Commonly affecting all ages, it is easily injured and gradually becomes painful with activity, eventually immobilising the patient. Due to its constant usage, this part becomes very prone to wear and tear. Physical therapy can help with a combination of manual therapy techniques, exercises, stretches, and deep tissue mobilisation. A program of stretching exercises in conjunction with deep tissue mobilisation for the tight muscles, coupled with strengthening other surrounding muscles, helps restore pain-free sporting activity. Assessment of other contributing biomechanical and sporting factors can help return to sport. At Hallmark physiotherapy, we focus on strengthening conditioning and fitness to improve pain and activity levels.

1) Ligament and Meniscus Injuries

a) Anterior Cruciate Ligament (ACL) Tears

The ACL is one of the main stabilising ligaments in the knee which connects the femur (thigh bone) to the tibia (shin bone). ACL injury is the overstretching or tearing of the ACL in the knee when the knee is bent beyond its normal range of motion or with excessive twisting.

b) Posterior Cruciate Ligament (PCL) Tears

The PCL runs along the back of the knee and is connected to the femur (thigh bone) to the top of the lower leg bone. PCL is stronger and larger than ACL and the injury is less commonly injured. PCL injury is a partial or complete tearing or overstretching of any part of the PCL.

c) Meniscal Tears

The menisci (plural for meniscus) are cartilage pads which function to cushion the compressive loads in the knee. One or both pads can be torn, which often occurs when the lower leg is forcefully bent and twisted resulting from aggressive pivoting or sudden stops and turns. The meniscus tear often has bucket handle or parrot beak shape and surgery is required if there is a large tear.

2) Osteoarthritis and Total Knee Replacement

Osteoarthritis occurs when the cartilage coverings in the end of the femur and the top of the tibia wear out. The tibia has two special cartilage pads called menisci. This cartilage becomes flattened causing the bone spurs to form, leading to the joint inflammation and loss range of motion which can affect the difficulty in movement.

3) Knee Replacement

The new joint, called a prosthesis, can be made of plastic, metal or both. It may be cemented into place or uncemented. An uncemented prosthesis is designed so that bones will grow into it. Total knee replacement is often the answer for people with x-rays and other tests show joint damage with moderate-to-severe persistent pain does not improve adequately with non-surgical treatment and when the limited range of motion in their knee joint diminishes their quality of life.