TLDR;
This video explains the three different types of knee swelling: effusion (intra-articular), soft tissue swelling (extra-articular), and apparent swelling (due to muscle atrophy). It details the causes, symptoms, and treatment strategies for each type, emphasizing the importance of restoring full knee extension, normal gait, and quadriceps activation to reduce swelling and regain function.
- Effusion is swelling inside the joint capsule, often due to damage to the meniscus, cartilage, or ligaments.
- Soft tissue swelling occurs outside the joint capsule, often due to inflammation or lymphatic system imbalance.
- Apparent swelling is a visual effect caused by muscle atrophy, making the knee appear swollen.
Introduction to Knee Swelling [0:02]
The video introduces the topic of knee swelling, clarifying that not all knee swelling is the same. It outlines the three main types of knee swelling: effusion (swelling within the joint capsule), soft tissue swelling (swelling outside the joint capsule), and apparent swelling (where the knee appears swollen due to muscle atrophy). The video aims to educate viewers on the causes of each type of swelling and provide strategies for treatment and restoring knee function.
Effusion: Intra-articular Swelling [0:50]
Effusion is described as intra-articular swelling, meaning it occurs inside the joint capsule. This type of swelling indicates a problem within the knee joint, such as damage to the meniscus, cartilage, or ligaments. This damage causes the synovium, the tissue lining the joint capsule, to produce excess synovial fluid. While effusion is a normal response to injury or surgery, it can limit mobility. Treatment includes rest, elevation, ice, compression, and NSAIDs.
Soft Tissue Swelling: Extra-articular Swelling [2:03]
Soft tissue swelling occurs outside the knee joint capsule, affecting muscles like the quadriceps (especially the VMO), the muscles of the Pez Anserinus, the gastrocsoleus complex, and bursal tissue. Initially, it's caused by inflammation from injury or surgery, but it can evolve into a fluid management issue in the lymphatic system. The lymphatic system relies on muscle contractions to circulate fluid. Lack of full knee extension or a limp can disrupt this system, leading to excess fluid buildup. Restoring full knee extension, range of motion, and a normal gait pattern are crucial for treatment. Passive methods like using a bag of rice for extension and active methods like prone knee extensions and theraband exercises are recommended.
Restoring Knee Extension: Passive and Active Methods [5:25]
The video details both passive and active methods to restore full knee extension, which is crucial for managing soft tissue swelling. Passive methods include using two chairs and a bag of rice to apply gentle, sustained pressure to the shin, encouraging extension. Active methods involve exercises like prone knee extensions, theraband passive extensions (walkouts), and theraband active extensions, all aimed at improving range of motion and quadriceps strength. The importance of maintaining proper form and gradually increasing the duration and intensity of these exercises is emphasized.
Apparent Swelling: Addressing Muscle Atrophy [8:17]
Apparent swelling is not actual swelling but rather the visual effect of muscle atrophy, particularly in the quadriceps. The injured leg may appear swollen because the muscles have shrunk, making the patella seem larger in comparison. Treatment focuses on restoring muscle mass, especially in the VMO (Vastus Medialis Oblique) muscle. Recommended exercises include side step-ups or step-downs with a VMO focus, multi-directional single-leg balance exercises, and shrimp squats or assisted shrimp squats.
General Recommendations for Knee Swelling [9:30]
The video concludes by stating that swelling without fever or redness is generally not worrisome. The initial approach should focus on achieving full knee extension, a normal gait pattern, and good quadriceps activation. If swelling persists after addressing these factors, seeking professional medical advice is recommended.