Y Magazine

Weak in the knees

Dr Shrinarsha, an orthapaedic surgeon at Burjeel Hospital, offers some insight into the body’s largest joint- the knee.

It’s amazing isn’t it? Something you use all the time without as much as a second thought.

Bending one’s knee to get out of bed, to put on your shoes or to sit down at the breakfast table; it’s an integral part of our day.

But when you suddenly can’t use it, then that’s when we realise the knee’s significance as a part of our anatomy. It’s the body’s largest joint.

For any athlete, a knee injury is probably the worst they can get. And 55 per cent of sporting injuries are those to the knee.

Strong knees are simply fundamental to an athlete’s performance; be it a football, rugby or tennis player, skier, swimmer or track and field athlete.

For the rest of us, knee problems can range from seemingly simple sprains to more serious afflictions caused by inflammation of the tendons,

To understand these problems any sufferer has to grasp the fundamentals. 

The knee joint is formed by three bones: the lower end of  the femur (thigh bone), the upper end of the tibia (leg bone) and the patella (kneecap).

Two cartilage discs, called menisci, allow the bones to glide smoothly against each other, absorb shock and act as a cushion between the femur and the tibia.

Fluid-filled sacks, called bursa, surround the outside of the knee. The knee joint is stabilised by muscles, tendons and four critical ligaments.

Any of these structures can get injured during sports either singly or together. Each injury and its management is different so it’s essential to know what the injury is and what’s involved in treating it.

Injuries can be classified under two groups: acute injuries and overuse injuries.

With acute injuries, the most common are sprains (in which a ligament is stretched or torn). These happen when an athlete changes direction quickly, stops suddenly or lands from a jump.

Overuse injuries are caused by a repeated action or continuous pressure on the knee. These can include:

Of course, it’s not just athletes who suffer from these kinds of problems.

Anyone who spends time doing things that make you bend your knees a lot, like walking, biking, and jumping can get runner’s knee.

Like everything else, there are vital signs to look out for if your knees start to hurt. These include swelling and stiffness; warmth and redness; limping and instablity; inability to fully straighten the knee; and “locking” of the knee.

Obviously, symptoms will depend on the severity of the injury. In acute ligament injuries, sometimes you will hear a popping sound, feel some pain and your knee will start to swell up.

The knee might start to feel unstable and you’ll find it difficult to walk. However, even with minor injuries, an athlete can continue to play his sport, albeit with discomfort while observing the swelling and increased pain later.

If there is an isolated minor injury to the meniscus or the cartilage, the player may feel only mild discomfort and pain initially, which will be followed by swelling in between six to eight hours later. A combination of rest, physiotherapy on the tendons and strengthening exercises can often work wonders.

For instance, the tennis player Rafael Nadal’s career has been blighted with knee injuries.

Despite a formidable combination of technical skill, athleticism and mental strength that took him to No.1 in the world, the Spaniard has been felled by knee problems.

What was it that caused so many problems to his knee joints and how did he combat them?

His team has said that the constant pounding of hard, clay courts certainly didn’t help. 

To overcome tendinitis, Nadal took to a special running machine that encloses the body from the waist down, and as a result, lessens the pressure on the body and makes it feel as if it is 30kg lighter than it really is.   

Many knee conditions can be treated with anti-inflammatory medications, rest, activity modification and proper physiotherapy. However, some require surgical treatment.

Injuries caused by overuse will require surgical treatment only if they fail to respond to adequate to non-operative treatment.

So, as with every other kind of injury, it’s essential to consult your doctor, who may refer you to specialist for proper diagnosis and treatment.