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10 Common Knee Injuries (Especially Among Athletes)

Dr Andrew Dutton - 10 Common Knee Injuries (Especially Among Athletes)
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Whether you’re an athlete or someone who simply has an active lifestyle, it is critical to be aware of various knee injuries, their symptoms, and appropriate treatments. A minor ache today could become a major issue tomorrow if not addressed properly.

Recognizing the signs of knee injury allows you to take suitable measures and make the right choices. As a rule of thumb, however, seek medical advice from a healthcare professional if you feel that there is something off about your knees . Read on for the 10 common knee injuries, especially among athletes!

1. Patellar Fracture

Patellar fractures are serious knee injuries that can lead to profound impairment. This occurs when you fall directly onto the kneecap, through overuse, or through direct trauma or a direct blow. If the amount of stress is more than what the bone can handle, it can result in a fracture. These types of injuries can vary depending on the location, severity and type.

Symptoms Of Patellar Fracture

  • Sudden onset of sharp, intense pain at the front of the knee
  • Swelling
  • A palpable defect in the kneecap
  • Inability to lift the foot
  • Obvious deformity (in severe cases)

A diagnosis is made by determining how the injury is obtained, through physical examination, and radiological findings. Treatment may involve re-alignment, surgical repair, or the use of protective and assistive devices (knee braces, plaster cast, or crutches). Athletes can undergo rehabilitation by gradually conditioning the patella in a safe and effective manner.

Patients with a patellar fracture usually make a full recovery with proper management. They can resume sports within a few weeks or months under close guidance from their physiotherapist or specialist. If poorly rehabilitated, this type of fracture can develop into other conditions such as post traumatic arthritis, chondromalacia, or patellofemoral pain syndrome.

2. Knee Dislocation


Knee dislocations can be classified into high-velocity and low-velocity categories. High-velocity knee dislocations are generally caused by a violent force, such as vehicular accidents. Meanwhile, low-velocity knee dislocations often occur in sports settings.

Knee dislocation occurs in athletes when the foot is planted on the floor and a rapid change of direction or twisting motion occurs. This is common in sports like soccer, cycling, skiing, gymnastics, and the long jump.

Symptoms Of Knee Dislocation

  • Rapid, acute swelling
  • Severe pain and tenderness
  • “Sloppy” kneecap (hypermobile patella)
  • Obvious deformity of the knee
  • Loss of sensation or pulse below the knee

To check the injury, the doctor will initially examine distal pulses , especially on the foot since vascular damage is common with knee dislocation. They may also order an X-ray exam to determine the extent of bone damage. Patients may also undergo an arteriogram , which is an X-ray of the artery to check for arterial injuries, or an ultrasound in some cases to assess arterial blood flow.

Treatment includes relocation (moving the lower leg back into position in a process called reduction), surgery (involves knee reconstruction and vascular repair to maintain blood flow), and immobilisation to prevent further damage.

Dislocations are considered serious injuries.While recovery is possible, the injured knee usually doesn’t regain its previous capacity to absorb stress. It is common for doctors to prescribe the use of supportive wraps or devices to protect the knee and spare it from undue stress.

3. Knee Bursitis


The knee bursae are fluid-filled sacs situated near your knee joint. When working correctly, they help the joints to guide smoothly and they help keep the tendons, ligaments and muscles from scraping the bones.

Knee bursitis occur when one or more of the bursae becomes irritated, inflamed, or damaged. Prolonged pressure, traumatic blows, and repetitive motions (e.g. running) can cause an irritating friction which can lead to bursitis. This worsens if the joint has been held in one position for too long.

Symptoms Of Knee Bursitis

  • An initial sharp or stabbing pain that is followed by a dull, aching pain
  • Swelling and redness on the front of the knee
  • Warmth around the joint
  • Pain when kneeling
  • Increased discomfort after the joint is kept stationary for long periods of time
  • Difficulty in straightening or bending the knee

Bursitis may sometimes be mistaken for some other knee problems such as arthritis, stress fractures, and tendonitis. To correctly diagnose the problem, the physical therapist or orthopaedic doctor will make a thorough evaluation and conduct special tests (e.g. X-ray, MRI, Ultrasound).

