Common Knee Injuries in Taekwon-Do
Dr. Vincent J. Muscarella DPM
7th. Dan Black Belt
- Graduated from Temple University School of Podiatric Medicine 1977
- Completed Surgical Residency from Metropolitan Hospital, Phila, PA 1983, served as Chief Resident
- Chairman Dept of Podiatric Surgery, Suburban General Hospital, 1983-1998
- Board Certified in Foot and Ankle Reconstructive Surgery- 1987
- Board Certified in Podiatric Orthopedics- 1987
- Assistant Dean for Clinical Education, TUSPM, Phila, PA 1995-2008
- Chairman of the Department of Podiatric Surgery, OCPM, Cleveland, OH 1998-2001
- Associate Professor, Dept of Surgery, OCPM, Cleveland, OH 1998-2001
- Associate Professor, Dept of Surgery, TUSPM, Phila, PA 2005-2008
- Residency Director for Podiatric Surgical Residency, Temple University Hospital, Phila, PA 2005-2008
- Noted national lecturer for Surgical Seminars
- Noted author for Surgical Journals
- Assistant Editor for the Journal of Foot and Ankle Surgery
- Maintains private practice in the Phila area
The knee is the largest joint of the body, and is vulnerable to a variety of injuries. Since it is a complex joint, care must be taken to evaluate any knee injury. In martial arts, especially in ones like TaeKwonDo, that emphasize fast snapping kicks, and high jumps, injuries can be not only devastating, but career ending. Knee injuries are the leading cause of long term disability in atheletes. The best prevention for knee injuries is: 1) proper conditioning of the muscles of the legs, 2) common sense in training, and 3) an understanding of the mechanics of the knee.
The 3 bones that make up the knee are the femur (thigh), the tibia (calf) and the patella (knee cap). Ligaments are dense, fibrous bands of tissue that connect the bones and provide stability. They do NOT stretch, but under enough tension will tear or rupture. The 2 major ligaments that provide side to side stability are the medial and lateral collateral ligaments. (See diagram).
The medial (means middle or inner) meniscus and the lateral (outer) meniscus sits between the femur and the tibia and act as cushioning devices (somewhat like a slippery pillow).
The real stabilizing structures are the anterior (one in front) and the posterior (the one in the back) cruciate ligaments. They are so named because the cross each other in the center of the knee joint. The are VERY important. They provide stability to the knee joint so it does not rotate in a circle, and over extend.
Lastly, the muscles surrounding the knee joint provide more stability, but more importantly the energy and force for the joint to move. One must remember: the knee joint’s primary movement or axis is in one direction only! The knee flexes and extends. It does not rotate in a circle like the hip. Any deviation to this principle will cause an injury.
The most benign and simplest injuries to the knee are caused by overuse. They include tendonitis, especially the patellar tendon and/or the hamstrings from over-extending a front kick, or excessive jumping. Rest, ice, anti-inflammatory medication (like ibuprofen) and sometimes physical therapy and immobilization with a brace are needed. Proper conditioning of the quadriceps and hamstrings are needed before return to full activity to prevent further injury.
Another, not so common, but possible injury is a dislocation of the patella, or knee cap. This occurs more commonly in younger practitioners, due to the weak nature of their immature ligaments. You may hear a “pop”, and the person will have pain, and an inability to stand. Upon visual observation, you will notice that the patella is pointing sideways on the knee. These can be reduced immediately, but if no one in the school has any experience in this condition, get the person to an Emergency Room where it can be reduced. Again, with proper treatment and conditioning, one may return to training after healing.
More serious injuries include: ACL (anterior cruciate ligament) tears, MCL (medial collateral ligament) tears, PCL (posterior cruciate ligament tears) and torn cartilage (medial or lateral meniscus tears.
ACL tears can occur when changing direction rapidly, landing from a jump, or keeping the foot planted and rotating the body around the fixed foot. These are serious and require proper evaluation by an orthopedic specialist, and many times surgery and rehabilitation.
PCL tears may be caused by a direct blow to the front of the knee. Again, this is a serious injury and requires immediate attention and a break from training until evaluation, treatment, and rehabilitation are complete.
MCL tears are caused by a direct blow to the side of the knee. An example is in sparring when the lead knee is accidently kicked by your opponent.
A tear in the cartilage (meniscus) occurs when twisting (can be while stepping, kicking, or landing), changing directions quickly, and pivoting (as in throwing a kick). Direct contact is often involved. Swelling and clicking or locking of the knee joint is common symptoms. Proper medical evaluation, possibly an MRI, and arthroscopic surgery may be needed. These should not be ignored, as they can cause progressive destruction of the joint which in later years will require a joint replacement surgery.
In conclusion, the most important advice is to seek treatment as soon as possible if you:
1) Hear a popping noise and feel your knee give out
2) Have severe pain
3) Cannot move the knee
4) Begin limping
5) Have swelling and or discoloration at the injury site
The best prevention is to train wisely both inside and outside the school. Strengthen the knee joint with strength training, stretch properly and often, and understand your limits for your rank, your body type, and your age.