Knee pain can be caused by a sudden injury, an overuse injury, or by an underlying condition such as arthritis. Treatment will vary depending on the cause. Symptoms of knee injury can include pain, swelling, stiffness and instability.
Understanding what is at the source of your pain or condition is the first step in finding a solution that is right for you.
Identifying specific issues with your knee and locating the source of pain is the first step in treatment. Does it swell? Does the joint feel unstable? Is there catching or clicking in the joint with movement? Does the knee have full range of motion?
Depending on the cause of your pain or instability, specific knee braces or foot orthotics to help with your alignment can be used. They can help alleviate pain and support the knee to help your recovery.
The knee is a joint which has three parts. The thigh bone (femur) meets the large shin bone (tibia) forming the main knee joint. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (patella) joins the femur to form a third joint, called the patellofemoral joint.
The knee joint is surrounded by a joint capsule with ligaments strapping the inside and outside of the joint (collateral ligaments) as well as crossing within the joint (cruciate ligaments). These ligaments provide stability and strength to the knee joint.
The meniscus is a thickened cartilage pad between the two joints formed by the femur and tibia. The meniscus acts as a smooth surface for the joint to move on. The knee joint is surrounded by fluid-filled sacs called bursae, which serve as gliding surfaces that reduce friction of the tendons. There is a large tendon (patellar tendon) which envelopes the knee cap and attaches to the front of the tibia bone. There are large blood vessels passing through the area behind the knee (referred to as the popliteal space). The large muscles of the thigh move the knee. In the front of the thigh, the quadriceps muscles extend, or straighten, the knee joint by pulling on the patellar tendon. In the back of the thigh, the hamstring muscles flex, or bend, the knee. The knee also rotates slightly under guidance of specific muscles of the thigh.
Trauma can cause injury to the ligaments on the inner portion of the knee (medial collateral ligament), the outer portion of the knee (lateral collateral ligament), or within the knee (cruciate ligaments). Injuries to these areas are noticed as immediate pain, but are sometimes difficult to localize. Usually, a collateral ligament injury is felt on the inner or outer portions of the knee. A collateral ligament injury is often associated with local tenderness over the area of the ligament involved. A cruciate ligament injury is felt deep within the knee. It is sometimes noticed with a “popping” sensation with the initial trauma. A ligament injury to the knee is usually painful at rest and may be swollen and warm. The pain is usually worsened by bending the knee, putting weight on the knee, or walking. The severity of the injury can vary from mild (minor stretching or tearing of the ligament fibers, such as a low grade sprain) to severe (complete tear of the ligament fibers). Patients can have more than one area injured in a single traumatic event.
Arthitis is associated with pain and swelling of a joint. The causes of knee joint pain and swelling range from noninflammatory types of arthritis such as osteoarthritis, which is a degeneration of the cartilage of the knee, to inflammatory types of arthritis (such as rheumatoid arthritis or gout). Treatment of the arthritis is directed according to the nature of the specific type of arthritis.
Pain in the kneecap area can be experienced by, among others, people who participate in jumping sports or track and field activities. Young women, and boys and girls in puberty (rapid growth of muscles and bones), also frequently experience kneecap pain. Symptoms become particularly noticeable when using stairs (walking downstairs can be especially painful) or when the knee remains bent for a long period of time. This means that prolonged periods of sitting, crouching, or sleeping with bent knees can lead to extensive pain.
Injuries such as Patella dislocation, patella tendoniitis or chodromalacia patella often have their beginnings with alignment issues compounded by muscle weakness patterns and other biomechanical factors such as anatomical variations and improper movement patterns. These can often be identified in a biomechanical exam and are often treated with physical therapy, specific knee braces and when foot mechanics are at effecting knee alignment foot orthotics may be utilized.
Your doctor may refer you to OKAPED to see a Canadian Certified Pedorthist for Pedorthic management of your knee pain. This may include orthopaedic footwear, shoe selection guidance, orthotics, foot related products or knee braces. If you know your condition and want to learn about new products and treatments please give us a call.