Sports & Knee Injuries Part 4 – Soccer
Did you know that Soccer is the most popular sport on Earth?
It requires endurance, agility, core strength and leg strength. Professional soccer players will travel anywhere from 7-11 KM each match. Much of this time is sprinting to an open area to get open for a pass or to attack an opposing player who has control of the ball. When the athlete has control of the ball or if they are defending and attacker, there are so many quick movements that involve the possibility of an injury. Whether a player slips on the ball, cuts quickly, missteps, or receives a tackle the athlete is at jeopardy of sustaining an injury – many of these potential injuries are knee injuries.
Knee injuries, that any level soccer player may experience over their playing career, might be:
- ACL sprain
- Osgood-Schlatter’s Disease
- Meniscal tear
- Patellofemoral Pain Syndrome
1. ACL Sprain
– a stretch or tear of the anterior cruciate ligament. More serious sprains involve complete tears of one or more of the knee ligaments. Changing direction rapidly or stopping abruptly while running can cause the twisting motion that tears the ACL. This is why it is so easily sprained or strained during soccer.
If you sprain your knee, at the time of injury, you may hear
Popping or snapping
Following the pop or snap, the athlete will almost instantly notice:
- Pain coming from within the knee
- Especially with movement
- Inability to weight bear on that leg
- Swelling
- Fluid behind the kneecap
- Instability in the knee or a feeling of looseness
2. Osgood Schlatter’s Disease
– inflammation of the bone at the top of the tibia (shin bone), where the tendon from the patella (kneecap) attaches, in children.
Osgood Schlatter’s Disease is an overuse knee injury rather than a traumatic injury.
Symptoms of Osgood-Schlatter’s Disease:
- Local pain, swelling and tenderness over the tibial tuberosity at the attachment of the patellar tendon
- Pain during exercise (running or jumping)
- Stairs, squatting and kneeling may be painful
- Quadriceps weakness
- Generally only one knee, however bilateral cases are possible
Causes of Osgood-Schlatter’s Disease:
- Strong repetitive quadriceps contractions that cause a force to be put on the tibial tuberosity which can disrupt the immature bone
- Generally occurs in adolescent growth spurts. When presented with strong, repetitive muscle contractions, tiny fractures occur at the immature area
- Results in symptoms of OSD, as well as irregular bone growth that explains an enlarged tibial tuberosity afterwards
- Lack of growth of the quadriceps in comparison to the femur
- During a growth spurt in a child, the lengthening of the muscle is unable to keep up with the lengthening of the rapidly lengthening femur
- Resulting in increased tensile force on the tibial tuberosity
- During a growth spurt in a child, the lengthening of the muscle is unable to keep up with the lengthening of the rapidly lengthening femur
- Generally occurs in adolescent growth spurts. When presented with strong, repetitive muscle contractions, tiny fractures occur at the immature area
At-risk individuals include:
- Boys: ages 11-15 years
- Girls: ages 8-13 years
- Athletes and individuals who perform repetitive motions
- Runners, gymnasts dancers
- volleyball, basketball and soccer players
Osgood Schlatter’s disease can be managed through:
- Physiotherapy
- Knee Protection (Breg FreeRunner)
- Restriction of high impact activities
- Anti-inflammatory treatments
- Ice, cryotherapy (Breg Kodiak Cold Therapy)
- TENS machines (KneeHab)
3. Meniscal Tears
-the meniscus is a rubbery, crescent shaped disc (cartilage) that cushions the knee. Each knee has two menisci. Meniscal tears occur mostly as a result of trauma.
The meniscus is vulnerable to injuries in which there is:
Compression or twisting across the knee
Meniscus tears are most common in:
- Soccer
- Basketball
- Volleyball
- Dancing
- Skiing & snowboarding
- Football
Like other knee injuries, it is not uncommon for one or more of the ligaments in the knee to be injured in addition to the injured meniscus.
Some symptoms that may be experienced by the injured athlete include:
- Swelling and stiffness
- Pain in the knee
- Popping sensation at the time of injury
- Difficulty during flexion and extension
- Knee locking
After sustaining injury, the athlete has a few options to maintain the state of the knee and to reduce chance of further injuring:
- Rest
- Avoid weight bearing
- Cold therapy (Breg Kodiak)
- To reduce pain and swelling
- Compression (Bauerfeind Venotrain)
- To reduce swelling
If the pain and swelling has not subsided after 2-3 days, surgical repair of the meniscus may be necessary. The decision to repair is based on many factors, including the location of the tear and age of the patient. At this time an orthopaedic surgeon is needed to help the injured individual decide the best course of action to resolve the situation. Unfortunately studies have shown that individuals who tear their meniscus are at a higher risk of developing osteoarthritis of the knee later in life.
4. Patellofemoral Pain Syndrome
– one of the most common knee injuries for athletes, especially soccer players. This involves pain behind the kneecap. This is mainly due to:
- Excessive patellofemoral joint pressure
- Poor kneecap (patella) alignment
Patellofemoral Pain Syndrome is commonly referred to as
“Runners Knee” or “Jumpers Knee”
This injury is caused by pressure buildup between the patella and the femoral groove (where the patella rides on the knee joint). The pressure builds when the patella is not properly positioned in the groove, which is called patella maltracking, making the patella rub against the femur (largest bone in the body). This causes the degeneration of the patella’s joint surface.
This is mostly seen in individuals and athletes who frequently:
- Run
- Jump
- Squat
Unfortunately, untreated patellofemoral pain syndrome can also eventually lead the athlete to patellar tendonitis. Symptoms are generally noticed during weight bearing or quick movement exercises that involve a bent knee.
