about patient therapy options, please visit us online or call 1-855-5NHILLS for a physician referral.