In most cases, knee bursitis resolve on their own with little or no treatment. However, in some cases it may require medical care, and an intervention is aimed at symptom relief. This involves basic treatments like lifestyle modifications, home remedies, and medications. For persistent symptoms, other options include corticosteroid injections, aspiration, and surgery.

4. Patellar Tendonitis


Patellar Tendonitis, also referred to as patellar tendinopathy or “jumper’s knee” is an overuse injury that is characterised by overstressed knees. Athletes often acquire this type of injury in sports where jumping or landing heavily is common (e.g. volleyball, basketball, long jump). It also occurs when you suddenly subject your body to more exercises or train on hard surfaces like concrete. The extra stress on the tendon results in tiny tears that inflame the muscle.

Patellar tendonitis typically has a gradual onset of pain. Athletes with mild to moderate symptoms would even continue to train and compete. At the first damage the injury may not cause any problems and would often heal quickly. However, if it occurs repeatedly, the tears may develop faster than the body is able to recover. The damage will progressively become worse resulting in pain and dysfunction.

Symptoms Of Patellar Tendonitis

  • Pain and tenderness below the kneecap
  • Pain that is made worse with jumping, landing, running or prolonged sitting
  • Weakness in the knee

To diagnose the problem, the doctor will assess by applying pressure to certain parts of your knee to determine painful areas. For patellar tendonitis, this will be at the front of your knee, just below the kneecap. For a more conclusive diagnosis, doctors will also do imaging tests such as X-rays, ultrasound, or MRI.

Medical interventions for this injury also include physiotherapy, and may even involve prolonged rehabilitation. With proper injury management and rehabilitation you can get back on the court, the track or the field as soon as possible.

5. Knee Ligament Injury

Ligaments are bands of tough connective tissue that surround a joint to provide support and control movement. Ligament injuries, commonly known as a knee sprain, often happen due to a sports injury which results in the knee joint becoming unstable. They also severely limit your knee movement.
The knee is stabilised by 4 major ligaments that connect the thigh bone to the shin bone, namely:
  • Anterior cruciate ligament (ACL) – The ligament at the centre of the knee which controls rotation and forward movement of the shin bone. An ACL injury is a tear or sprain of the ACL caused by sudden stops or change in direction, jumping and landing. It is common in sports like downhill skiing, basketball, and football.
  • Posterior cruciate ligament (PCL) – The ligament at the centre of the knee which controls the backward movement of the shin bone. The PCL, the strongest ligament in your knee, can be injured when stretched or torn with a sharp, violent blow, usually during a football tackle or similar sports.
  • Lateral collateral ligament (LCL) – The ligament responsible for the inner knee’s stability. The LCL can be injured in activities that involve twisting, bending or a quick change of direction. AN example is when the inside of the knee gets hit during a football game.
  • Medial collateral ligament (MCL) – The ligament that stabilises the outer knee. Often called an MCL sprain, this injury is caused by a direct blow to the outer side of the knee, such as when playing football or hockey.

When any of these four are damaged, the knee exhibits instability in the direction that the injured ligament stabilises. There are four special tests to evaluate injuries and these are the Anterior Dawer Test (for ACL), the Posterior Dawer Test (for PCL), the Valgus Stress Test (MCL), and the Varus Stress Test (LCL).

Symptoms Of Knee Ligament Injury

  • A loud pop or snap at the time of the injury
  • Sudden and severe pain, sometimes preventing you from participating in your sport
  • Black-and-blue discoloration around the knee
  • Knee instability
  • Swelling within the first 24 hours after the injury
  • A feeling of looseness in the joint
  • Inability to put weight on the affected joint due to pain
  • Knee buckling toward the outside

To diagnose ligament injury, the doctor starts with a physical exam. They will inspect the knee for swelling and tenderness. The process can be uncomfortable because it involves different knee movements to assess your range of motion and the application of external pressure on the knees.

