Archive for “Knee Injuries” Tag

5 Tips You Need to Know About Knee Injuries

Tips About Knee Injuries

football-619243_640Knee injuries are rampant, and in the physical therapy world they tend to keep us employed.

There are so many types of knee injuries that, for coaches, it can be hard to know what is what.

Patellofemoral Syndrome? Patellofemoral Dysfunction? Lateral Tracking Patella? Did you know those are the same thing?

So to break down the barriers to understanding knee injuries, here are…

5 Knee Related Tips that Every Coach Should Know

Tip #1: Basic Anatomy Factoid

The knee is the largest, most unstable, joint in the body. Somehow our evolution created a very large, somewhat disarticulated joint with a bony hockey puck on top, and 4 ligaments stringing it all together.

The ankle can move in two planes of motion very well. The hip moves in three planes of motion, and then the part between the two moves in one and if it moves in three, you have now lost your ACL!

This body part is set up for failure so that’s why tip #1 will hopefully shed light on tips #2-5.

Tip #2: The Joint is Sensitive But for Good Reason

There are millions of receptors coursing through the knee that transmit a lot of information.

When cutting on a basketball court and a little rotation at the knee is registered, what happens? Simple, the hips and lower back rotate—and the athlete goes up onto the ball of the foot to allow fluid motion to prevent twisting. This creates strong and efficient movement patterns.

The orientation of the kneecap (patella) allows the quad to generate increased force by making a bigger lever arm with every jump, land or sprint. It’s a great shock absorber when used correctly.

So when aches and pains start showing up in the knee, the message to the head is “I can’t handle the pressure, please stop.” Just think of it as a barometer for the lower body.

Ankles and hips have this type of capacity but they are also so intricately involved in balance strategy that they are focused on other tasks.

Tip #3: Address the Problem Early

Rolled ankles occur frequently. Hip joint injuries are less common, such as a labral tear, and when they happen it will really slow down or stop an athlete.

As a clinician that teaches online courses for Patellofemoral Syndrome and ACL Rehabilitation, please heed my recommendation to not ignore knee pain because there are a lot of causes.

For young athletes the most common response is “it’s just growing pains”, right? Sure, that could be the answer but let ME, (the Physical Therapist), figure that out.

Before, I mentioned the idea of the knee as a shock absorber. If a knee cannot handle the load, pressure, force, etc. going through it and the athlete continues to push through, changes will start to occur.

Pro Tip: Correctly using the forces of physics can build great athletes but when mismanaged becomes a wrecking ball.

Problems are much easier to address in the first couple of weeks. Timing and positioning mechanics of the knee—when pushed too far—eventually fall apart. Excessive loading through the patellar tendon can cause painful bone formation that we know as Osgood Schlatter’s.

Constant pain behind or on the side of the knee cap can cause maltracking. This is due to a bad combo of tightness and weakness in the quad muscles, known as Patellofemoral Syndrome.

Repeated abuse of the knee joint will begin to shut down quad strength because of this awful pain/inflammation cycle. If there is any uncertainty to the cause of knee pain, get the athlete to the doctor and hopefully to a sports-minded clinician that is going to figure out the underlying cause.

Pro Tip: The longer knee pain persists, the longer it will take to correct the problem.

Tip #4: Pain Does Not Equal Damage

This applies to any injury, but I find it very relevant to the knee. The knee is a very painful structure, as I mentioned—lots of tiny cells that relay information with every step. It is pretty well known in the physical therapy world that the fat pad behind the kneecap, which provides cushioning, when pinched is “drop to the floor” painful.

An IT band that slaps awkwardly across the outside of the knee joint may also take an athlete’s breath away. While both incredibly painful, when addressed appropriately can be quickly resolved.

Bringing this back to the “get it checked out” message I have already conveyed—as a coach it is important to realize this because fear and doubt will settle into the athlete’s brain.

Pro Tip: Pain is a way for the body to say “Hey, I don’t like what is going on here, do something about it.” Lots of things affect pain so getting a clear understanding of the cause is critical, before some real damage starts.

