Knee Trauma and The Epidemiology
The knee joint is often referred to as the 'Patellofemoral joint' or 'PFJ'. It is categorised as a 'hinge joint' which allows flexion and extension along with a limited amount of rotation also. It is made up of the Patella, Femur and Tibia. A study looked into common injuries in athletes, which found the knee being at the top, along with ankle injuries (Misra,2014).
Osteoarthritis, is a degenerative disease and is a condition that develops from wear and tear. If not treated, the condition will typically worsen. It is suggested that exercise is key in both preventing and also treating, Osteoarthritis. One of the reasons why exercise is so key, is that it can improve blood flow and in turn the quality of the Synovial fluid, giving the joint an improved range of motion whilst releasing joint stiffness. Healthy synovial fluid normally contains high level of hyaluronic acid, which provides the lubricating effect. Hyaluronic acid is reduced in those with Osteoarthritis, therefore the joint is not being adequately lubricated. Exercise will also assist in strengthening the muscles surrounding the joint, which will in turn help support and protect the joint.
The ACL (anterior cruciate ligament) is a ligament that stabilises the joint and prevents the tibia from excessive forward movement as well as limiting rotation. When someone suffers with a complete rupture of this ligament, they have the option of having it surgically repaired, which many do opt for. With that being said once the surgery is completed, it is key that the patient then begins their recovery, which will be broken into appropriate phases. Initially, you want to look at reducing the swelling and gaining movement in particular extension. Surgery will have disrupted the tissues, causing bleeding and swelling inside the joint. If left post surgery, it can create further pain and joint stiffness. The rehabilitation process will gradually progress according to patient and patient needs. Once swelling is reduced, you are able to progress as more range at the joint returns.
Above we have discussed two very different conditions, however what is key in both management plans, is exercise. It is key that the exercise programs that are given, are prescribed to meet each individual needs and specific to their needs. How one person may respond to surgery, can be very different to another. Let's also not forget other factors such as pain perception, stages of healing and the impact psychological effects can have on rehabilitation. Completing an injury assessment and having a great understanding of the individuals lifestyle and previous injury history will assist in creating a beneficial tailored program. Without this, you could create further injury and or delay recovery from an injury. A great balanced exercise rehab program would be inclusive of, but not limited to, regaining full range of movement, strengthening and stabilising the joint and be sport specific.