Ultimate Frisbee Knee Injuries with Wil Seto
Mark: Hi, it's Mark from Remarkable Speaking. I'm here with Wil Seto, he's the clinical director, the owner of Insync Physiotherapy in Vancouver. And we're gonna talk about your health. We're gonna talk about knee injuries today. How you doing Wil?
Wil: I'm good. Thanks. Yeah, I want to talk specifically about knee injuries in Ultimate Frisbee.
Mark: So, is there something different about knee injuries that have to do with this sport?
Wil: The reason why I wanna talk about Ultimate Frisbee knee injuries as well is because I I have some experience with it personally. I used to play competitive Ultimate Frisbee and I've sustained a knee injury. And it just seems like a growing sport that keeps growing here in the lower mainland. And there's a lot of cutting and there's a lot of fast starting and stopping type of movements and then pivoting and then things that basically cause you to plant your foot and then you have to like change directions really quickly.
A little bit more so than like soccer. Football's a little bit different, but like football you get tackled below the knee. But I think it's something that's worth talking about because there's actually a high rate of knee injuries related to sport.
And I used to work a lot of Frisbee tournaments and teams. And having my experience working with national teams and at world championships and world games. Definitely see it at the high level to the more recreational levels. So you can classify the knee injuries as either overuse repetitive type of injuries or more like acute and traumatic injuries.
And so I think it's really important to get a feel for like, when you have an injury, if it doesn't get any better after like 48 hours. And especially if it goes three or four days and it's still not getting better. Then you should probably get it looked at because you wanna really get an accurate diagnosis of what's going on.
And so this is where, like, if you have a repetitive type of injury, then you wanna really see, okay, well what's going on in there. You may not have had a contact the knee or let's say you did, but maybe you're not really sure. Because you can get things like overuse, repetitive tendinopathy, And this is an overuse injury in the tendon of the quads that attaches below the knee, and that's very common. Or you can get an overuse syndrome in the kneecap where it's like pulling on what's called the IT band. And so there's this syndrome called IT band syndrome. And so those are two of the more common type of overuse type of injuries in the knee.
And especially with younger athletes and with Ultimate Frisbee now being taught in the school curriculum. So you have these kids who are growing and they're playing the sport and they're starting to play it at a competitive level. And so you can get a condition where it may seem like an overuse injury, which it could be, but then there's this condition called Osgood Schlatter. It can be a serious condition where, you know, like it's the insertion point of that tendon onto the bone because with maturing bones and maturing athletes, their bones aren't fully formed yet. And so it can cause disruption of that attachment point, which is important to treat and to really look at and manage.
So that's sort of the repetitive and overuse side of things. And then things that we see a lot of in the clinic as well is the acute stuff. So whether it's a ligament injury from your medial or your lateral ligaments, which is called the medial collateral or the lateral collateral ligaments, or some of the more major ligaments in your knee, like your ACL, which is the anterior cruciate ligament. And then usually if you have like something bigger happening within that, you can also have an injury to your meniscus, which is basically the shock absorber in the knee, but it also acts not just as the shock absorber, but also provides more normalization of your movement of that knee.
So quite often, when you have an injury to like say your ACL. The major ligament in your knee that provides stability. And this can commonly happen, if you're planting your foot and then you go to pivot and then change directions really quick, or someone just hits you lightly, but you're planted, it can injure that ligament or your MCL, or your meniscus. Quite often, there's a term it's called the triad of injuries, which basically involves all three. So your ACL, MCL and your meniscus.
Mark: If this has happened, I've hurt myself playing Ultimate Frisbee, my knee is hurting. It's not getting better after 48 hours, like you said, but I can't get in to see my doctor. That's a really common thing these days. Is it actually alright for me to get in to see a physio who can diagnose exactly what's going on. And if I need referral to a doctor, you're gonna refer me to a doctor?
Wil: Exactly. And it's actually even better if you come see physio first. Unless like there's the rare occasion where I have some clients who their doctor is really adept and they can get in to see them and they're able to like, Hey, yeah, know exactly what's going on.
But typically what you wanna do is you wanna come see your physio first and we do work with your doctor or doctors and that's the healthcare team. For example, we had a gal who injured her knee earlier this year, actually, I think it was back in January. I can't remember how she did it, but she ruptured her ACL.
Fortunately was just the ACL and there was nothing else going on with meniscus or MCL. And she wasn't really sure what to do and she was very uncertain and she was starting to train. She wanted to do like her first Ironman. And then felt really deflated. But when we looked at it, I said, you know, you gotta get some scans done, get this looked at.
So I sent her back to her family doctor, but also in that visit to her family doctor, I recommended that she's the specialist that I connected her with. And then also recommending that maybe we should get some scans. Turns out that she had that blown ACL, complete rupture. And you know, and there's different options for that, but it's just good to know that diagnosis and that's what I was suspecting.
But if we have that accurate diagnosis whether it's like assessing it through us at the physio clinic, but then getting more detailed through scans that we recommend. It's gonna help us guide you towards the management of this injury or injuries whatever's going on because we wanna like, you know, okay, so this is what's happening, it's not just an overuse injury. So we have to be careful with it and this is kind of how we wanna progress.
Or if it's like just an over, I mean, I'm not saying just, but it it's just an overuse thing happening and it's not like a major ligament injury at all and quite often people may think that it could be right because they're having pain and it feels clunky or whatever. Then we wanna start to progress it and work on the rehab and the treatment and the management of that non-acute aspect. So that way we can get it better, faster.
Mark: So diagnosis is really important. What's a typical course of treatment?
Wil: Well, first and foremost, if it's you know, acutely injured, even if it's a repetitive thing, like it could be like a repetitive overuse, but it's just like recently flared up. We wanna just let that settle down for the first 24 hours, at the most 48 hours. Typically, with injuries, they'll settle down within 48 to 72 hours. So ice, compress, elevate. They'll follow the RICE PRICE principle. They'll protect it, rest it, ice it, compress it and elevate it. And then we wanna start to get it moving a little bit more and we start look at, well, the body's gonna compensate like you wouldn't believe, like within those first 24 or 48 hours.
So we wanna start to normalize, not only the motion as best we can, but the ability for that knee to take on weight and to take on load and resistance. And that's important. And depending on what's going on with it, we wanna be careful what kind of load that we're gonna do.
So for example, if it's a completely torn ACL, we're not gonna do certain things within the first 48 to 72 hours in terms of loading it. Versus if it's an overuse thing, then we will load it in a different way. So that's important to know. Because like you don't wanna do certain motions if it's a torn ACL, versus if it's an overuse thing. We do wanna work through if it's a overuse of the patella tendon and whatever it is, we want to work through certain things to get it moving better. So then we know how to prescribe things. We know what to release and what things to really focus and get you back playing again.
Mark: If you've injured your knee, if it's hurting, get in to see the physiotherapist at Insync Physio, you can reach them in Vancouver, (604) 566-9716. Or on their website, you can book right there insyncphysio.com. They have two locations. They're also in North Burnaby. You can call them there at (604) 298-4878 or book online same thing. Thanks Wil.
Wil: No problem.