Knee Injury Update

This small blogging world is cool.

I have been reading other bloggers in the physical therapy and research world.

It is amazing how much incredible information is out there.

Let me know if you have some recommendations on blogs that I should be reading.

Let me get to today’s blog post on knee injuries.

Everyone Has Messed Up Knees

Speaking of one of the blogs that I like to read, this one was posted on Eric Cressey’s blog.

Eric brought up some great points:

  1. Do a thorough assessment
  2. Focus in on movement issues
  3. Address the movement issues before the structures, which have increased stress on them, lead to pain and injury

These are all great points and excellent ideas for future blog posts.

Let’s look at what they covered in the research.

What They Looked At

They looked at 56 knees of 28 males that are 14 to 15 years old that had no pain or injuries (asymptomatic).  One group were soccer players and the other group were not.

They performed MRI scans on the knees of both groups and looked at fat pad, meniscus, articular cartlage, bone marrow signal changes and the amount of fluid in the knee.

What They Found

Of the soccer player group, 64% of them had some knee abnormalities when looking at the MRI, while 31% of the non-soccer group did.

Take Home Message


No Pain, No Injury? – Just because the person is not in pain or the stress placed on their tissues (ligament, cartilage, tendon, muscle, bones, nerves, etc.) is at a point that the tissues can handle it, does not mean that there isn’t an injury waiting to happen.

Assessment of the Lower Body – With clients, you need to assess their lower bodies and identify any issues.  One of the assesments that I do is a muscle imbalance assessment.  After the assessment you can address any issues.

Don’t Freak Out Over MRI Results – One should not freak out when they get their MRI results.  There is a good chance, if you are active or inactive, that you will have knee abnormalities.

Preventative Exercises – Those in sports should do a dynamic warm up that helps prepare the knee and prevent knee injuries.  I go through an example in the 9 Exercises a Day Keeps Knee Pain Away workout:

Where to get more information: Soder RB, Simões JD, Soder JB, Baldisserotto M. (2011). MRI of the knee joint in asymptomatic adolescent soccer players: a controlled study. AJR Am J Roentgenol. 2011 Jan;196(1):W61-5.

Prehabiliation Before Knee Replacement Improves Strength and Function


What They Looked At

They had a group of 36 with severe osteoarthritis (OA) who were waiting for a knee replacement (knee arthroplasty).  They were put into two groups.  One group who received the usual care, and the other group got usual care and exercise.

The exercise group did a comprehensive prehabilitation program that included resistance training using bands, flexibility and step training 3 times per week for 4 to 8 weeks prior to their knee replacement.

What They Found

The group that exercised prior to knee replacement had an improvement in knee strength and function.

Take Home Message


Can Be Done at Home – These exercises can be done at home with very little and inexpensive equipment.  I like that.  Going to the gym or the clinic can be difficult for clients but there is a benefit for doing specific exercises at home.

Exercise Before Surgery – Every individual is different, but if the surgeon recommends an exercise program, there is benefit when it comes to strength and function if they start an exercise program prior to knee replacement surgery.  Who does not want that?

I go through osteoarthritis exercises in the Exercise Rehabilitation of the Knee course:

Where to get more information:  Swank AM, Kachelman JB, Bibeau W, Quesada PM, Nyland J, Malkani A, Topp RV. (2011). Prehabilitation Before Total Knee Arthroplasty Increases Strength and Function in Older Adults With Severe Osteoarthritis. J Strength Cond Res. 2011 Jan 6. [Epub ahead of print]

Rick Kaselj, MS