Tip #5: It’s Too Important to Cover Up

If you do not know what the issue is affecting the knee, don’t cover up the problem. I am talking about all the braces, bands, clips, gels, and bottles of anti-inflammatories that young athletes get rigged up with.

If your doctor or therapist recommended something like this, absolutely listen and follow the sound advice.

If an athlete is limping around and you slap on a compression sleeve and wrap, and then it miraculously feels better, it doesn’t mean the issue doesn’t still exist. The typical response is “back to business as usual”. STOP, and direct that child towards the doctor.

As adults, we mask things to make it through the workday, manage pains at home so we can bend over and bathe the kids, or perhaps to participate in recreational softball tournaments.

Children are not adults.

Take Home Message

A lot of the article may be interpreted as “any knee problem, take an athlete to the doctor.”

If an athlete’s knee is sore after doing box jumps for the first time, is slow moving following a run into a wall, or is a bit irritated after increasing running mileage from 5 to 7 miles, there are cases where you know a potential cause or instigator.

For the athletes that have been limping around for weeks and getting worse, a professional medical evaluation is warranted. I am always going to error on the side of caution with this type of thing because at the least, an athlete will get their part checked out and learn ways to head off problems before they start.

Dr. Keith Cronin, DPT


Help Prevent Injuries by Preparing Athletes To Perform

Learn how to leverage the Long Term Athletic Development Model to ensure your athletes are prepared to perform. In expert Wil Fleming’s free 7-minute video and PDF checklist, he covers how to create a training system that prepares young athletes to move better, get stronger, and enhance their performance.

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About the Author: Keith J. Cronin

Keith CroninKeith J. Cronin is a physical therapist and owner of Sports and Healthcare Solutions, LLC. Keith currently supports US Operations for Dynamic Tape®, the “Original” Biomechanical Tape®, providing guidance for education, research, and distribution. He graduated with his Doctorate in Physical Therapy (DPT) from Belmont University in 2008 and later earned his Orthopedic Certification Specialist (OCS).

Prior to graduate school, Keith was a collegiate baseball player and top-level high school cross country runner. He also had the opportunity to work as a personal trainer (CSCS) prior to his career in physical therapy, providing a very balanced approached to educating fitness and rehabilitation. Keith has focused his career on the evaluation, treatment, injury prevention, and sports conditioning strategies for athletes, with particular attention to youth sports. He currently lives in the St. Louis, MO area with his wife and two daughters, Ella and Shelby.

Additional noteworthy items about Keith:

  • Keith is currently a reviewer for the International Journal of Sports Physical Therapy (IJSPT) on a variety of topics including throwing athletes, concussions, and ACL rehabilitation.
  • Keith has produced several online CEU courses for PTWebcuation.com on the topics of running injuries, ACL rehabilitation, Patellofemoral Syndrome, and injuries to the Foot and Ankle.
  • In 2012, Keith participated in a concussion education program in Newcastle, OK that resulted in the documentary “The Smartest Team: Making High School Football Safer” which had several runs on PBS worldwide.
  • Keith has also been published in a variety of media, publishing almost 100 articles through venues including MomsTEAM.com, Advanced Magazine, the 9s Magazine, the American Coaching Academy, and Suite101.
  • Keith was also featured on Fox2News several times on topics of concussions and ACL injuries.
  • In 2008, Keith was a winner of the Olin Business Cup at Washington University for his product innovation “Medibite” a jaw rehabilitation system designed to improve the outcomes for individuals suffering TMJ dysfunction.

 

Plyometric Progressions for Young Athletes

Young Athletes and Plyometric Progressions

By Wil Fleming

On the surface plyometrics are all about force production. For young athletes they are a great way to learn to produce force, apply it into the ground and propel their body in a new direction.

The overlooked part of plyometrics, that needs to be considered is the role of force absorption in an athlete’s development.

If athletes never had to land, or never had to stop there wouldn’t be as many injuries. Plain and simple. Almost 70% of knee injuries occur from non-contact movement. A great percentage of those injuries occur in change of direction movements or landing.

These types of stats should raise our eyebrows and make us look not only at force production but at force absorption. We must prepare our athletes for landing, otherwise plyos are like equipping your your young athletes with a bigger motor, but no brakes.

