Knee Injuries in the Young Athlete

Matt Kirchoff, DPT

With the ever increasing number of children participating in organized sports, the incidence of knee injuries is on the rise. Each year in the United States there are over 1 million emergency room visits and 1.9 million primary care visits for knee injuries. Children make up a large percentage of these visits as their developing musculoskeletal systems are more susceptible to injury. Knee injuries in children often occur as a result to damage of soft tissue structures around the knee which act to stabilize and cushion the joint. Such injuries can not only take a child off of the court or field for the season, but may also result in long term damage to the knee. This is why it is exceedingly important for parents and coaches to understanding why knee injuries occur and how to prevent them.

The knee joint is comprised of the connection between the thigh bone (femur) and the shin bone (tibia). Stability of the knee is derived from 4 major ligaments and two menisci that help cushion the joint. The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) are the two primary stabilizers of the knee that help to control rotation through the joint. The medial collateral ligament (MCL) and lateral collateral ligament (LCL) provide stability to the inside and outside of the knee, which help to prevent sideways movement. The crescent shaped medial and lateral menisci are found on top of the tibia and play an integral role in shock absorption and joint stability. The kneecap (patella) sits in a groove in the femur, called the patellofemoral joint, which gives the quadriceps muscle more leverage for straightening the knee. Damage to any of these structures can be quite painful and limit participation in sports. While the incidence of ligament and meniscus tears in on the rise in the pediatric population, dysfunction of the patellofemoral joint is one of the most common causes for referral of children to physical therapy.

Patellofemoral Pain Syndrome (PFPS) is usually attributable to an imbalance of forces that control tracking of the patella. Young athletes experiencing PFPS may report pain behind the patella which is typically exacerbated with running, jumping, squatting and stair-climbing. Additionally, athletes may report clicking or catching when fully bending the knee. Visual swelling of the knee joint is not characteristic of PFPS and may suggest more serious pathology. Onset of PFPS typically occurs when an athlete has begun a new sport or changed the frequency or intensity of an existing sport. Consequently, with mild cases of PFPS relative rest can help to decrease the intensity of symptoms. However, when left untreated PFPS can potentially result in chondromalacia, a condition where roughening of the cartilage on the underside of the patella occurs.

Research indicates the physical therapy is an effective treatment strategy for PFPS. Physical therapy treatment of a young athlete with PFPS emphasizes correction of muscle imbalances across the knee joint in order to promote more optimal patellar tracking. In acute stages of PFPS this may be achieved by taping the knee to prevent excessive lateral tracking of the patella. During early stages of rehabilitation for PFPS manual therapy techniques may be used to improve mobility of the patellofemoral joint or decrease over-activity of adjacent musculature. A strengthening program, with an emphasis on strengthening the medial stabilizers of the knee, is typically initiated within the first 1-2 physical therapy visits. Additionally, progressive stretching of involved muscles around the knee and hip play an important role in the treatment of PFPS. Young athletes are also instructed in a home exercise program of strengthening and stretching exercises to promote a pain-free return to sports. This not only places the responsibility of rehabilitation into the athlete’s hands, but also gives them the tools to independently address potential flare-ups of PFPS in the future.

Advancements in Total Joint Replacement Lecture

We invite you to join Matt Kirchoff, DPT and Mike Caravelli, MD orthopedic surgeon from The Center, as they will be giving a free community lecture on the Advancemented in Total Joint Replacement.

Date: June 28th, 2011

Time: 6:30 PM

Where: Fireside Room at The Athletic Club of Bend

Space is limited for the lecture. Please RSVP by contacting our clinic at 541-382-7890 or athl@taiweb.com

Visit our website to check out more upcoming events...

Golf Performance Program Now On Facebook

Therapeutic Associates Physical Therapy at the Athletic Club is excited to announce that you can now follow our Golf Performance Program on Facebook.

By following us on Facebook, we'll provide you with the following up-to-date information:

• Upcoming seminars
• Program specials
• Golf fitness information
• Injury and rehabilitation information

For more information, visit us today on Facebook...

Oyster Off-Road Adventure Race

Rugged Course of Challenges (10-20 Miles)

+ Foot and Mountain Bike

+ Teams of 2-4

= The Ultimate Off Road Adventure

Therapeutic Associates is proud to present the 2011 Oyster Racing series. Benefitting the Arthritis Foundation, the 2011 Merrell Oyster Racing Series is the ultimate race that combines athleticism with thought provoking strategy, as racers complete crazy challenges on a mystery course. The Oyster has something for EVERYONE – from weekend warriors to elite athletes and anyone in between!

Schedule of Events:

Friday, June 24th

4:00pm – 7:00pm – Mandatory Check-in (all divisions)

Dick’s Sporting Goods, 63455 N Hwy 97 Ste 8, Bend, OR 97701

Saturday, June 25th

Race Day!

Transition Area: Deschutes Brewery (901 Southwest Simpson Ave., Bend, OR 97702).

6:30am – Transition Area (TA) opens. Please do not arrive any later than 7:15am or you may not be able to race.

8:00am – The Oyster Urban Adventure Race begins! The first Passport is handed out, and racers are off

2:30pm(ish) – After Party begins when a minimum of 75% of teams have completed the course. Enjoy post-race food, Deschutes beer, and the awards ceremony during the After Party. Take the time to relax, stretch and share a beer and your stories with other racers!

To learn more about the upcoming Off-Road Adventure Race, or to register your team, visit our website today... 

Mandatory modes of transportation and equipment needed:

• Running
• Biking (mountain bike) for each team member on course
• Bike helmet for each team member on course
• 1 cell phone
• 1 digital camera (a cell phone that takes pictures is acceptable)
• A smart phone is highly-recommended as internet is legal in this race. Phone-a-friend is also acceptable.
• A good attitude and sense of adventure!

Possible (BUT NOT LIMITED TO ) activities found on AN OYSTER course:

• Rafting
• Shopping
• Zip line
• Eating
• Canoeing
• Kayaking
• Climbing
• Trivia

*Note: Any equipment needed to complete above tasks will be provided by race directors.
** Swimming is not listed as a discipline; however we do reserve the right to get you wet.