The extent of damage is classified according to a grading system, Grade I (mild), Grade II (moderate), and Grade III (severe). How long a knee sprain persists depends on the type of knee sprain, the severity of the injury, your rehabilitation program, and the type of sport that you play.

Mild to moderate injuries often heal on their own. Most collateral ligament tears (LCL and MCL) usually don’t require surgery. However, in instances where the cruciate ligaments (ACL or PCL) are torn and stretched beyond limits, reconstructive injury will be the only option. Generally, you can expect a full recovery with proper treatment and a good physical therapy program.

6. Iliotibial Band Syndrome


The iliotibial tract or iliotibial band (ITB) is a thick band of fascia that runs along the outer length of your thigh down to the top of the shin. It is composed of dense fibrous connective tissue that extends from the iliac crest and inserts at the knee. The ITB and its associated muscles function to extend, abduct, and laterally rotate the hip.

Iliotibial Band Syndrome is considered a non-traumatic overuse injury that is associated with underlying weakness of the hip abductor muscles. Overuse is brought about by repetitive knee flexion and extension causing pain on the side of the knee usually among cyclists and runners. It is also associated with other activities like cycling, hockey, swimming, hiking and basketball.

Symptoms Of Iliotibial Band Syndrome

  • Pain and/or tenderness of palpation of the outer aspect of the knee
  • Lingering pain after exercise
  • Clicking sensation
  • Tenderness in the buttocks
  • Warmth and redness around the knee

A diagnosis is made with a health history that details your health problems and current symptoms. This will also involve a physical exam and a thorough assessment of your knees’ range of motion and strength. Using certain tests, your doctor can distinguish between iliotibial band syndrome and other potential causes behind your knee pain (e.g. osteoarthritis, meniscal tears). Imaging tests such as X-rays or MRIs would have to be done for a definitive diagnosis.

Most people respond to pain or anti-inflammatory medications, cold compress, stretching and strengthening exercises. It is also necessary that one limits his activity for a while to minimise pain, prevent further damage, and to allow the knee to heal fully. Ultrasound and electrotherapy are sometimes recommended to reduce tension. Meanwhile, some may even require surgery to treat the injury.

Most patients recover from iliotibial band syndrome, but it usually takes weeks or months to return to full activity without any pain or discomfort.

7. Meniscal Injury


The meniscus is a crescent-shaped pad of cartilage in the knee that acts as a shock absorber. Meniscal tears are considered a widely common knee injury and they are caused either by a sudden twist or significant trauma especially in sports settings.

The injury can occur in isolation or in combination with ligament injuries. It can also range from minor to severe, depending on the extent of the damage.

Symptoms Of Meniscal Injury

  • Localised pain to the medial or lateral side of the knee
  • Locking and clicking sensations
  • Delayed intermittent swelling

A torn meniscus is diagnosed on the basis of thorough history taking and physical exam. To confirm a diagnosis, imaging tests such as an MRI, X-ray, or Arthroscopy may have to be done as well.

Immediate management for meniscal injuries include the RICER method (rest, ice, compression, elevation and referral). It is important that this protocol is followed within 48-72 hours to reduce the pain and for prompt medical attention. In addition, the No HARM protocol must also be applied – no heat, no alcohol, no running or activity, and no massage. It helps decrease swelling and bleeding of the injured knee.

Through physical therapy, the muscles around your knees and your legs can be strengthened, building stability and support to your knee joints. A patient may even have to wear a knee brace that is specifically designed to support a meniscus injury. However, if pain persists and your knee locks despite rehabilitative efforts, the doctor may recommend surgery.

A positive prognosis is possible after a meniscal tear. Patients can achieve this either through conservative or surgical treatment. Athletes are even able to return and compete in their sports. However, it is also true that once the cartilage is damaged, it cannot be repaired to be as good as the original. This is why everybody must seek ways to prevent a torn meniscus (e.g. strength training of surrounding muscles, proper body mechanics, or the maintenance of a healthy weight).

