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Physical therapy for knee complaints.
During the examination, the possible cause of your knee problems will be examined. Especially with knee problems, it is necessary to get a clear picture of the symptoms. The questioning along with additional orthopedic testing provides a clear physical therapy diagnosis. Based on this examination, a treatment plan is developed. We find it very important that you understand how possible the complaints arise and what you can take into account to recover as quickly as possible from your complaints! In addition to specific advice, treatment may include increasing mobility through manual therapy, various muscle techniques and training the muscles through exercise therapy and strength training. With some knee problems a longer rehabilitation is necessary, especially when the goal is to be able to perform your sport with full conviction again.
How do knee problems occur?
Knee pain can develop slowly or be present suddenly due to a fall or accident. In our practice, we often see sports injuries. For example, you may twist your knee on the soccer field or suffer symptoms through contact with your opponent. We often see then that the knee gives swelling. Usually this indicates injury within the joint. Climbing stairs and simple things like getting up from a chair can cause problems at that point. We see the following knee complaints a lot in our practice. When the symptoms slowly worsen over time we often speak of an overuse injury. In this case it is often the tendons or muscles that cause the complaints in the knee. Osteoarthritis in the knee is more common as we age. Cartilage then becomes of lesser quality and can potentially cause pain. Osteoarthritis in the knee does not mean that there is always pain provocation. But when symptoms match image on, for example, a X-ray then the pain may well be due to osteoarthritis.
Anatomy of the knee
A joint is a place in the body where two pieces of bone come together. In the knee, this is the femur (upper leg) and the tibia (lower leg). Between these bone parts is cartilage which has a very smooth surface so it can move smoothly. To properly control the knee joint, there are different types of ligaments in and around the knee. On the inside and outside are the collateral ligaments. Between the femur and tibia is the inner and outer meniscus which acts as a shock absorber between these two parts of the bone. In the knee there is the anterior and posterior cruciate ligament. The anterior cruciate ligament provides passive stability. Tires, bones, capsules and the position of joints provide passive stability you have no control over. Active stability is controlled by muscles and tendons. So you do have control over this. Active and passive stability together determine how stable a joint is.
Causes of knee pain
Knee pain can have many different causes. Certain knee complaints are more common than others. Here are some common knee complaints.
Meniscus complaints: The knee has a medial (inner) meniscus and a lateral (outer) meniscus. The meniscus looks like two half-shaped moons sitting on the lower leg. When the knee has to make a quick and forceful rotational movement during sports, a meniscus injury can occur. Because inner meniscus is attached to the capsule of the knee, it gets damaged much faster. When the knee moves into a vulnerable position, the inner meniscus is much less flexible and, as a result, much greater forces are released on the inner meniscus. In addition to this acute form of meniscus injury, the injury can also develop gradually. Minor damage can also cause long-term symptoms. Read here further on meniscus complaints.
Front cruciate ligament injury: An injury to your anterior cruciate ligament(VKB) is one of the most common injuries to the knee joint. Every year more than 860,000 knee injuries occur during sports in the Netherlands. A large proportion of these involve an injury to the anterior cruciate ligament. The VKB is very important for the stability of your knee during sports. When your anterior cruciate ligament is torn, we see a decrease in the stability of the lower leg compared to the upper leg. This injury usually occurs without an opponent nearby where you have to brake explosively. You are also at a higher risk of injuring your anterior cruciate ligament in movements where you have to turn, cut or jump quickly. To get back to your old level of sports, it's important to know what your options are. Read here on about an anterior cruciate ligament injury.
Osteoarthritis: about 600,000 Dutch people have osteoarthritis of the knee. It is more common in women than in men. Each year, about 21,000 men and 33,000 women develop complaints of osteoarthritis in the knee joint. The risk of osteoarthritis increases with age. Just like gray hair and wrinkles in the body on the inside, it is also subject to wear and tear. A natural process and nothing to worry about. However, if the symptoms match the image on an X-ray or MRI, then the symptoms are probably due to osteoarthritis. Read here more about knee osteoarthritis.
Muscle- and tendon-related complaints of the knee: On the front of the knee runs the tendon of the quadriceps. Among other things, this muscle stretches the knee and keeps the kneecap in place. When overloaded, this tendon can become irritated. The symptoms are then usually located just below the kneecap and can cause an unpleasant feeling when you tighten this muscle. We see these complaints most often in sports such as volleyball and basketball where there is a lot of jumping. Hence, this complaint is also called a Jumpers knee. Symptoms of a Sweaters knee are often:
- Pain at the front of the knee
- Startup complaints
- Pain when climbing stairs
- Pressure under the kneecap causes symptoms
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