Knee I Say More?

This column provides a general overview of Roller Derby medical problems and their initial treatment, and it is not intended for advice for an individual. Therefore, you must consult appropriate medical professionals for advice in treating any injury or medical problem that you specifically have. This manual is not intended to be a complete or final guide to medical treatment of anyone’s individual medical injury or problem.

The knee is a hinge joint that suffers greatly in roller derby. To paraphrase a song, these knees are made for walkin’. This is an overview of the injuries that seem most common, how to defend against them, and a plan of action if you are injured.

In a short article, I cannot provide coverage of all possible injuries but can highlight those seen in derby generally. Contusions are an “occupational hazard”, often due to knee pads slipping out of position and knee landings. These are treated by rest, ice, and a compression dressing. The frequently injured ligaments are, in order of frequency: PCL, ACL, and collateral.

The PCL (posterior cruciate ligament) and ACL (anterior cruciate ligament) are criss-crossing ligaments that limit the back and forth motion at the knee. Women are more susceptible to ACL injury due to anatomy and the tendency to land from jumps with the knee extended rather than flexed. Learning to land with the knees more flexed will help prevent ACL damage.

PCL injuries may relate to the knee pads not extending far enough down on the shin (see discussion on WFTDA Safety Squad). The collateral ligaments limit the side to side motion and are usually injured by side forces to the knee-one reason blocking low is dangerous and not allowed.

The femur rests on fiber-cartilage rings on the tibia (main bone of lower leg); they are called menisci. These rings can be damaged by repeated trauma or by a single forceful trauma. Fortunately, fractures of the knee are rare because fracturing the knee requires forces not easily generated in sports.

Protecting the knees requires strength and flexibility of the supporting muscles and ligaments. Although there are other support structures, including the cartilage and joint capsule, they are not responsive to proactive measures. You must build the muscle support of the knee. The major muscle groups to build are the quads and the hamstrings.

Your goal is strong muscles, not necessarily bulky ones. Flexibility is also crucial. You must gain and maintain flexibility. This includes a good warm up routine to get the blood flowing to the muscles and ligaments (remembering it takes longer in cold weather) and adherance to a thorough stretching program-in between bouts and practice as well as before.

You may have a plan from previous sports experience; if not, your trainer, PT person, or coach should be able to help. The WFTDA Safety Squad (see above) has posted useful plans online. The important thing is to be as faithful to a routine as you would to your significant other.

Knee pads are required and essential. I cannot go through all the possible pads available but good fit and bulk are vital. There are fans of 187 Pro Knees and Rector Fat Boys which are thicker. Pro Designed, Inc. provides custom-fit pads for those who experience slippage problems. The WFTDA Safety Squad site had a recent lengthy discussion of pads, including the thought that hockey-style pads (which include shin guard) are worth considering.

When should you see a medical professional? If you cannot be certain whether it is dangerous to skate. How do you know? Inability to use or bear weight on the knee is the best marker. Rapid swelling and/or bruising is a serious sign. If your knee pain is not easily relieved with rest and icing, see a doctor right away.

Inability to move your knee through a complete range of motion or locking (catching) of the knee can indicate an injury with which you need help.

Roll and Rock, safely. Your knees are yours long after derby.