Knee pain physiotherapy Mechelen
The knee is one of the most complex joints of the human body. The knee is a joint formed by the femur and tibia, in between there is a layer of smooth cartilage to keep the friction between these two bones as low as possible. On top of this cartilage layer are the 2 meniscal discs who are responsible for absorbing shocks. The patella or kneecap ensures that bending and stretching of the knee can be done smoothly. Furthermore, 4 ligaments (anterior and posterior cruciate ligaments and the medial and lateral collateral ligaments) provide stability together with the joint capsule.
Well developed biomechanics ensure that the knee is both stable and mobile enough to move and load. When we see changes in these biomechanics, it can lead to knee complaints with every step.
In the event of overuse injuries at the knee, it is crucial to look at the surrounding joints such as the ankle and the hip in order to detect dysfunctions in the biomechanics. Only by addressing these dysfunctions will the biomechanics recover and so the symptoms can disappear and stay away in the long term.
Chondromalacia of the patella or cartilage disease behind the kneecap:
In chondromalacia of the patella we see damage to the cartilage behind the kneecap (retropatellar). This can be the result of exaggerated sports, incorrect biomechanics, weak hamstrings and/or quadriceps or a trauma at the level of the kneecap. This pain will mainly occur at deep bends because the pressure of the kneecap on the femur increases with knee flexion.
After a consultation with the doctor, an MRI can show to what extent the degeneration of the cartilage has progressed. The rehabilitation starts with an extensive screening so that we can determine the underlying cause, tackling the cause is crucial for a sustainable and smooth recovery.
Anterior cruciate ligament tear:
The anterior cruciate ligament is a thick ligament that is very important for stability in the knee. This ligament is crucial especially for the prevention of excessive forward or backward movements of the femur with respect to the tibia. In the case of high impact sports such as football, rugby and basketball, the risk of tearing the anterior cruciate ligament is greater. Situations where the knee is twisted or overstretched put the most load on the anterior cruciate ligament and can lead to a rupture of this ligament.
The symptoms of a ruptured cruciate ligament can vary from person to person, but often we see a severe pain accompanied by swelling in the knee and a highly limited mobility of the joint. After the trauma, a consultation with a knee specialist and an MRI scan are required for the correct diagnosis.
Because there are no blood vessels in or around the anterior and posterior cruciate ligaments, no spontaneous recovery can occur, in contrast to the collateral ligaments, that have a good blood flow. A torn cruciate ligament remains torn unless it is operated. However, a front cruciate ligament should not always be operated. The choice for a reconstruction is a choice you make together with your specialist and depends on your goals and practiced sport. A few months waiting for a decision is no disadvantage for your future rehabilitation.
The rehabilitation after an anterior cruciate ligament reconstruction can best be divided into 5 phases: In the first phase we work on reducing the pain and swelling after the operation. In the second phase, the focus is on regaining the complete motion of the knee. The third phase focuses on improving the strength and endurance of the musculature. In the fourth phase, there is even more functional and sport-specific training. During the final phase we work on the return to sport. In total, this rehabilitation can take 6 to 9 months. During the rehabilitation all factors that may be a risk factor for a new tear are taken care of. Injury recurrences is what we absolutely want to avoid at Sportkinetics.
Iliotibial friction syndrome
As the name suggests, an iliotibial friction syndrome results from repeated frictions of the tendon against the epicondyl (bony protrusion) on the outside of the knee. This is an injury that is mainly seen in long distance runners and is caused by an imbalance in muscle activation. More developed muscles are easier to activate by the body. The body often chooses the easiest way, the one that requires the least amount of energy. In sports with repetitive movements such as walking or running, an overactivation of the musculature on the outside of the upper leg (tensor fascia latae and gluteus minimus) causes the tendon of the iliotibial band to rub against the bone. This can cause pain in the course of time due to the development of an inflammation.
During rehabilitation it is important to tackle the imbalance in muscle activation and to teach the body to move in a different way
Meniscal tear, (partial) meniscectomy and meniscal repair:
A tear in one of the 2 meniscal discs often occurs during a combination of a flexion and rotational movement in the knee, typically during a fall. After a tear in the meniscal disc, you experience a stabbing pain with certain movements. Sometimes a meniscal injury can give rise to a 'blocked' joint, one has the feeling that the knee is blocked and in most cases this can be 'released' by a flexion-extension movement.
After this kind of trauma, it is best to consult your doctor. A meniscal tear is operated in most cases, but only after confirmation of the diagnosis by MRI or CT-scan. We make a distinction between a meniscal repair and a meniscectomy. If the size and the location of the tear allows it, the surgeon can opt for a meniscal repair and the tear will thus be reattached. If this is not possible with a larger or more complex crack, it is decided to remove a piece of the meniscal disc. We then speak of a partial meniscectomy.
The rehabilitation after a partial meniscectomy is faster than after a meniscal repair. This is because after a meniscal repair little or no support may be placed on the knee so the healing process can take place. In the first place, the focus is on regaining mobility and learning to activate the muscles again. Later on, more and more functional and sport-specific training will be integrated in your session with the eventual return to sport as goal and end point. The duration of rehabilitation depends on the type of operation and the size of the tear. In general, we state that this rehabilitation can take between 6 weeks and 3 months
Patellar tendinopathy or jumpers knee:
When the patellar tendon is overloaded, we speak of a patellar tendinopathy or 'jumpers knee'. This is a common injury for athletes who regularly have to perform explosive movements with many accelerations and decelerations. We see this especially in volleyball, basketball, football and athletics. This can be the result of an acute overload or the repeated occurrence of microtraumata where small tears develop in the tendon. The pain arises gradually, decreases with warming up, but then increases again as the activity progresses. It is also common that after both the activity as the day after the tendon can be sensitive or painful.
In this type of complaint, it is advisable to go to the doctor for a clear diagnosis, an ultrasound or, in more advanced cases, an MRI is also recommended for determining the degree of tendinosis. A tendinopathy is an overuse injury, which is the result of a disbalance in muscle activation and biomechanics. Determining the cause with a thorough screening is crucial in order to be able to start the rehabilitation and avoid a chronic injury or recurrence.
Through an extensive screening we can see which exercises will make your knee joint pain free again. You also receive an exercise program for at home and we make the chance of relapse as small as possible.
