One of the most common types of injuries is damage to the knee joint. At risk are professional athletes, as well as people leading an active lifestyle, including football players, cycling, skiing, snowboarders, etc. However, quite often those who are far from sports also get injured - after a car accident, during an unsuccessful fall, or a sudden load on the knee joint. If we are talking about a slight bruise, you need to apply a cooling compress, use a special ointment and reduce physical activity for a while. If a more severe injury occurs, it is important to consult a traumatologist in a timely manner - in some cases, surgical intervention, rehabilitation and physiotherapeutic measures cannot be avoided.
Risk factors
Of course, no one is immune from a knee injury, but there are certain factors that can increase the likelihood of its occurrence:
- Excess weight . It increases the load on the joint parts even during normal movements - when walking, climbing or descending stairs. Moreover, heavy weight increases the risk of arthritis and arthrosis and destroys articular cartilage.
- Poorly developed muscular system . Well-trained muscles allow you to hold joints, increase range of motion if necessary, and protect against injury. If the muscles are very poorly developed, this leads to much more frequent injuries.
- Presence of old injuries and pathologies . Various inflammatory diseases, destruction of cartilage and bone tissue, insufficient tissue nutrition, as well as poorly healed injuries significantly increase the risk of various types of ailments.
- Participation in individual sports . Thus, skiers, basketball players, football players, hockey players, as well as runners (especially those who jog) are at risk.
Methods for restoring a knee after a bruise
Treatment of the spine and joints through surgery is an extreme measure that specialists resort to in cases where bone and muscle tissue are seriously damaged. For ordinary fractures and cracks, a plaster cast is applied; in all other cases, a tight bandage on the knee is recommended.
So, what should you do if your knee is swollen and painful due to a bruise? Any traumatologist will tell you that you will have to resort to the help of anabolic steroids, which are taken orally or applied to the site of the injury in the form of an ointment. If a large hematoma has formed at the site of the bruise, it is punctured to ensure blood flow and reduce pressure on the injured area. If, with a knee injury, the leg below is swollen, and the injury itself is accompanied by an open wound, it is carefully treated and a sterile bandage is applied. If the wound has healed, but the leg continues to hurt and the swelling does not subside, ointments are prescribed that effectively remove swelling, as well as drugs that reduce pain.
Main types of knee injuries
Anterior cruciate ligament (ACL) injuries
The ACL provides dynamic stability to the knee; it fixes the lower leg and prevents it from moving inward and forward. In fact, the ACL is the main stabilizer of the knee, and if it is damaged, then normal function of the limb is simply impossible. ACL injury is very common - it can occur both during sporting events and at home, when falling from a bicycle, etc. In most cases, it is caused by sudden braking, stopping while walking or running, and is often found in accidents and in contact sports.
Posterior cruciate ligament (PCL) disorders
It is much less common. The job of the PCL is to keep the tibia from moving backward. As a rule, if there is a rupture of the PCL, we are talking about a serious and serious injury. PCL rupture occurs only under very strong physical impact - for example, with a powerful blow to the leg during a sports competition, or when hit by a car bumper.
Meniscus injuries
Refers to the most common injuries of the lower extremities. The menisci perform a shock-absorbing function in the joint; they prevent friction from occurring even under the most severe loads. The underlying cause of injury is a blow, a fall, an atypical turn of the leg, or a sharp extension.
First information, scientific materials on the topic
- Knee joint: damage and pain syndromes. Guide to the diagnosis and treatment of injuries and certain diseases of the knee joint. Girshin S.G., Lazishvili G.D., 2007.
- Traumatology and orthopedics. Management. Kornilov N.V., St. Petersburg, vol. 2, pp. 56–58, 197–201.
- First medical aid, textbook. Buyanov V. M. M.: Medicine, 2000, pp. 56, 174, 192.
- First aid for injuries, accidents and some diseases. Bulay I.P., Mn.: Belarus, 1984, p. 48.
