Should I begin physical therapy right after a knee injury? | Total Performance Physical Therapy

Should I begin physical therapy right after a knee injury?

July 12, 2013

A common occurrence in physical therapy is for patients to delay treatment after an injury. Individuals often begin therapy months after pain or injuries arise instead of seeking immediate care. This can be attributed to several factors. Sometimes individuals want to “tough it out” and hope that the pain will go away on its own. This is very common in athletes who do not want to be sidelined from an injury. Another common reason is that individuals do not want to go through all the time and hassle of scheduling appointments and setting aside time to attend therapy sessions. Whatever the reason may be, it is extremely important to begin physical therapy as soon as an injury arises in order to prevent further damage from occurring and to prevent pain from impacting your everyday life for an extended period of time.

Pain in the knee joint is often overlooked and thought to be a result of overuse or doing too much. While sometimes this may be the case and the simple treatment of R.I.C.E. (rest, ice, compression, elevation) does the trick and you are pain free within a few days then you probably did overdo it. However, if you are still experiencing pain after a week of taking it easy then it is time to seek physical therapy. If you experienced a direct hit to your knee and you are having extreme pain and difficulty walking it is important to seek medical attention immediately.

The knee joint.
The knee joint.

The knee joint is composed of several bones, ligaments, tendons, and cartilage that support the entire weight of the body.  The cartilage acts as a shock absorber for the knee while ligaments and tendons provide support and stability at the joint. When any of these components become injured it places more stress on the other structures of the knee. If untreated this can lead to other injuries at the knee or even at neighboring joints.

When a knee ligament becomes injured, such as the anterior cruciate ligament (ACL) stress is placed on the other ligaments and cartilage of the knee because the body is trying to counteract the decreased stability by gaining stability through other structures. These other structures are not used to the increased force placed through them so they can get injured as well. In untreated ACL injuries it is very common to see meniscal tears, which is the cartilage in the knee. When the meniscus becomes compromised it can no longer provide effective cushioning at the knee and the bones begin to rub together. Early osteoarthritis is a result of this cascade of cartilage compromise due to untreated ligamentous injuries.

After an injury occurs the body tries to protect itself by increasing blood flow to the injured tissue in an attempt to begin the healing process. This results in swelling and pain initially but will resolve with proper treatment. If untreated this inflammation can continue and become a chronic issue that limits motion and function involving the knee. This inflammation can even damage tissues surrounding the injury if it becomes a chronic condition.

Injuries to the surrounding muscles can also result if physical therapy is not initiated soon after an injury. When your knee is injured and stability is compromised the quadriceps, hamstrings, and calf muscles must be relied on for stability. Since these muscles are not used to firing in this way they are often too weak to perform this new job and they experience over use injuries. This compensation mechanism your body uses by firing surrounding muscles in different ways can place stress on surrounding joints such as the ankle and hip joint.

If injuries are put on the back burner and physical therapy is not sought out right away recovery times can be much longer. If treated right away most individuals return to their previous level of activity within a short time frame, depending on the injury. However, if physical therapy is put off, what once was a quick fix turns into a longer recovery process due to the need to treat secondary injuries and improper mechanics that have developed.  This will not only impact your return to recreational activities but also increase the cost of treatment. More visits will be needed in order to correct the underlying issues than if treatment was initiated when there was only one injured structure.

Physical therapy should be initiated right after an injury to prevent secondary injuries from occurring. This can be accomplished using less time and appointments than before with the help of Direct Access. Direct Access allows individuals with certain insurances to set up an evaluation with a physical therapist without a referral from a physician. This allows treatment to begin much sooner in order to prevent secondary effects from occurring. Once an appointment is set up, a physical therapist will evaluate you and determine what impairments are causing you pain and limiting you from participating fully in recreational or everyday activities. Most often patients will be prescribed a strengthening program to improve the stability at the knee and prevent the surrounding muscles from developing overuse injuries. With the help of physical therapy you will be back to your favorite activities in no time!

Call Total Performance Physical Therapy today to schedule your appointment!  #TotalPPT