Applying the brakes to plyos can be done simply by using a progression of multi-planar jumps. Young athletes should do each jump at a high intensity and then “Stick” the landing for 3-5 seconds.

This progression is appropriate for athletes of nearly all ages, and will be challenging to young athletes of all ages.


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Preventing Knee Injuries With Youth Strength Training Programs

Does Your Youth Strength Training Program Promote ACL Injuries?

 

Youth Sports knee injuries

 

The good news about knee injuries these days, and Anterior Cruciate Ligament (ACL) tears in particular, is that medical science has turned what used to be a career-ending injury into something most athletes can recover from in time.

 

The bad news is that ACL tears are occurring more often than ever. Anyone involved in a youth strength training program likely knows at least one athlete who has had a severe knee injury in the past year.

 

Why do these injuries occur?

 

The ACL is a small ligament that runs diagonally inside the knee and connects the upper leg (femur) to the main shin bone (tibia). It’s job is to prevent the knee from twisting or moving side-to-side more than just a few degrees. When pushed beyond its relatively small limit, the ACL can either be partially stretched or ripped completely.

 

Youth Sports training knee injuries

 

In a sports setting, the ACL almost always gets torn during a one-time event. This can occur due to contact with another athlete, or during non-contact moments where the knee may be pushed out of position from a high level of force placed on it. Non-contact situations where this normally happens are during cutting, pivoting, out-of-control stopping, and awkward landings on jumps.

 

Surprisingly, about 70% of ACL tears in young athletes occur during non-contact events. Female athletes are between 3 and 8 times more likely than males to tear their ACL. Although all youth sports have some level of ACL injuries, soccer and basketball have the most for girls playing sports. For boys, it is football and lacrosse.

 

With nearly 150,000 tears occurring annually in the United States alone, more focus has not just gone into the rehabilitation process, but also in preventing these injuries from happening in the first place.

 

How To Prevent ACL Injuries With Your Youth Strength Training Program

 

One big piece of preventing ACL tears is to focus on both the ankle and hip joints, strange as that may seem. Knees basically go where the ankles and hips send them, so ‘prehabilitation’ measures focus on those areas.

 

For the ankle, it is crucial that young athletes limit the amount of side-to-side movement that occurs in that joint. Either during one leg standing postures or when running, the more their ankles roll the better the chance it will push their knees either in or out during faster-paced athletic events. Kids who tend to roll their ankles a lot may be much more susceptible to knee injuries when they get bigger, faster and stronger in their later years.

 

The hip joint needs to both be flexible and strong to function correctly, making it a little harder to train. For the flexibility side, stretches that specifically target the hips may be needed for those with limited ability to do a deep squat. Very young athletes (ages 11 and younger) are almost never in need of these, but once the teenage years approach and growth spurts really kick in, more stretching may be warranted.

 

Youth Strength Training Program

 

Strengthening the hips can be tricky, because most athletes with weak hip muscles have learned to move in a way that shifts the stress to their stronger leg and back muscles. You’d think a basic exercise like a squat would work the hips very well, but not for those who are leg-muscle dominant already. Isolated strength for the hip muscles plus relearning other exercise patterns, such as squatting, must both be done to stabilize and protect the knees.

 

Just as important in this equation is for young athletes to learn how to move properly. Being able to efficiently absorb the force of gravity when landing on a jump can lower your ACL tear risk substantially, and is relatively easy to learn for most focused and dedicated athletes. In addition, controlling momentum during stopping and cutting movements will further decrease your risk. These skills tend to take much more repetition to improve on, but it certainly can be done.

 

Although it is true that the younger someone starts improving these skills the better chance it will lower their future injury risk, it is never too late to build the strength, flexibility and movement skill required in sports with a great youth strength training program to keep your knees stable and safe.

 

Help young athletes train the RIGHT way, perform to their full potential and learn from the very best in industry by getting your IYCA Youth Fitness Specialist Certification today!

 

Youth Fitness Training

 

SOURCES: British Association of Sports Medicine, www.livestrong.com