The knee is one of the most commonly injured areas of the human body, it is especially prevalent in the athletic community with traumatic possibly career ending injuries and then at the other end of the spectrum it is a common source of knee pain in our elderly population as well.
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The knee is a very complex joint, its surfaces are not congruent with one another and due to this anomaly it sets us up for bouts of pain and injury, whether early in our lives or later on in our lives. The knee has 2 major supporting ligaments, the anterior and posterior cruciate ligaments which help to limit the amount of forwards and backwards shearing forces going through the joint, as well as limiting rotational forces. It is also surrounded by other strong ligaments to support the knee in its various roles along with it surrounded above and below by your quadriceps, hamstrings, adductors and your calf muscles (gastrocnemius and soleus). The knee also has many fluid filled sacs known as bursa to help with friction free movement amongst these muscles.
As well as this to help protect the joint you have two menisci in each knee plus cartilage for shock absorption and to stop the bones rubbing against one other. Another important part of the knee is your patella, which is often another source of knee pain. Pain in and surrounding the knee itself does not mean that it is actually from these areas however. Often times with the knee, poor foot and ankle bio-mechanics can predispose us to knee problems, as does poor bio-mechanics of the hip.
Your low back and hip are also two musculoskeletal areas that can refer pain to your knee. Rarely, pain can be attributed to an inflammatory condition or underlying pathology. As you can see due to the many structures and areas of referral to the knee it is integral to your health and well-being that if you have any knee pain to get an appointment and get it checked out.
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If you have knee pain you should get it checked out if:
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It has lasted nonstop for a few days
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You are getting pain at night
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You are having difficulty walking or moving about
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The knee is locking in place without warning
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The knee is giving out from underneath you
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You have had trauma to the area
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You have pain elsewhere but you are getting referral to the knee
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You have had a previous injury to the area and it has been unresolved
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You have any clicking, grinding, popping or a mixture of any of these
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If there is any warmth and swelling around the area
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If you have a fever and knee pain
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If you have knee pain plus any of the following fever, loss of weight, night sweats, fatigue and constantly getting sick
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You have any questions regarding your knee
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Prevention Of Knee Pain
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There are a number of things that you can do to help minimise the risk of you getting knee pain or worsening the pain that you are experiencing:
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Making sure you are using proper equipment that is specific to you, including proper footwear
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Making sure the grounds/facilities don’t have any dangerous areas before you begin your activity e.g. potholes, water on the ground etc.
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If you have an injury, rest it, don’t risk it
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Making sure training procedures are structured properly and that they allow for adequate rest
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Losing weight decreases pressure on your knees significantly
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Low impact exercises are great for the knee and help keep your knees pain-free for longer
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Getting regular treatment can help prevent re-occurrence due to the fact that someone is constantly keeping an eye out and make adjustments with you
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Common Knee Complaints
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The knee is a large, intricate structure and as such it there are many structures that can cause it pain. Therefore it is best to divide the knee into areas.
These include:
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Front of the knee
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Patellofemoral pain disorder
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Osgood Schlatter’s disease
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Bursitis/tendinopathy
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Osteoarthritis
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Back of the knee
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Calf muscle strain/tendinopathy
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Hamstring muscle strain/tendinopathy
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Baker’s cyst
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Osteoarthritis
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Posterior cruciate ligament sprain/rupture
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Inside the knee
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Cartilage tear
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Meniscus tear
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Cruciate ligament sprain/tear
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Swelling inside the knee
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Osteoarthritis
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Loose bone fragments
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Inner portion of the knee
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Ligament sprain/rupture
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Osteoarthritis
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Meniscus tear
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Outer portion of the knee
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Ligament sprain/rupture
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Meniscus tear
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Iliotibial band tendinopathy
Your pain may not be on this list, this is only the most common sources of pain in the knee and we do address other sources and causes of pain as well.
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Treatment Of Your Knee Pain
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Depending on the cause of your knee pain, how you got your knee pain, severity of the pain, duration of pain, extent of pain and other bio-mechanical adaptations that are contributing to the pain, play a factor in how it is treated. Usually in the initial stages of treatment we focus immediately on the knee and its most immediate surrounding and supporting structures to help prevent further damage to it as well as to support proper healing. After this has settled then what occurs is we take a look at the other areas of bio-mechanical dysfunction that we found during the initial consultation and address them, these areas will particularly involve the pelvis, hip and foot as well as the knee. After this stage we then take a global approach to your pain and make corrections that we saw from your initial consultation and treat the whole body such that the pain syndromes that you have been experiencing don’t come back as often or with the same intensity or duration.