Knee pain and injury can have a wide range of causes and conditions.

At Agility Physiotherapy and Pilates our experienced practitioners regularly manage and treat knee pain from sports injuries, and adolescent injuries to arthritis and knee replacements.

Our clinics offer hands on treatment together with well-equipped Pilates Studios and a Gym to progress you through your journey to full strength and recovery from knee pain and injuries.

More information about Acute knee injuries

These can occur from a sporting injury or a fall.

The knee joint superficially is supported by muscles such as the quadriceps at the front and the hamstrings at the back. Deep in the knee at bone level the knee is stabilized by 4 ligaments.

The medial collateral ligament and lateral collateral ligament are positioned on the sides of the knee, inside and outside and secure the femur bone to the tibia on the inside and the femur to the fibula on the outside providing lateral and medial directional support. The medial ligament is the most frequently injured in field sports with injuries usually involving another player hitting the outside of the leg and forcing the knee inwards.

Collateral ligament tears are graded 1-3. Most of them heal without surgery. If it’s a grade 2 or 3 tear a knee brace is recommended to be worn for 4-6 weeks to ensure there are no further episodes of force on the ligament that could tear the newly forming repair.

Our physiotherapy treatment for these ligament tears includes assessment to ascertain the extent of the injury, pain management, bracing if necessary, graded exercises to maintain and improve strength in the muscles supporting the knee. We will recommend a referral for imaging if the injury seems serious so that we can work with you to understand your time lines with recovery and plan the right treatment plan for you.

Cruciate ligament tears

The anterior and posterior cruciate ligaments are deep in the knee and cross over one another providing diagonal and rotary support to the knee. The most frequent mechanism of injury is, pivoting, twisting, changing direction with force added. That usually puts load on the anterior cruciate ligament. These injuries are most commonly seen in football, netball and skiing where there is acute stopping and sudden changes in direction .

Rehabilitation: Complete tears of the ACL usually necessitate surgery and a long slow rehab of over 12 months. Our experienced physiotherapists can assist with the pain, stiffness and getting into the right rehabilitation plan.

Graded strengthening after surgery needs to be closed chain - feet in contact with ground or equipment to prevent strain on the new graft. Work on Pilates equipment such as the Reformer and Wunda chair is a natural go to for rehabilitation. We can start you on rehabilitation journey with safe gentle effective exercises in our Pilates studios soon after surgery.

The meniscus (cartilage)

The meniscus is a moon shaped wedge of cartilage positioned between the tibia below and femur above. It acts as a cushion, deepens the knee joint and helps with knee stability as well as movement like twisting.

The meniscus can be torn from one big twisting event or many microevents involving twisting.

The preferred management for meniscal tears is conservative management. Our physiotherapists can assist with pain management, managing swelling, graded exercise and planning your rehabilitation. Imaging can be recommended for acute injuries in younger clients with a lot of locking and pain to determine the type and location of the tear as surgical repair of the meniscus may be warranted.

Fractures and Dislocations

Serious injuries to the knee can also involve fractures of any of the bones depending on the injury force and patella (knee cap) injuries like dislocations can also occur.

After bone healing strengthening is important and we can advise you about time lines and what to do and plan out a rehabilitation pathway.

Overuse and Repetitive Strain injuries

Overuse injuries occur over time with repetitive tasks and the underlying cause needs to be identified and mitigated so they don’t keep coming back. As well as treating the actual injury our physiotherapy staff set about examining muscle imbalances, biomechanical issues, foot alignment and training issues.

Common over use injuries around the knee include:-

Tendinitis

Inflammation of the tendons around the knee, such as the patellar tendon (jumper's knee) or hamstring tendons.

Chronic tendonitis is usually termed tendinopathy if it has been present for longer than 6-8 weeks. We use Shockwave to accelerate healing in chronic tendinopathies of the knee to stimulates a healing response.

Patellofemoral Joint Pain

Pain around the kneecap due to improper tracking of the patella. Patellofemoral Joint Pain can occur in adults and adolescents.

In adults its usually caused by training errors, weight gain and inactivity, another knee injury that has left you with knee weakness, especially in the quadriceps, poor knee alignment like knock knees and very weak gluteals and muscles around the pelvis.

This condition is very treatable with a knee taping technique called the McConnell technique and specific quadricep exercises. Our physiotherapists will also assess alignment, look for tight muscles, check for weakness around the pelvis. Proper foot wear and even orthotics may be indicated.

You will be shown how to tape your knee to “realign” the patella so it doesn’t rub and cause pain and a treatment plan of exercise and scope of how long this will take to recover will be discussed.

Iliotibial Band Syndrome (ITBS)

Pain on the outer side of the knee, often occurs in runners and cyclists. We can assess the likely cause and assist you with pain management, stretching and strengthening programs.

Adolescent injuries

Patellofemoral Joint Pain

This can occur in adults and adolescents. Its pain under the knee cap brought on by running, stairs, and prolonged sitting. Big growth spurts in adolescents often correspond to this injury. With growth comes relative weakness in the quadriceps muscles combined with the increase in training load as a teenager reaches rep teams or training is more frequent.