8. Osgood-Schlatter Disease

Dr Andrew Dutton - Knee Injuries - Osgood-Schlatter Disease - Illustration
Osgood-Schlatter Disease is a common overuse injury that affects the growth plate at the tibial tuberosity, causing inflammation and pain. It primarily affects adolescents during growth spurts and is more common in those who participate in sports that involve running, jumping, and rapid changes in direction.

Symptoms Of Osgood-Schlatter Disease

  • Swollen Patellar Tendon and Tibial Tuberosity
  • Pain, swelling, and tenderness at the tibial tuberosity (bony prominence below the kneecap)
  • Increased pain during activities such as running, jumping, or squatting
  • Temporary relief from pain with rest
Treatment typically involves rest, ice, compression, and elevation (RICE), along with anti-inflammatory medications and physical therapy to strengthen the surrounding muscles. In most cases, the condition resolves on its own as the growth plate closes.

9. Patellofemoral Pain Syndrome

Dr Andrew Dutton - Knee Injuries - Quadriceps & Hamstring Strains - Illustration
Patellofemoral pain syndrome, also known as runner’s knee, is characterised by pain around the kneecap (patella) and is caused by imbalances and misalignments in the muscles and structures surrounding the knee. It is common in athletes who participate in sports that involve repetitive knee flexion, such as running, cycling, and jumping.

Symptoms Of Patellofemoral Pain Syndrome

  • Dull, aching pain in the front of the knee
  • Pain that worsens with activities like squatting, climbing stairs, or prolonged sitting
  • Occasional knee buckling or giving way
Treatment options include physical therapy to strengthen the muscles around the knee, improve flexibility, and correct imbalances, as well as using orthotics or shoe inserts to support the feet and reduce stress on the knee joint.

10. Quadriceps & Hamstring Strains

dr andrew dutton knee injuries quadriceps & hamstring strains illustration

The muscles of your thigh can be divided into two primary groups: the hamstring and the quadriceps. The hamstring comprises a trio of muscles – the biceps femoris, semitendinosus, and semimembranosus – which stretch from your thigh to your knee along the rear of your leg.

These muscles work together to enable knee flexion and hip extension. Meanwhile, the quadriceps muscles are located on the anterior part of your thigh, between your hip and knee. They connect to your pelvis, hip bones, femur (thigh bones), and patella (kneecaps) through their respective tendons.

Quadriceps and hamstring strains are common muscle injuries that occur when the muscle fibers are overstretched, leading to tearing. These injuries are prevalent in sports that require sprinting, jumping, or sudden changes in direction.

Symptoms Of Quadriceps And Hamstring Strains

  • Sudden, sharp pain in the front (quadriceps) or back (hamstrings) of the thigh
  • Swelling and bruising
  • Difficulty walking or bearing weight on the affected leg
  • Treatment for these injuries typically involves rest, ice, compression, and elevation (RICE) to minimise swelling and pain. Physical therapy may also be necessary to restore strength and flexibility to the injured muscles.

The Takeaway

Don’t ignore aches and pains in the knee area as they may be a sign of knee injury. To make an informed decision, it’s essential to have accurate and comprehensive information from a certified medical professional. With an experienced orthopaedic surgeon, you can rest assured that proper surgical techniques are employed, minimising potential complications and reducing re-injury risks.

If you need more information about knee injuries, please book a consultation with A/Professor Andrew Dutton or fill up the form below. You may also call us at (+65) 6836 8000, and we would be happy to answer your questions.

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About A/Professor Andrew Quoc Dutton

A/Professor Dutton, also known as, has been in clinical practice since 1996 after graduating from Marist College, Canberra and the University of New South Wales, Sydney, Australia. A/Professor Dutton has worked at the Prince of Wales Hospital, Sydney, and the St. George Hospital, Sydney, before completing his orthopaedic surgery training in Singapore. He is currently an associate professor of orthopaedic surgery at the National University of Singapore (NUS).

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