Knee Pain After Baseball
• Knee swelling?
• Can’t kneel down?
• Pinching and catching?
• Knee Pain Pitching?
Knee injuries can happen in baseball. We are not distance runners, we are sprinters.
We accelerate, decelerate, plant, pivot, throw and hit… not to mention pickles.
Knee injuries revolve around stabilization and proper stacking of the hips, knees and ankle… rehab works the same way.
You do not have to suffer through a knee injury. You don’t have to have knee pain pitching or catching.
You do not have to wait it out.
In this article, I will be going through the three most common knee injuries a baseball player can experience. I will go over some rehab concepts and what you need to know.
The three most common knee injuries are:
• Meniscus Tear
• Tendonitis
• Muscle strain
MENISCUS TEAR
• Knee catching?
• Clicking pain?
• Minor swelling or fluid?
A Meniscus Injury or Tear is the most common and most serious of the three.
Why?
Because it is a cartilage injury. If it is small and you can rehab early, it will not be surgical.
The larger and older the meniscus tears, the more probable you will be on the surgical route.
The meniscus is a cartilage cushion sitting in between the bones of the knee. In the past, we all thought it was only a cushion, but we now know it assists in positioning of the knee bones.
Like I said, knee health mainly revolves around stacking or geometry.
The great news about the meniscus is it is a rarity amongst cartilages. It has a blood supply to the outer one-third, which means that it can heal if it’s in the right environment.
The deeper the tear, the less potential of self-healing.
Meniscus Tear Causes
The knee is not intended to bend all three directions. Rotation or twisting is the one motion it hates the most. In fact, rotation of the leg happens primarily from the hip, so the knee really doesn’t need to rotate at all. So, don’t make it rotate. Rotation creates tearing on the meniscus, and just like many other baseball injuries, the tearing doesn’t always occur in a single incident.
Meniscus Tear Rehabilitation
The first thing we need to do is stabilize the knee from further rotation.
To do this, I like to recommend a lateral bend and rotational stabilization brace with minor extension check.
Here is one we recommend.
The next step we like to take is to locally strengthen the muscles of the knee.
We start from being off your feet to being on again.
Here is a great video on some starter knee meniscus rehab exercise.
Next, we advance to some proprioceptive weight-bearing exercises such as:
There are many progressions of exercises we give for knee pain pitching.
Meniscus Tear Treatments
Knees with meniscus injuries often have pain, swelling, and muscle guarding. These therapies will assist.
• Active Release Technique
• Deep tissue massage
• Tool-assisted tissue work
• Acupuncture
• Prolotherapy
• Chiropractic adjustments or mobilizations
• PRICE therapy
TENDONITIS
• Burning around the knee?
• Guitar string tendons?
• Worse when you run?
• Knee pain pitching?
Tendon injuries are fairly common in baseball.
Reduction of pain and treatment of Tendonitis are fairly easy, but Tendinitis itself is often a sign there are more injuries to come.
As we mentioned in the meniscus article, knee health is all about how the core, hip and ankle function.
Read this article and learn all you need to know about knee tendonitis. We will go over some treatments and physical therapy.
What is Tendonitis?
A tendon is a structure that connects muscle to bone. It is the long, stringy, dense portion of the drumstick that is not muscle or bone.
These tendons can become inflamed and painful.
Tendonitis Causes
Tendonitis occurs as damage builds to the tendon and muscle. Slowly, small tears will accumulate due to overuse or over demand on the tendon. These small tears are called micro-trauma. They fill with scar tissue and as such, are easily torn again. It’s an endless cycle if you allow it to be. Breaking this positive feedback loop is the key to complete recovery.
Typically it involves reoginization of cellular matrix, which only occurs as you use the muscle/ tendon complex under resistance (after a short rest period). Without using resistance in some form, typically tendonitis will not improve.
Tendonitis Rehabilitation
With tendonitis, we need to decrease pain before we rehab and then allow a steady resistance to help the tendon repair in a favorable way. Corrective exercise seems to stick better when the area is without pain, which is why a reduction of pain, via passive care, is helpful as we load the tendon in a controlled fashion.
If you need to decrease pain, a few deep tissue therapies can assist such as Graston and Active Release.
Here’s a video on them both.
After knee pain pitching is decreased, I like to start some corrective exercise with emphasis on how the knee is stacking.
Here is a short video on hip range of motion.
I know you’re thinking, “What does the hip have to do with the knee?” Actually, a lot so you’re going to have trust me on this. I have a 30-page article on knee injuries that will be published later this year for you to read if you still need convincing.
Here is the hip mobility. Enjoy.
What kinds of treatments can be done for Tendonitis?
These treatments are very helpful with muscle and tendon injuries. If you are looking for your “quick-fix”, these can be considered as such, but remember after your pain is gone, the need for rehab is still there.
• Active Release Technique
• Deep tissue massage
• Tool assisted tissue work
• Acupuncture
• Prolotherapy
• Chiropractic adjustments or mobilizations
• PRICE therapy
MUSCLE STRAIN
• Deep muscle ache?
• Worse when running?
• Better with massage?
Muscle strains are the most commonly occurring injury for a baseball player. There are many muscles in the body and all of them can be injured.
Around the knee, the most common muscles to be strained are ones that cross two joints.
These are:
• Three of the four hamstrings muscles: The semitendinosus, semimembranosus, and biceps femoris (long head)
• One of the four quad muscles: The rectus femoris
• Two of the calf muscles: The heads of the gastrocnemius
Complicated, I know.
Don’t worry too much about the specifics. Much of the advice I’m writing about will cover them all.
What is a Muscle Strain?
A muscle is the contracting part of the leg or calf. It is the girth. It is the part you see.
Muscles contract to move the knee and control running and pivoting.
They are the workhorses, and they can become damaged.
A strain is a low-grade tear. A Grade I tear to be exact.
Muscle Strain Causes
Muscles can be overused or overstretched.
Overuse can come in the form of doing too much over the day or week, but it can also be from poor running mechanics.
Improper running mechanics are a huge risk factor for development for muscle strains. If you require your muscle to do too much with poor form, they will tear while even while doing a normal day’s work.
Muscle Strain Rehabilitation
Rehab starts with decreasing spasm. Deep tissue work like Active Release is a great way to address this quickly so we can get to loading the muscle.
Next, as we load the muscle, we often need to start with a low load and low movement challenge. This video is an example of a hamstring isometric hold we start our players on. We called these Heel Digs
Next, we take them into normal squats and deadlifts.
Then, we move through sprinting drills. A- skip and B – skip are great starts if you have not seen them before. I know I never did in baseball.
If you are having knee pain pitching then you should have your pitching mechanics assessed as well. A decrease in knee bend will decrease your velocity according to current research.
What kinds of treatments can be done for a Muscle Strain?
These treatments are very helpful with muscle and tendon injuries. If you are looking for your “quick-fix”, these can be considered as such, but remember after your pain is gone, the need for rehab is still there. • Active Release Technique • Deep tissue massage • Tool assisted tissue work • Acupuncture • Prolotherapy • Chiropractic adjustments or mobilizations • PRICE therapy
After reading about all of these knee conditions I’m guessing you could still be wondering what to do about your knee. I know it’s a lot of information to take in at one time.
I like to start knee exams off with some history, orthopedic testing and Ultrasound examination whenever possible.
This video may shed some light on what that could look like.
If you need my assistance I am around as well. Just go the “Book Now” button at the top of the page.