This condition is very treatable with a knee taping technique called the McConnell technique and specific quadricep exercises. Our physiotherapists will also assess alignment, look for tight muscles , check for weakness around the pelvis. Proper foot wear and even orthotics may be indicated.

You will be shown how to tape your knee to “realign” it so it doesn’t rub and cause pain and a treatment plan of exercise and scope of how long this will take to recover will be discussed.

Osgood Schlatter’s condition

This is a growth-related condition where the growth plate in the tibia just below the knee becomes painful. The patella tendon, the tendon connecting all the quadricep muscles to the tibia connect at this growth plate line. When an active sporty adolescent is going through the rapid growth spurt the bone cells at this growth plate are widened and it is prone to jarring injuries.

See our experienced physiotherapists for optimal results. This is a condition that we teach you to manage. No need to stop sport. We teach you taping techniques and give advice about stretching, strengthening and managing your training workload.

Knee Arthritis

The most common causes of knee arthritis are:-

• Osteoarthritis
• A previous traumatic injury or fracture into knee
• Rheumatoid arthritis
• Poor alignment - genetic

Hip arthritis

The most common causes of hip arthritis include:-

• Osteoarthritis - wear and tear from aging and overuse.
• Rheumatoid Arthritis- An autoimmune disease that causes inflammation in the joints.
• Other Causes: Injuries such as a car accident resulting in knee fractures or joint dislocation.

Osteoarthritis is the most common cause

In osteoarthritis the meniscus in the knee joint wears away, bones press on bones causing pain, stiffness, inflammation and reduced mobility. It develops gradually, often due to wear and tear, and can significantly impact daily activities.

Pain felt is most commonly on the inside of the joint (medial).

The knee may feel stiff, especially after period of rest like getting out of bed or out of a chair. Range may be limiting in squatting.

You can’t reverse the damage that has been done but progress can be slowed and some range gained with targeted knee muscle strengthening to stabilize the joint, gait modification, a switch to low impact exercise like cycling or swimming and weight loss if you are overweight.

Treatment

Our physiotherapists can assess your knees and identify weakness and prescribe a treatment and strengthening program so you can manage your knee pain. We are all trained in Clinical Pilates.

Clinical Pilates is a go to for knee muscle strengthening as many of the Pilates exercises can have less loading into the knee joint and we target the knee and pelvic stabilizing muscles.

If you are in a lot of pain, we can also start you on Hydrotherapy.

Other lifestyle changes:-

• Modify Activities: Adapt daily activities to minimize pain and strain on the knee
• Pace Yourself: Avoid prolonged periods of sitting or standing, and take breaks when needed.
• Choose Appropriate Footwear: Wear supportive shoes with cushioned soles. No high heels
• Lose weight if you are overweight
• Join our GLA:D program: This is an education and strengthening program that runs for 6 weeks to kick start your hip rehab. See our website article about GLAD

Knee replacement surgery

Pre-Hab and Rehabilitation for knee replacements

Pre-Hab
If you need to have surgery for a knee replacement our team can help you build strength, flexibility, mobility, and balance before surgery to improve your post-surgical outcomes.

We can design a Clinical Pilates program targeting strengthening knee muscles, pelvis and core to improve mobility, balance and to expedite your recovery after surgery or we can give you a home program.

A great conditioning program before surgery will kick start your recovery and give you the strength and balance to get up and about with confidence after surgery.

We can also assist with training on using crutches, how to set your home up with shower chairs and elevated toilet seating, height of “lounge chairs” etc, and Chair transfers.

Post-operative treatment
After surgery we can see you for home visits and assist with pain management then move you towards post operative rehabilitation to strengthen and mobilize. You should be starting strengthening and mobilizing exercises from day one.

Hydrotherapy, after your wound has been deemed by your surgeon to be healed enough, can be a great way to mobilize and exercise with less weight through your joints. Your first session in a warm pool will feel amazing in terms of pain relief.

Clinical Pilates offers light graded exercises in the early post op period through to increased loading and more complex movements in preparation for return to your activity goals.

Our physiotherapists and exercise physiologists can progress your exercise rehabilitation and tailor your progressions for you.

A prosthetic knee will reduce the pain but you must put the work into strengthening throughout the legs, pelvis, trunk and legs to get your optimal result.

Our team of physiotherapists and exercise therapist love to see our clients through the full course of their rehab and to see them off to a happy, strong, pain free life.

Home visits for post knee surgery

We are happy to see you at home for the first few sessions and set you up with some small equipment to start you on your path to recovery.

We do home visits in suburbs up to 8kms from our clinics including:-

Ascot, Hamilton, Hendra, Nundah, Eagle Farm, Pinkenba, Clayfield, Wooloowin, Wilston, Gordon Park, Grange, Stafford, Herston, Newstead, New Farm, Nudgee, Red Hill, Kedron, Paddington, Milton, Toowong, Bardon, Kelvin Grove, Newmarket, Alderley.

Bulimba based Physio and Pilates Clinic - suburbs as far as Bulimba, Hawthorne, Morningside, East Brisbane, Seven Hills, Cannon Hill, Coorparoo, Camp Hill, Carina, Murarrie, Norman Park, East Brisbane, Kangaroo Point, Westend, South Brisbane, Coorparoo, Stones corner, Carindale.