LB – INJURIES & CONDITIONS – KNEE

INJURIES to the KNEE

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· ITBS – ILIOTIBIAL BAND SYNDROME
· KNEE OSTEOARTHRITIS – EXPLAINED 

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· PFPS – PATELLOFEMORAL PAIN SYNDROME (RUNNER’S KNEE)
  • Runner’s Knee – 11 Options .
  • How to Prevent Runner’s Knee
  • Runner’s Knee – How to Fix the Pain .
  • Runner’s Knee Pain Fixed
  • Foam Rolling .
  • Kaitlyn Physio: Instagram
    SOME of the main causes for this injury include:
    ➡️ Muscular imbalances; typically weakness in the hip abductor muscles (glute med) and/or inside quad muscle (VMO)
    ➡️ Tightness in the IT band/muscles connecting into the ITB
    ➡️ Patellar orientation and alignment (ie. valgus or knee falling inward)
    ➡️ Inability for the foot to function properly when moving to and from a flattened and arched position.
    PFPS – 1 .
    1️⃣ Banded Split Squat: band on outer aspect of outside knee, prevent the knee from caving inward by pushing into the band.
    2️⃣ Banded Pistol Squat or Lateral Step Down: same concept as above.
    3️⃣ Banded Bulgarian Split Squat: this exercise on its own is excellent at promoting glute activation; however the band will increase that even more.
    4️⃣ Side Steps with Band: keep slight bend in hips and knees. Prevent knees from caving inward and try to ensure toes stay facing forward.
    PFPS – 2 .
    1️⃣ Skater Squat: maintain all weight on stance leg. Find stability in ankle, knee, and hip on that side as you bend the knee.
    2️⃣ Single Leg Hip Abduction: as the one leg is moving further from the body, you activate the stabilizers on the opposite side in order to maintain good alignment
    3️⃣ Reverse BOSU Step Back w/ Ball Catch/Throw: working the leg that maintains contact with the bosu. Ensure that the knee is stable throughout.
    4️⃣ Banded Hockey Strides: weight distribution should maintain on the stance side. The other leg is tapping back at about 45 degrees. The focus here is on the stance side; however, you may also feel it on the side that is performing the movement
    PFPS – 3 .
    1️⃣ TRX Pistol Squat: can do the same exercise off of a box as well if you do not have a TRX
    2️⃣ Reverse Lunge to Knee Drive: an exaggeration of the movement that occurs during running (loading and then stabilizing in single leg stance)
    3️⃣ Walking Lunges: focusing on stabilization in a single leg stance position as you go from one lunge to the next.
· PATELLAR TENDINOPATHY – JUMPER’S KNEE – REHAB
  • Kaitlyn Physio  .
    – Patellar Tendinopathy:  is a common source of pain in the front of the knee, just below the patella (knee cap)
    – Sports: most commonly seen in relatively young athletes who participate in sports with repetitive loading of the knee extensor muscles (quadriceps)⠀⠀⠀
    – Rehabilitation: short period of unloading the tendon (avoid of activities that are aggravating it), followed by progressive re-loading to build the strength back up
    Patellar Tendinopathy – 1 . 
    1️⃣ 2-leg squat – heels elevated: 3 x 12-15 reps (4 sec down, 2 up)
    2️⃣ 1-leg isometric pistol squat – heel elevated: isometric hold in bottom position; 3 x tolerance
    3️⃣ 1-leg pistol squat (eccentric only): 2-legs to return to top of movement; 3 x 8-12 reps
    4️⃣ Banded TKE pistol squat: 1-leg stand on step box; box leg has band attached to post for TKE; 3 x 12-15
    5️⃣ 1-leg pistol squat – heel elevated: eccentric and concentric; 3 x 8-12 reps
    6️⃣ Forward step box resisted split squat: (@strengthcoachtherapy); band around waist anchored to post in front of body; 3 x 12-15 each side
    Patellar Tendinopathy – 2 . 
    1️⃣ Box Squat: to load within a smaller range of motion (decreased depth); touch and go; 3 sets of 8-12.
    2️⃣ Box Squat/Band Squat: to load within a smaller range of motion (decreased depth); touch and go; 3 sets of 8-12.
    3️⃣ Bulgarian Split Squat – BB on back:  unilateral = increased demand on the tendon. 3 sets of 6-10 each side
    4️⃣ Bulgarian Split Squat – BB front: the front rack position puts more demand on your anterior chain (ie. quads, knee)
    5️⃣ Bulgarian Split Squat – Isometric + ball throw/catch: 3 sets of ~20 throws/catches while maintaining depth in this position
    Patellar Tendinopathy – 3 .
    1️⃣ Sled Push: heavier weight slow and controlled or lighter weight with more speed and explosiveness
    2️⃣ Sled Pull: slow and controlled sitting close to 90 degrees so that quads/patellar tendon are working in a lengthened position
    3️⃣ Box Jumps/Plyos + Sprint (slow and controlled): here the focus is on proper mechanics and controlling acceleration and deceleration
    4️⃣ Box Jumps/Plyos + Sprint (explosive): this is usually very sport specific and has increased load on the quads and patellar tendon.

Sports Health

  1. Tendinopathy: is typically used to describe any problem involving a tendon. The tendons can be worn, injured, stretched, and/or torn.
  2. Tendonitis: Once used to describe almost any tendon pain, medical professionals now only use the term tendonitis to describe acute inflammation of the tendon due to small (micro) tears (the suffix “itis” indicates inflammation)
  3. Tendinosis: is the non-inflammatory degeneration of a tendon. This degeneration can include changes to the structure or composition of the tendon. These changes often result from repetitive strain-injuries to a tendon without adequate time to heal.
    COMPARISON FACTOR TENDONITIS TENDINOSIS
    Recovery time in acute cases 2 to 3 days 2 to 3 months
    Recovery time in chronic cases 4 to 6 weeks 3 to 6 months
    Long-term outlook with non-surgical treatment Almost 99% of cases recover completely Up to 80% of cases recover completely
    Treatment goals Decrease inflammation by: Rest, anti-inflammatory medication (short-term course), icing the tendon intermittently, and/or use of cast or splint Encourage formation of collagen and other proteins by: Physical therapy, exercise, and/or surgery (in some cases)
    Long-term outlook after surgery Almost 95% of cases recover after surgery 70 to 85% of cases recover after surgery
    Recovery time after surgery 3 to 4 weeks 4 to 6 months

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