Initial Knee Injury Management

Initial Knee Injury Management

• Initially, Rest, Ice, Compression, and Elevation (RICE) are generally advised if the correct course of action is unclear, to alleviate discomfort.

Proprioceptive Enhancement

• Supports enhance proprioceptive sense, improving self-regulation.
• Knee braces or ace wraps give 30 minutes to 2 hours of enhanced proprioceptive sense.
• Taping or wrapping before sports enhances functioning due to improved proprioceptive sense.

Enhancing Knee Function

• Stretching, strengthening, and stabilizing the knee joint enhances functioning.

Medication Options

• NSAIDs reduce swelling and symptoms from overuse or minor knee injuries.
• Acetaminophen reduces pain perception in the brain, allowing continued function and healing.

Injections

• Fluid is often extracted from the knee due to overuse injuries.
• Steroid injections can be administered a few times a year for pain management.
• Lidocaine provides short-term relief for severe pain.
• Supplements may enhance shock absorbency or gliding, but benefits are time-limited and require repeated injections.

Osteopathic Considerations

• Assess somatic dysfunction in the knee, hip, and ankle.
• Observe motor patterns to see how the knee affects ankle and hip.
• Promote homeostasis and fluid function in the musculoskeletal system.

Demographic Considerations in Knee Pain

• Children and adolescents often experience knee pain from overuse or growth.
  • Possible conditions include patellar subluxation, tendonitis, jumper's knee, or Osgood-Schlatter.
  • Arthritis is less common, but bony tumors like osteosarcoma and exostosis should be considered.
• Patients under 45 are prone to patellar syndromes and ligamentous or meniscal trauma.
• Hip pathology frequently contributes to knee issues.
• Abnormal angles or functioning can lead to knee pain.
• For those over 45, degenerative arthritis is the most prevalent.
  • Possible conditions include avascular necrosis and meniscal tears.
  • Hip pathology influences knee pain.
• Knee, hip, and ankle angles should all be evaluated.

Localizing Knee Pain

• Pain at the front of the knee may indicate patellofemoral issues or tendonitis.
  • In younger patients, consider Osgood-Schlatter.
• Pain at the back may stem from referred ankle pain or cysts.
• Medial pain might involve the medial collateral ligament or bursitis.
• Lateral pain could indicate lateral collateral ligament issues or fibular head dysfunction.

Patellofemoral Pain Syndrome Treatment

• Rest is crucial, especially if overuse is the cause.
• Ergonomic aids like splints or Bledsoe braces prevent overextension and enhance proprioception.
• Analgesics, taping, and wrapping can be beneficial.
• Physical therapy and OMM correct abnormal mechanics and teach knee protection strategies.
• Long-term exercise strengthens quadriceps and hamstrings for severe cases.
  • Soft tissue techniques offer short-term benefits and improved flexibility.

Anterior Knee Pain Considerations

• Conditions to consider: osteochondritis dissecans, patellofemoral pain syndromes, acute articular cartilage injury, bony tumors, chondromalacia patella, patellar fracture, or iliotibial band syndrome.

Comprehensive Knee Examination

• Assess knee biomechanics and function.
• Examine the joints above and below the knee to understand the overall impact.
• Address potential biomechanical imbalances to prevent further issues.

Patient Trust

• Active listening and sharing observations can foster trust and prevent further deterioration.