- Traumatology and orthopedics. Kavalersky G. M., Silin L. L., Garkavi A. V., M.: Medicine, 2008, pp. 149–152, 202–207.
- Knee surgery. Kushner Fred D., Scott Norman W., Scuderi Giles R., 2014.
Knee dislocations
Accounting for about two percent of all injuries, professional athletes, as well as those who lead a sedentary lifestyle, are at risk. Dislocations occur as a result of a blow or sudden movement.
It is customary to distinguish between primary and secondary injuries. After the primary, it is extremely important to properly carry out treatment and recovery. It is old, untreated injuries that ultimately lead to secondary trauma, as well as the development of other pathologies.
Nonsteroidal anti-inflammatory drugs
The first thing to do to eliminate sharp pain in the knee is to apply an ointment from the group of non-steroidal anti-inflammatory drugs, which is used as a first aid remedy. Such medicines are characterized by rapid action - the active components penetrate into the deep layers of tissue, relieve swelling and pain, and stop the further development of inflammation.
Effective anti-inflammatory drugs:
- Butadion;
- Indomethacin;
- Diclofenac;
- Voltaren;
- Ortofen;
- Finalgel;
- Ketorol;
- Ketoprofen;
- Piroxicam.
Anti-inflammatory ointments begin to act very quickly - within 20-30 minutes after application they relieve pain, relieve muscle tension, reduce swelling and restore joint mobility.
Such drugs improve tissue nutrition, accelerating their recovery after injury.
When using these medications, existing contraindications must be taken into account. Most of these drugs are prohibited for use during pregnancy and breastfeeding, with open wounds on the skin and allergic intolerance.
General symptoms of injuries
Depending on the type of damage, it may be accompanied by various symptoms. The most common are the following:
- Severe swelling;
- Decreased mobility, blocking of a number of movements;
- Crunching, clicking, extraneous sounds;
- Deformation of bone tissue;
- Increased temperature in the kneecap area;
- Inability to lift a heavy object;
- Acute pain;
- Constant aching pain;
- Decreased sensitivity.
Classification
The most popular classification among practicing doctors is the ICD-10 classification. The ICD is an international classification of diseases revised in 2010, which systematizes into categories all possible pathologies of the human body.
In the ICD-10 system, a contusion of the knee joint occupies position S80. Further in this classification other superficial injuries of the lower leg are presented.
In addition, knee bruises are divided into two groups:
- Fluid under the skin on the knee after a bruise or injury: symptoms, first aid and treatment
- Complete – in which damage occurs to all components of the joint.
- Partial. Here, due to the damaging agent in isolation: either ligaments, or soft tissues, or muscles and their tendons are injured.
A complete bruise may be accompanied by more severe complications. For example, such as a fracture, dislocation, subluxation, sprain of the knee joint and even separation of the kneecap.
Diagnosis of knee injuries
The first thing the doctor does is collect anamnesis. The doctor carefully collects information about how the injury occurred, whether the patient has any pathologies, and what lifestyle he leads. In addition to clinical assessment, measures such as radiography, laboratory tests, magnetic resonance imaging, computed tomography may be required. Through examination, it is possible to identify the location - a rupture of the quadriceps tendon (in this case the patella is displaced to the lower side), a rupture of the patellar ligament (in this case it is displaced to the upper part), a transverse fracture (by palpation you can feel the boundaries between different fragments of the bone). Severe swelling may interfere with identifying the problem. If the swelling is very large, you cannot do without a CT or MRI. In addition, the possibility of joint extension is assessed. X-rays can reveal displacement, but sometimes they show that everything is normal even if there is serious damage.
Hemarthrosis
Hemarthrosis
- trauma – sports, domestic, professional, criminal, road traffic and any other;
- surgery – sometimes hemarthrosis occurs as a complication of arthroscopy or open surgery on the joint.
