Knee Joint Pain
The knee is the largest joint in the body and normally one of the most stable. It has large ligaments which control its movement and large muscles to give it power and stability. Despite the strength of the knee it is often injured because of the very large forces placed on it in sports and recreational activities. Physiotherapists are closely involved in knee assessment and treatment.
There are many causes of knee pain, varying with the age of the person and the activities they pursue. Your physiotherapist can diagnose and treat your knee problem effectively.
Patello-femoral syndrome or anterior knee pain
The patello-femoral joint is between the knee cap and the front surface of the thigh bone at the knee. The kneecap tracks in the groove on the front of the thigh bone and a disturbance in the balance of the knee muscles can allow the kneecap to track more to the outside.
This can increase the pressure on the joint areas and cause pain. Any changes in the cartilage behind the kneecap can also contribute. A softening of the cartilage of the back of the kneecap is known as chondromalacia patella.
Physios can treat weakness of the quadriceps muscles and stretch out any tight structures which contribute to the problem.
Recurrent patellar dislocation
The kneecap can dislocate sideways to the outside under certain conditions, such as lunging or twisting on the knee whilst weight bearing. This is more common in hypermobile people, especially young women. Physiotherapy is used to strengthen the quadriceps, regain joint movement and improve stability and control.
Collateral ligament sprains
The major ligaments at each side of the knee prevent the knee from being forced into an abnormal amount of knock-knee or bow-leg. Both the lateral (outside) ligament and the medial (inside) ligament can be sprained, with the medial ligament the more commonly affected.
Medial knee pain causes are usually sudden impacts on the outside of the knee such as in football or rugby.
Sprains will heal with correct management which varies from plaster of Paris to splints to reduced weight bearing for a while. Physiotherapy is often required to regain joint movement and strength and to rehabilitate the knee back to sporting or other activities.
Cruciate ligament sprains and cruciate rupture
The cruciate ligaments are major internal ligaments of the knee joint. They give back and forwards stability to the knee. The anterior cruciate ligament is damaged much more often than the posterior cruciate ligament.
If the anterior cruciate ligament is damaged or torn the knee becomes unstable when the person twists whilst weight bearing on the knee. Rehabilitation can improve knee function but if there are still problems then anterior cruciate ligament reconstruction is the most favoured option.
This is a problem of sporty teenagers. They develop pain on activity over the tibial tuberosity, the small bump below the knee cap on the front of the shin bone. The condition is caused by too much traction or pulling on this area while the person is growing rapidly. Rest and gradual physio rehabilitation are the treatments.
This is a condition of athletes who perform jumping or changing direction rapidly. The patellar tendon attaches to the lower point of the patella and it is this area which becomes irritated and causes pain. Physiotherapy treatment can improve the symptoms and prevent the problem from becoming a chronic condition.
Osteoarthritis is the most common joint condition in the world. Knees are commonly affected with the symptoms being pain, swelling, stiffness, reduced range of movement, reduced mobility and disability. Exercise is a core management strategy and physiotherapists can assess the knee and plan a treatment.
If conservative treatments are unsuccessful then total knee replacement is a option with very high quality of life improvements.