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As the largest joint in the body, the knee is complex and vulnerable to the most injuries. The medical team at Seacoast Orthopedics & Sports Medicine is at the forefront of treating all knee injuries. While some injuries can be treated without surgery, others require surgery to correct. The experience of our physicians leads to the best medical treatment and successful outcomes. Common Knee Problems: Anterior Cruciate Ligament (ACL) Injury (Back To Top) The physicians at Seacoast Orthopedics & Sports Medicine have decades of experience treating injuries to the anterior cruciate ligament (ACL), located in the middle of the knee. As one of four strong bands of tissue (ligaments) in the knee, the ACL connects the thighbone (femur) to the shinbone (tibia) and works to prevent the tibia from sliding, turning, or moving forward from beneath the femur. Athletes often injure their ACL by quickly and forcefully changing the direction of the knee and twisting it while the leg is firmly on the ground or landing a jump. ACL injuries also occur when the knee is hit directly on the outside, as when tackled in football, or when straightened further than normal, as when skiing or suddenly stopping while running. ACL injuries can have a major impact on stability of the knee. More females rupture their ACL than males.  (Click to Enlarge) Anterior Cruciate Ligament (ACL) Symptoms If you believe you may have injured your ACL, it is important that you contact your physician or a physician at Seacoast Orthopedics & Sports Medicine as soon as possible. Some signs that you may have injured your ACL include:
Immediate treatment includes placing an ice pack on the knee for 20-30 minutes every 3 to 4 hours while elevating the knee on a pillow. The physicians at Seacoast Orthopedics & Sports Medicine will evaluate the knee joint to confirm if you have an ACL injury or any other injuries. You may need an MRI or x-ray, available onsite at Seacoast Orthopedics & Sports Medicine, or pre-surgery rehabilitation. Our physicians will discuss all surgical and non-surgical options available to you. The physicians at Seacoast Orthopedics & Sports Medicine are also skilled in the double bundle surgical technique, a method that more closely replicates the normal anatomy of the ACL and impacts long-term outcomes, especially in reducing the development of degenerative joint disease and arthritis. Anterior Cruciate Ligament (ACL) Recovery People recover from injuries at different rates. The longer you wait to have treatment, the longer it will take to get better. Athletes will be able to return to their sports depending upon their rehabilitation. Some athletes are able to return to full competition within six months while others may need more time. Your Seacoast Orthopedics & Sports Medicine medical team will work with you to return you as swiftly and safely to your activities. Baker’s Cyst (Back To Top) A Baker’s cyst is an abnormal swelling in a fluid-filled sac (bursa) in the hollow behind the knee that connects to the membrane covering the knee joint. Any knee joint damage can result in swelling and a Baker’s cyst. The cyst can occur when the lining of the knee joint produces too much fluid after an injury, with tears of the meniscus, or in certain kinds of arthritis like rheumatoid arthritis.  (Click to Enlarge) Baker’s Cyst Symptoms
A medical provider at Seacoast Orthopedics & Sports Medicine will examine your knee. You may need an MRI, available on-site at Seacoast Orthopedics & Sports Medicine. If it is determined that you have a Baker’s cyst it may be treated with an anti-inflammatory medication, by wearing an elastic bandage or sleeve around your knee, or by having the cyst drained or surgically removed. Baker’s Cyst Recovery Sometimes the cyst simply goes away, but if surgery is needed recovery should be complete in eight to twelve weeks. Iliotibial Band Syndrome (Back To Top) Iliotibial band syndrome is inflammation and pain on the outer side of the knee. The iliotibial band is a layer of connective tissue that runs along the outside of the thigh. It connects a muscle near the outer side of your hip to the outer side of your upper shinbone (tibia). Iliotibial band syndrome occurs when this band repeatedly rubs over the bump of the thighbone (femur) near the knee, irritating or tightening the band. The medical team at Seacoast Orthopedics & Sports Medicine most often sees iliotibial syndrome in runners, as a result of having tight muscles in the hip, pelvis, or leg, or having legs that are not the same length. Running on sloped surfaces or in running shoes with a lot of wear on the outside of the heel can also cause this syndrome. The best way to prevent iliotibial syndrome is to warm up properly and do stretching exercises before sports or other physical activity.  (Click to Enlarge) Iliotibial Band Syndrome Symptoms The main symptom of iliotibial band syndrome is pain on the outer side of the knee. Iliotibial Band Syndrome Treatment For immediate treatment, place an ice pack over your iliotibial band for 20 to 30 minutes every 3 or 4 hours for 2 to 3 days or until the pain goes away. You can also ice massage your knee with ice by freezing water in a Styrofoam cup. Peel the top of the cup away to expose the ice and hold onto the bottom of the cup while you rub ice over your knee for 5 to 10 minutes. Your Seacoast Orthopedics & Sports Medicine provider may recommend an anti-inflammatory medicine, stretching and strengthening exercises, or an injection of a corticosteroid medicine to reduce the inflammation and pain. Iliotibial Band Syndrome Recovery While your knee heals, you will need to change your sport or activity — bicycle instead of run, for example. If you continue doing activities that cause pain, you may worsen your injury, cause your symptoms to return, and delay your recovery. The length of recovery depends on many factors such as your age, health, and if you have had a previous injury. A mild injury may recover within a few weeks, but a severe injury may take 6 weeks or longer to recover. You may safely return to your normal activities when your injured knee can be fully straightened and bent without pain, your knee and leg have regained your normal strength, and you are able to walk or jog straight ahead without limping. Jumper’s Knee (Patellar Tendinopathy) (Back To Top) Patellar tendinopathy, also called jumper's knee, is inflammation or microtears in the tendon that connects the kneecap (patella) to the shinbone. Too much jumping is the most common cause, as jumping puts repeated stress on the patellar tendon, causing inflammation. Other repeated activities such as running, walking, or bicycling also cause the problem. Jumper’s knee can also happen if your hips, legs, knees, or feet are not aligned properly. People whose hips are wide, are knock-kneed, or have feet with arches that collapse when they walk or run can have this problem. Jumper’s knee can also happen if you are knock-kneed, have wide hips, or have feet with arches that collapse, as these are indicative of not being aligned properly. The patellar tendon may sometimes rupture or tear completely during strenuous activity. Having strong thigh muscles can best prevent jumper’s knee. It also helps to stretch before and after exercising, and wear shoes that fit properly and are right for the activity.  (Click to Enlarge) Jumper’s Knee (Patellar Tendinopathy) Symptoms Symptoms of jumper’s knee (patellar tendinopathy) may include:
For immediate treatment, place an ice pack on your knee for 20 to 30 minutes every 3 to 4 hours for the first 2 to 3 days or until the pain goes away. Elevate your knee by placing a pillow underneath your leg when your knee hurts. Your Seacoast Orthopedics & Sports Medicine provider will examine your knee to diagnose if you have a problem with over-pronation. You may have X-rays or an MRI of your knee, both available onsite at Seacoast Orthopedics & Sports Medicine. You may be prescribed an anti-inflammatory pain medicine or receive recommended exercises to help decrease the pain behind your kneecap. In severe cases, you may need surgery. Treatment options may also include:
Jumper’s Knee (Patellar Tendinopathy) Recovery The goal at Seacoast Orthopedics & Sports Medicine is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate depending on how soon your knee recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. A tendon that is only mildly inflamed and has just started to hurt may improve within a few weeks. A tendon that is significantly inflamed and has been painful for a long time may take up to a few months to improve. You need to stop doing the activities that cause pain until your tendon has healed or your symptoms will return and it will take longer to recover. You may safely return to your sport or activity when your knee is not swollen and is as strong as prior to your injury and you are able to:
Knee (Prepatellar) Bursitis (Back To Top) Knee (prepatellar) bursitis, also known as housemaid’s knee, is an irritation or inflammation of a bursa located in front of the kneecap near the attachment of the kneecap (patellar) tendon. A bursa is one of several fluid-filled sacs that surround joints or tendons to reduce friction by cushioning muscles or tendons and bones that move back and forth across each other. Bursitis occurs from overuse, a direct blow to the knee, or chronic friction resulting from frequent kneeling. The injury is common in wrestlers who get it from their knees rubbing on the mats and volleyball players who get it from diving onto their knees for the ball. Knee (prepatellar) bursitis is best prevented by avoiding direct blows to the kneecap area and by avoiding prolonged kneeling. Proper protective kneepads will help prevent inflammation of the bursa.  (Click to Enlarge) Knee (Prepatellar) Bursitis Symptoms Prepatellar bursitis causes pain and swelling over the front of the knee. You may have pain when you bend or straighten your leg. Knee (Prepatellar) Bursitis Treatment Immediate treatment includes resting the joint that is hurting. Do not put any pressure on the sore and swollen area until the swelling subsides. Use ice packs on your knee for 20 to 30 minutes every 3 to 4 hours or until the pain goes away. A member of the Seacoast Orthopedics & Sports Medicine medical team will examine your knee for tenderness over the bursa. A needle and syringe may be used to get a sample of fluid from the bursa to check for infection and look for other causes of the bursitis. You may have X-rays and blood tests, all available at the Seacoast Orthopedics & Sports Medicine office. Treatment may include:
Pain from knee (prepatellar) bursitis is usually gone within a few weeks although there may be painless swelling for up to several months. Everyone recovers from an injury at a different rate. The length of recovery depends on many factors such as your age, health, and if you have had a previous injury. The longer you wait to have treatment, the longer it usually takes to get better. Recovery time also depends on the severity of the injury. Returning to your sports or activities depends on how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. It is often safe to return when you progress through the following:
Medial Collateral Ligament (MCL) Sprain (Back To Top) Seacoast Orthopedics & Sports Medicine has extensive experience in treating medial collateral ligament (MCL) sprains. A MCL sprain is a joint injury that causes a stretch or tear in a ligament (a strong band of tissue connecting one bone to the other). Located on the inner side of the knee, the MCL attaches the thighbone (femur) to the shinbone (tibia). Sprains vary from minor tears in a few fibers of ligament to complete tears of the ligament, making the joint very loose and unstable. Sprains are graded 1, 2, or 3 depending on their severity:
 (Click to Enlarge) Medial Collateral Ligament (MCL) Sprain Symptoms MCL symptoms may include the following:
A common way to treat the injury when in occurs is to place ice on the knee for 20 to 30 minutes every 3 to 4 hours while elevating your knee under a pillow to help reduce swelling. Your Seacoast Orthopedics & Sports Medicine medical provider will examine your knee by gently moving your knee around to see if the joint is stable and if the ligament is stretched or torn. You may need X-rays or an MRI of your knee, both conveniently located at the Seacoast Orthopedics & Sports Medicine office. Your provider may offer treatment options that include:
Medial Collateral Ligament (MCL) Sprain Recovery Everyone recovers from a MCL injury at a different rate dependent upon several factors that include age, health, and if there has been a previous knee injury. Typically the longer you wait to have treatment, the longer it will take to get better. Recovery time also depends on the severity of the sprain. A mild sprain may recover within a few weeks, but a severe sprain may take 6 weeks or longer to recover. Grade 3 sprains (complete tears) may be immobilized for several weeks. Returning to your sports and activities depends on how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. Return to your prior level of activity gradually. If you return too soon you may worsen your injury. Often you may safely return to your normal activities once you have progressed through each of the following:
Osgood-Schlatter Disease (Back To Top) Osgood-Schlatter disease is a painful enlargement of the bump of the shinbone (tibia) just below the knee. This bump is called the tibial tuberosity. The tendon that attaches the kneecap to the shinbone attaches at the tibial tuberosity. The Seacoast Orthopedics & Sports Medicine team most often sees Osgood-Schlatter disease in children between the ages of 10 and 15 and usually appears during a period of rapid growth. Osgood-Schlatter disease is caused by overuse of the knee in normal childhood and sporting activities. It is possible that muscles are too tight in the front of the thigh, the back of the thigh, or in the calf. The best way to prevent pain is to use exercise to build muscle strength and avoid overtraining.  (Click to Enlarge) Osgood-Schlatter Disease Symptoms Your child will complain of a painful bump below the kneecap. You or your child may notice a bony enlargement at the top of the shinbone. The pain will sometimes come and go and usually is gone by the time your child has stopped growing. Sometimes the pain still lasts into adulthood. The bump may remain painful and some activities, such as kneeling, may be difficult. Osgood-Schlatter Disease Treatment Your Seacoast Orthopedics & Sports Medicine healthcare provider will examine your child’s knee and review your child's symptoms. Your child may need an X-ray, conveniently available at the Seacoast Orthopedics & Sports Medicine office. The X-rays may show an enlarged tibial tuberosity and may also show irregular or loose bony fragments from the tibial tuberosity. Your child may need to rest or do activities that do not cause knee pain. Ice packs should be put on the knee for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain goes away. If the knee is swollen, it should be elevated under a pillow. Your child may be prescribed a special padded brace or an anti-inflammatory medicine. Exercises may also be recommended. Osgood-Schlatter Disease Recovery As your child gets older and past the growth spurt, symptoms of Osgood-Schlatter disease go away. This commonly takes about 6 to 24 months from the start of the symptoms. Your child will always have a bump even after the pain has gone away. It is possible for your child to sometimes have pain in the area of the bump even as an adult. Adults with persistent pain from bony fragments around the knee need to have the fragments surgically removed. Everyone recovers from an injury at a different rate and not by how many days or weeks it has been since the pain began. The goal is to return your child to normal activities as soon as is safely possible. If your child returns too soon the injury may worsen. Often your child may safely return to sports or activities when, starting from the top of the list and progressing to the end, each of the following is true:
The goal at Seacoast Orthopedic & Sports Medicine is to return your child to normal activities as soon as is safely possible. Osteochonditis Dissecans (OCD) of the Knee (Back To Top) Osteochondritis dissecans (OCD) of the knee, also known as chondral fracture and osteochondral fracture, is a disorder in which there is an injury to the bone or cartilage that make up the knee joint. The cartilage covering the femur (thighbone) or kneecap (patella) is usually affected. There can be fragments of bone or cartilage that come loose and float around in the knee joint. The fragments may also be referred to as a joint mouse or loose bodies. There has usually been a previous injury to the knee that caused a fragment of bone or cartilage to be chipped off the end of the femur or the back of the patella. This may be due to a major injury or due to repeated minor injuries. A problem with the blood supply to the bone may also be part of the cause. OCD is usually caused by injuries to the knee that can't be prevented.  (Click to Enlarge) Osteochonditis Dissecans (OCD) of the Knee Symptoms Symptoms of osteochondritis dissecans (OCD) include:
Osteochonditis Dissecans (OCD) of the Knee Treatment Your Seacoast Orthopedics & Sports Medicine healthcare team will examine your knee and may find that it clicks or locks. Fragments may be felt along the joint line. You may also have an X-ray or an MRI, conveniently available at the Seacoast Orthopedics & Sports Medicine office. The discomfort you experience from OCD may continue until surgery is done to correct the problem. Osteochonditis Dissecans (OCD) of the Knee Recovery You may need to change your sport or activity to one that does not make your condition worse. For example, you may need to bicycle or swim instead of run. You may also need to rest if your knee is swollen and painful. If you feel that your knee is giving way or if you develop pain or have swelling in your knee, you should see your Seacoast Orthopedics & Sports Medicine healthcare provider. Everyone recovers from an injury at a different rate. Returning to your activities depends on how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. If you return too soon you may worsen your injury. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. You may safely return to your normal activities when, starting from the top of the list and progressing to the end, each of the following is true:
Patellar (Kneecap) Subluxation (Back To Top) A subluxing patella is a temporary, partial dislocation of the kneecap from its normal position in the groove at the end of the thighbone (femur). This groove is located between two bumps at the end of the thighbone called the femoral condyles. A temporary dislocation of the kneecap usually happens during forced leg straightening, with the kneecap moving out of the groove to the outer side of the knee. The cause is usually an abnormal structure in the leg:
 (Click to Enlarge) Patellar (Kneecap) Subluxation Symptoms They symptoms of patellar (kneecap) subluxation include:
Immediate treatment for patellar (kneecap) subluxation includes placing ice packs on your knee for 20 to 30 minutes every 3 to 4 hours and elevating your knee to help any swelling go away. Your Seacoast Orthopedics & Sports Medicine healthcare provider will ask about your symptoms and examine your knee to feel the kneecap slipping to the outside as you bend and straighten your leg. An X-ray may show underdevelopment of the lateral femoral condyle. Seacoast Orthopedics & Sports Medicine is able to provide on-site X-rays for your convenience. Your Seacoast Orthopedics & Sports Medicine provider may recommend that you:
While you are recovering from your injury you will need to change your sport or activity to one that will not make your condition worse. For example, you may need to bicycle instead of run. Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. If you return too soon you may worsen your injury. If you develop pain, swelling, or the feeling that your kneecap is moving out of place again, you need to contact your Seacoast Orthopedics & Sports Medicine healthcare provider. You may safely return to your activities when, starting from the top of the list and progressing to the end, each of the following is true: Your injured knee can be fully straightened and bent without pain. Your knee and leg have regained normal strength compared to the uninjured knee and leg. Your knee is not swollen. You are able to bend, squat, and walk without pain. The goal of Seacoast Orthopedics & Sports Medicine is to return you to your normal activities as soon as is safely possible. Runner’s Knee (Patellofemoral Pain Syndrome) (Back To Top) Patellofemoral pain syndrome, also called runner's knee, patellofemoral disorder, patellar malalignment, and chondromalacia, is pain behind the kneecap. It can occur from overuse of the knee in sports and activities such as running, walking, jumping, or bicycling. The kneecap (patella) is attached to the large group of muscles in the thigh called the quadriceps and to the shinbone by the patellar tendon. The kneecap fits into grooves at the end of the thighbone (femur) called the femoral condyle. With repeated bending and straightening of the knee, you can irritate the inside surface of the kneecap, causing pain. Runner’s knee may also result from the way your hips, legs, knees, or feet are aligned. For example, if you have wide hips, underdeveloped thigh muscles, or if you are knock-kneed (your knees are abnormally close together and ankles are wide apart). You may also have this problem if your foot flattens too much when you walk or run (a condition called over-pronation). Runner's knee can best be prevented by strengthening your thigh muscles, particularly the inside part of this muscle group. It is also important to wear shoes that fit well and that have good arch supports.  (Click to Enlarge) Runner’s Knee (Patellofemoral Pain Syndrome) Symptoms The main symptom of runner’s knee is pain behind the kneecap. You may have pain when you walk, run, or sit for a long time. The pain is usually worse when you walk downhill or down stairs. Your knee may swell at times. You may feel or hear snapping, popping, or grinding in the knee. Runner’s Knee (Patellofemoral Pain Syndrome) Treatment Immediate treatment includes placing an ice pack on your knee for 20 to 30 minutes every 3 to 4 hours for the first 2 to 3 days while elevating your knee under a pillow until the pain goes away. Your Seacoast Orthopedics & Sports Medicine healthcare provider will review your symptoms and examine your knee. You will have knee X-rays and may have an MRI to check for damage to the surface of the patella, femur, or another injury. X-ray and MRI services are conveniently located at the Seacoast Orthopedics & Sports Medicine office. Your medical team may recommend that you:
Runner’s Knee (Patellofemoral Pain Syndrome) Recovery Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. If you return too soon you may worsen your injury. You may safely return to your normal activities when, starting from the top of the list and progressing to the end, each of the following is true:
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