Whether as a result of a sudden injury, a more gradual onset or a medical issue, such as different types of arthritis, knee pain can be frustrating and have a detrimental impact on your ability to perform your daily tasks. This can be as simple as getting up from a chair, climbing stairs or limiting your ability to take part in your usual exercise or sport and thus can have a big impact on your quality of life.
Common symptoms you may be experiencing:
- Catching or locking
- Inability to move knee through full range of motion/stiffness
- Clicking/grinding/crunching (crepitus)
- Feeling of knee “giving way”
- Reduction in your function and mobility
Common conditions that can cause your knee pain:
Osteoarthritis (OA) is the most common form of arthritis with the knee joint being the most common. In the early stages, your pain is activity dependant, relieved with rest but often feels worse at the end of the day. You may find your knee stiff after a period of inactivity, particularly in the early morning but soon resolves within 30 minutes of movement. You may also have some swelling within the joint, a grinding sensation and a sensation of the knee ‘giving way’. The recommended management for the OA knee is to rehab in lieu of surgery, i.e. avoid joint replacement. This form of treatment is supported by studies that show that Physiotherapy can improve the symptoms of OA knee pain by up to 40% and is more effective than taking anti-inflammatories (NSAID’s).
There are four main ligaments around your knee which can be injured, from a simple sprain to a complete rupture.
An ACL injury affects the anterior cruciate ligament within your knee and is particularly common in people who play sports with pivoting and twisting demands. Females unfortunately have a higher incidence of ACL injury than their male counterparts- around three times more multiple reasons. If you injure this ligament you may have heard or felt a “pop”, experience marked swelling and your knee may feel unstable. The good news is not all ACL injuries require surgery and many people can return to a good level of exercise without their ACL. Physiotherapy is of equal benefit whether you require surgery or not and studies have shown that Prehab (physiotherapy before Surgery) can improve your post op recovery and return you to sport quicker.
Posterior Cruciate Ligament (PCL): This ligament within your knee is less commonly injured than the ACL. PCL damage typically arises as a result of a sporting injury or a road traffic accident. These injuries often co-present with other injuries to the knee.
Medial Collateral Ligament (MCL) is the ligament in the inside of your knee and the Lateral Collateral Ligament (LCL) is on the outside of your knee. These are commonly injured with an impact on the inside or outside to the knee.
The medial and lateral menisci are shock absorbers and force distributors located between your femur (thighbone) and the tibia (shin). Injuries to the meniscus can be due to trauma or degenerative wear (i.e. in knee joint arthritis) and can compromise the force distribution across the knee joint. Symptoms of meniscal issues can be pain, swelling, and catching/locking, and buckling of your knee joint. Surgical intervention is required if your knee is locked and you are unable to ‘unlock it’, otherwise physiotherapy has been shown to be more beneficial for long term outcomes versus knee arthroscopy.
This can occur to the bones of the knee, including the kneecap and is most likely due to trauma. Your management will depend on the nature and site of your injury. This may involve a period of immobilisation followed by Physiotherapy to regain your range of movement and function.
Patellar (kneecap) dislocations
Dislocations are most common in athletic teenagers when the kneecap is completely displaced from its normal position on the front of the knee. Most dislocations occur outwardly. Recurrent dislocations may require a surgical opinion; however, Physiotherapy is crucial to regain your movement, function and to help prevent recurrence.
Patello-Femoral Pain Syndrome (PFPS) (“Runners knee”)
PFPS is characterised by a gradual onset of pain behind and around the patella. Your pain will likely be aggravated by squatting, stair-climbing and running and will be eased with rest. In other cases, PFPS can present as a dull ache with prolonged sitting. This type of knee condition is most common in teenagers and females and, particularly in those who are overweight.
Recent guidelines for the management show that exercises for your hip and knee exercises are the most favourable for improving your knee pain and function in PFPS and Physiotherapy plays a key role in mitigating this pain.
Patellar Tendinopathy (“Jumper’s knee”)
This is primarily a condition of the relatively young (15-30 years) sporting population, who participate in high impact sporting activities. Your pain will typically be focused around your tendon at the front of the knee and maybe very tender to touch. Tendon problems tend to be as a result of changes in your training. As with most tendon problems exercise therapy is crucial in the management of this condition.
The human body is a complex machine and there are many other structures that can cause pain, which have not been covered in this blog. However, if you book an appointment here at Functional Physio Glasgow, we should be able to pinpoint your issue and help you on your road to recovery.