Brief Outline of Osgood-Schlatter Disease

Osgood-Schlatter disease is a condition that affects young teens. It is more prevalent in males than females and has a slightly higher prevalence in the left knee than the right. The patella tendon pulls on the tibial tuberosity just below the knee, and when the quadriceps are tight or repetitive flexion and extension is present, this stress may cause small avulsion fractures, resulting in inflammation and pain. Active children or those with previous knee injuries are more susceptible to this condition. During running, jumping, and kicking activities, the quadriceps must contract and relax continuously, which also stresses the attachment at the tibia.

Cause of Osgood-Schlatter Disease

Tight quadriceps due to growth spurt. Prior knee injury. Repetitive contractions of the quadriceps muscles.

Signs and Symptoms of Osgood-Schlatter Disease

Pain, worse at full extension and during squatting, subsides with rest. Swelling over the tibial tuberosity, just under the knee. Redness and inflammation of the skin just below the knee.

Complication if left Osgood-Schlatter Disease unattended

If left unattended the condition will continue to cause pain and inflammation and could lead to muscle loss in the quariceps. In rare cases, untreated Osgood-Schlatter syndrome could lead to a complete avulsion fracture to the tibia.

Immediate Treatment for Osgood-Schlatter Disease

R.I.C.E. Anti-inflammatory medications.

Rehabilitation and prevention for Osgood-Schlatter Disease

Most cases of Osgood-Schlatter syndrome responds well to rest that is followed by a regimen of stretching and strengthening of the quadriceps muscles. Limiting activities that cause pain and tend to aggravate the issue is important during recovery. Gradual increases in intensity and proper warm-up techniques will help prevent this condition.

Long-term prognosis and surgery for Osgood-Schlatter Disease

Osgood-Schlatter disease tends to correct itself as the bone becomes stronger and mature. The pain and inflammation go away and there are seldom any long-term effects. Rare cases may require anti-inflammatory injections to aid recovery.

Brief Outline of Lateral Collateral Ligament (LCL) Rupture

A ligament is tough, fibrous connective tissue that provides support and strength to joint. A lateral collateral ligament (LCL) rupture (as opposed to an MCL rupture) involves tearing or stretching of this ligament of the knee. This ligament is designed to hold the knee joint together on the lateral (outside) surface. Force applied to the inside of the knee causes the outside of the knee to open, stretching the LCL. The extent of the stretch determines whether the ligament simply stretches, tears partially, or tears completely. An LCL rupture is much less common than an MCL rupture.

Knee Structure

Cause of lateral collateral ligament (LCL) rupture

Force applied to the medial side (inside) of the knee joint.

Signs and symptoms for lateral collateral ligament (LCL) rupture

Pain over the lateral portion of the knee. Swelling and tenderness. Instability in the knee and pain with weight bearing.

Complications if left lateral collateral ligament (LCL) rupture unattended

The ligament, in rare cases, may repair itself if left unattended, but the injury could develop into a more severe rupture. The pain in the knee and instability of the joint may not go away. Continued activity on the injured knee could lead to injuries of the other ligaments, due to the instability.

Immediate treatment for lateral collateral ligament (LCL) rupture

R.I.C.E. Immobilisation. Anti-inflammatory medication.

Rehabilitation and prevention for lateral collateral ligament (LCL) rupture

Depending on the severity of the rupture, simple rest and gradual introduction back to activity may be enough. For more severe ruptures, braces may be needed during the strengthening phase of rehabilitation and the early portion of the return to activity. The most severe ruptures may require extended immobilisation and rest from the activity. As range of motion and strength begins to return, stationary bikes and other equipment may be used to ease back into activity. Ensuring adequate strength in the thigh muscles, and conditioning before starting any activity where the risk of hits to the knee is high, will help prevent these types of injury.

Long-term prognosis and surgery

The ligament will usually heal with no limitations, although in some cases there is residual “looseness” in the lateral part of the knee. Very rarely is surgery required to repair the ligaments. Meniscus tearing that requires surgical repair may also result from an LCL rupture.

Call (+65) 6471 2674 (24 Hour) to make an appointment to see our knee specialist regarding LCL rupture today.