There are internal reasons that increase the likelihood of hemarthrosis. In some people, even minor trauma results in severe bleeding. First of all, the risk factors are disorders in the blood coagulation system. The cause may be a congenital deficiency of coagulation factors, acquired diseases (for example, cirrhosis of the liver), a decrease in the number of platelets in the blood (thrombocytopenic purpura, a history of severe bleeding, disseminated intravascular coagulation syndrome).
The main types of injuries that most often lead to hemarthrosis:
- meniscus damage;
- knee ligament rupture;
- damage to fatty bodies;
- intra-articular bone fractures.
Both direct (a blow to the knee) and indirect (twisted leg) injury can lead to severe damage with bleeding.
Conservative treatment of injuries
If we are talking about a minor injury, they resort to conservative treatment methods. First of all, this:
- Therapeutic gymnastics , performing various types of exercises under the guidance of a specialist for the allotted time (as a rule, this is a whole course of exercise therapy - there is no effect from one lesson);
- Physiotherapeutic measures - magnetic therapy, ultrasound, kinesio taping, exercises on special simulators;
- Taking medications.
The doctor will determine which medications will be prescribed and which physiotherapeutic procedures will be used – he will prescribe treatment depending on the severity of the injury and the characteristics of the individual patient’s body.
Prevention
To prevent bruises, it is recommended:
- play sports, but do not put stress on your knees;
- wear comfortable shoes with good arch support;
- eat right and lead a healthy lifestyle;
- stop wearing heels all the time.
If you fall or get hit, even minor, go to the hospital. Do not try to treat a bruise or relieve pain on your own. Remember: treatment with drugs that a neighbor or even a pharmacist recommended to you can cause disastrous consequences. A traumatologist can provide competent and qualified assistance.
Knee surgery
If we are talking about a torn meniscus or ACL, then surgery is impossible. Today, few people resort to open surgery; the most effective and safe method of treatment is arthroscopy of the knee joint. It allows minimal damage to surrounding tissues, and also makes it possible to accurately diagnose the problem and immediately carry out treatment. Using a trocar, two or three holes are made in the knee (as necessary), surgical instruments are inserted through one, and the intra-articular cavity is washed. A long tube with a camera at the end - an arthroscope - is inserted into the other hole. The image is displayed in high resolution on the screen, thanks to which the doctor can observe in real time all the manipulations being performed. This allows the operation to be performed with the highest quality and without complications.
One of the added bonuses of arthroscopy is rapid recovery. In most cases, rehabilitation can begin on the third day. There is no need to spend a lot of time in the hospital, and within a few weeks the patient will have access to the usual movements and return to sports. Another plus is the absence of large scars. Since arthroscopic intervention is minimally invasive, only small marks remain on the side of the knee.
Read more about knee arthroscopy
Rehabilitation after knee surgery
After surgery, it is extremely important to carry out rehabilitation, which includes physical therapy and exercises. In particular, the following are used:
- Unstable boss platforms to stabilize the lower body;
- Lunges and exercises on a fitball;
- Eccentric squats, speed-strength movements;
- Rehabilitation using the Neurac system using Redcord equipment;
- Kinesiotherapy at TechnoGym multi-stations, etc.
First aid has been provided: what next?
It is not surprising that with serious injuries to the knee, the leg hurts for a long time. In addition to the medications prescribed by the doctor, you can use traditional medicine. If your knee hurts badly after an injury, and you don’t know what to do, and the prescribed remedies do not bring relief, you need to reduce the load on the injured leg, and ideally, stop walking altogether for several days. A tight bandage around your knee will help minimize joint mobility and reduce pain. In the first days after injury, you should avoid drinking large amounts of liquid to prevent swelling of the limbs. Sometimes, after such injuries, patients’ temperature may rise—in this case, it is worth using antipyretics.
If quite a lot of time has passed after the injury, joint mobility has been restored, but the knee still hurts when bending after the injury, you should contact your doctor again, who will prescribe additional physiotherapeutic procedures. This can be massage, warming up, physical therapy, which will help relieve pain symptoms and will be the last stage of rehabilitation after an injury.