BY LUGA PODESTA, MD
Knee pain is a common complaint among drummers. When the knee becomes painful and or swollen, these are signs that should not be ignored.
There are a number of conditions that occur commonly in the knee as the result of excessive activity or a singular traumatic event such as a twist. Many of these conditions will result in knee pain. Differentiating which needs immediate medical attention and which conditions need medical evaluations is crucial.
The knee joint in made up of four bones: the femur (or thighbone), the tibia (or shinbone), the patella (or kneecap), and the fibula. The bones are held together by four ligaments: the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL). These ligaments provide the major stability for the knee.
There are also two types of “cartilage” within the knee, the meniscus and articular cartilage. Both structures provide stability and an almost friction-free, cushioned surface for the knee to bend.
The knee is also supported by a number of muscle tendons that attach to the bone of the knee to provide movement. All these structures can become injured due to a singular traumatic injury or more commonly from repetitive or overuse.
Kneecap or patellofemoral pain is the most common knee complaint among drummers. It is typically due to the kneecap moving abnormally within the groove of the femur or thighbone resulting in softening of the articular cartilage (chondromalacia). Pain is localized around the kneecap and swelling usually does not occur. Pain occurs or worsens with sitting, getting out of a chair, and climbing or descending stairs.
The knee is surrounded by several bursae (synovial fluid filled sacs) that can swell, become warm, red, and quite painfull. Bursitis can develop as a result of a blow to the knee or after repetitively kneeling. If this occurs this needs to be evaluated by a physician to determine that an infection has not developed.
Muscle tendon injures can also develop in drummers resulting in knee pain. These are also typically due to an acute injury or more commonly the result of repetitive stress on the tendon or repetitive use. These conditions are not orthopaedic emergencies, and typically resolve with conservative treatments such as rest, elevation, and ice.
However, if the pain does not subside within several days or if the injury is associated with a pop, severe pain, immediate swelling, giving way or buckling, locking, bruising or gross knee deformity seek medical attention immediately.
The development of knee pain in drummers needs to be taken seriously and if not treated appropriatly can lead to chronic problems and an inability to play effectively.