Brief Outline of Iliotibial Band ITB Syndrome

Iliotibial band syndrome is caused by excessive friction between the iliotibial band (or tract) and the lateral epicondyle, at the end of the femur where it forms the knee. This friction can also occur at the hip as well. The friction causes inflammation and pain in the iliotibial band. Since this band of tissue crosses over the bony prominences whenever the knees and hips and flex or extend, the condition can be very painful. The iliotibial band is actually the connective tissue for the tensor faciae latae muscle: the band attaches to the hip at the top, crosses the knee, and attaches to the tibia at the bottom. If the iliotibial band becomes inflamed due to excessive irritation from the friction when crossing over the bone, it will cause pain and tightness.

Iliotibial Band Syndrome

Cause of Iliotibial Band ITB Syndrome

Repetitive hip and knee flexion and extension while the tensor fasciae latae is contracte, such as with running or cycling. A tight tensor fasciae latae muscle and iliotibial band. Muscle imbalances.

Signs and symptoms for Iliotibial Band ITB Syndrome

Pain in the lateral side of the knee over the lateral epicondyle of the femur. Pain with flexion and extension of the knee.

Complications if left Iliotibial Band ITB Syndrome unattended

The iliotibial band and accompanying tensor fasciae latae become tight due to the pain and inflammation. If left unattended this can lead to chronic pain and injuries to the knee and/or hip.

Treatment for Iliotibial Band ITB Syndrome

R.I.C.E. Anti-inflammatory medications. Shockwave therapy to promote blood flow and healing. Anti-inflammatory injection.

Rehabilitation and prevention for Iliotibial Band ITB Syndrome

Increasing flexibility as pain allows will help speed recovery. After pain has sibsided, increasing strength and flexibility of all the muscles of the thighs and hips to develop balance will help prevent future issues. Identifying and fixing any errors in running form will also help to prevent recurrence of the injury.

Long-term prognosis and surgery for Iliotibial Band ITB Syndrome

Iliotibial band syndrome can be treated successfully with no lingering effects. Inflammation and pain may return when the activity is resumed, and corrections of form must be made to prevent future problems.

Call (+65) 6471 2674 (24 Hour) to make an appointment to treat your ITB syndrome today.

Brief outline of hamstring tendinitis

Hamstring tendinitis, like other versions of tendinitis, involves inflammation of the tendon. This can be a result of repetitive stresses to the hamstring tendons or excessive stress before the muscles are conditioned to cope with it. Pain at the back of the leg above the knee, especially when extending the knee, usually accompanies this injury. Repetitive stress, especially under contraction (such as when accelerating or decelerating), can cause inflammation of the tendons. Minor tears may also occur in the tendon as well when the stress is too much for the tendon to handle.

Cause of hamstring tendinitis

Repetitive stress to the tendons, such as running, jumping, sprinting, etc. Untreated injury to the hamstrings.

Signs and symptoms of hamstring tendinitis

Pain at the bottom of the hamstrings, just above the back of the knee joint. Pain is aggravated by jumping, running, and excessive flexion of the knee.

Complications if left hamstring tendinitis unattended

The hamstring muscles may also become inflamed and the tendon will become weak if left untreated. This could lead to a complete rupture of the tendon. A change in gait or landing form can lead to other injuries as well.

Treatment for hamstring tendinitis

Rest and ice. Anti-inflammatory medications. Shockwave therapy. Anti-inflammatory injection.

Rehabilitation and prevention of hamstring tendinitis

Rehabilitation should include stretching and strengthening exercises for the hamstrings. Activities such as swimming can be helpful to reduce the stress on the tendon during rehabilitation. Return to a normal activity schedule should be delayed until pain subsides completely and strength is restored. Keeping the hamstrings and lower back flexible and strong will help prevent this condition.

Long-term prognosis and surgery

A full recovery with no long-term disability or lingering effects can be expected in most cases of tendinitis. Surgery is only necessary on extremely rare cases of the condition.

Call (+65) 6471 2674 (24 Hour) to make an appointment with our knee specialist to treat hamstring tendinitis today.

Acute Knee Injury

Acute knee injuries are those that occur from a single traumatic event. They may be caused by excessive force placed on a joint, such as a blow to the area, forceful twisting, or force unevenly applied. For the knee, this could be caused by a blow to the lateral or medial side of the knee, forceful twisting of the knee with the foot in a fixed position, landing incorrectly, a forceful blow to the front of the knee, or even a force applied to the upper or lower leg. Tendons in the knee may be injured when the muscles have to act against a force beyond their strength level, especially when it is an explosive force or when the muscles are in a stretched position.

Knee Anatomy

Common acute injuries of the knee include ligament sprains and tears (especially the MCL and ACL), meniscus tears, dislocations of the kneecap or knee joint, LCL and PCL can be strained as well. The patella may be chipped or fractured, as may the head of the femur or tibia.

Acute injuries, if left untreated or if return to activity is too soon, can lead to chronic issues later. A properly treated and rehabilitated acute injury should not have lingering effects. Some injuries respond well to the normal course of R.I.C.E., while other, more severe injuries, may require surgery. In order to have a full return to activity with no lingering effects, it is important to follow the full treatment recommendations for the injury sustained.

Chronic Knee Injury

Chronic knee injuries, on the other hand, usually occur over time due to an improper wear, improper balance, or incorrect form issue. A chronic injury may be the result of an acute injury that was not allowed to heal properly. Muscle imbalances, poor form while doing activities involving the lower body, improper footwear, incorrect gait, or even continuous running on uneven or excessively hard surfaces may also lead to chronic knee injuries.

Although chronic knee injuries develop over time, this does not negate their severity. If allowed to continue they can cause severe pain and disability. The pain of chronic injuries may come and go at first, but over time this may develop into a constant pain that increases in severity with activity. Often, untreated chronic knee injuries lead to an involuntary cessation of activity due to the pain.

Chronic injuries of the knee include bursitis, patellar and quadriceps tendinitis, arthritis, and compartment syndrome (if wraps and braces are used incorrectly or acute injuries are not treated promptly). These injuries can often be avoided, or reversed, by correction of the underlying problem. Most chronic injuries develop as a result of the mistreatment of a correctable problem.

How Are Knee Injuries Classified?

As well as classifying a knee injury as acute or chronic, knee injuries are also classified according to their severity. Injuries are graded into one of three classifications: mild, moderate, and severe.

mild knee injury will result in minimal pain and swelling. It will not adversely affect sporting performance, and the affected area is neither tender to touch nor deformed in any way. Examples of a mild knee injury include minor sprains, strains, and simple overuse injuries like tendinitis.

moderate knee injury will result in some pain and swelling. It will have a limiting effect on sporting performance, and the affected area will be mildly tender to touch. Some discolouration at the injury site may also be present. Examples of a moderate knee injury include partial tearing of ligaments and other soft tissues.

severe knee injury will result in increased pain and swelling. It will affect not only sporting performance, but also normal daily activities. The injury site is usually very tender to touch, and discolouration and deformity are common. Examples of a severe knee injury include dislocations, fractures, and ligament ruptures.

How Are Soft Tissue Knee Injuries Classified?

The term sprain refers to an injury of an ligaments, as opposed to a strain, which refers to an injury of the muscles or tendons. Remember, ligaments attach bone to bone, whereas tendons attach muscle to bone.

Injuries to the ligaments, muscles, and tendons are usually graded into three categories: these types of injury are referred to as Grade 1Grade 2, and Grade 3 sprains and strains.

Grade 1 sprain/strain is the least severe. It is the result of some minor stretching and some tearing of the ligaments, muscles, or tendons. There is increased swelling and pain associated with Grade 2 sprain/strain, and a moderate loss of stability around the knee joint.

A Grade 3 sprain/strain is the most severe of the three. It is the result of a complete tear or rupture of one or more of the ligaments, muscles, and tendons. A Grade 3 sprain/strain will result in massive swelling, severe pain, and gross instability of the knee joint.

Call (+65) 6471 2674 (24 Hour) to make an appointment to see our knee specialist regarding your knee injury today.