Knee Pain
Knee pain is one of the most common presenting areas at Excel Body & Health Clinic. Knee pain can present in people of all ages and activity levels. It can be caused by trauma, inconsistent or sudden increase in exercise, genetics, degenerative changes or referred pain from the hips or feet. Your knees are vital for key movements like bending, lifting and walking and running therefore knee pain can be debilitating.
Ligaments, tendons and muscles are crucial for optimal function of your lower limb, at Excel Body & Health Clinic we guide you in reducing knee pain, strengthening and preventing future knee injuries.
Some common causes of knee pain includes:
PATELLO-FEMORAL JOINT PAIN
WHAT IS THE CONDITION?
Patellofemoral joint pain is also known as Patellofemoral pain syndrome (PFPS). These are both ‘umbrella’ terms used to describe pain in the soft tissues around the knee cap when there is no diagnosis on x-rays and MRI’s. This means the diagnosis weighs heavily on a thorough clinical history and examination.
WHAT CAUSES THIS CONDITION?
Patello-femoral joint pain can be caused by;
- Incorrect knee cap alignment (caused by weakness or tightness in the hip or thigh muscles)
- Overuse or overloading of the knee with exercise (walking, stairs, running, sports)
- Poor knee and ankle flexibility
- Flat feet
- Knock knees
WHO DOES IT AFFECT?
SYMPTOMS
- Pain with walking
- Pain with climbing stairs
- Sitting with a bent knee for long periods
- Pain while squatting or lunging
PATELLA TENDINOPATHY
WHAT IS THE CONDITION?
Tendons are strong, rope-like structures that attach muscles to bone, this means they are essential for making us mobile. Tendons love consistent habits and routines and therefore can cause us pain when they are overused or under prepared for exercise. There are two types of tendinopathy; Tendinitis (acute tendon injury) and Tendinosis (chronic tendon injury).
Patella tendinopathy is the umbrella term to describe tendon pathology of the patella tendon.
WHAT CAUSES THIS CONDITION?
In tendinopathies the internal structure changes due to the inconsistent exercise or loading (sudden increase of decrease in activity). The tendon initially becomes inflamed and painful but still functions reasonably well. If left untreated and managed incorrectly it can develop into a chronic issue with weakness, persistent pain and an increased risk of tendon tearing or rupture.
Other common causes include;
- Years of running or cycling
- Sudden commencement of frequent exercise
- Change of activity surface
- Change of footwear
- Calf muscle weakness
WHO DOES IT AFFECT?
While tendinopathies can occur in anyone, patella tendinopathy is more common in;
- Runners
- Cyclists
- Sports that involve jumping or running (basketball, tennis, soccer, football)
- HIIT classes attendees
SYMPTOMS
- Pain just above or below the knee cap
- Minor swelling around the sore area
- Knee stiffness
- Pain with excessive knee usage
KNEE OSTEOARTHRITIS
WHAT IS THE CONDITION?
Knee osteoarthritis (OA) is also known as degenerative joint disease, this is commonly a result of age related changes. OA normally develops in people as they age, therefore it is more commonly seen in elderly people. It’s critical in OA that strength and movement exercises are performed for the hips and knees to slow the progression of the condition. The team at Excel Body & Health utilise exercises from the GLA:D program (developed in Denmark) which has been shown to reduce pain by 36%, reduce medication intake and reduce the need for joint replacement surgery.
WHAT CAUSES THIS CONDITION?
OA most often occurs with age but can be caused by obesity, genetics, repetitive stress or loading, high impact sports and trauma. Repetitive exercise includes running and sports (football, soccer, basketball etc)
WHO DOES IT AFFECT?
OA of the knee affects people over the age of 45 and increases as people age.
SYMPTOMS
- Gradual onset of knee pain
- Stiffness in the mornings or after long periods of sitting
- Minor knee swelling after exercise
- Crepitus or cracking sounds with knee joint movement
OSGOOD-SCHLATTERS
WHAT IS THE CONDITION?
Osgood-Schlatters disease is a type of apophysitis (inflammation of the bony growth plates in children). Osgood-Schlatters’ disease occurs in children’s shin bones from the quadriceps tendon repetitively stressing the growth plate. Osgoods-Schlatters disease requires careful exercise management during the painful stages to prevent progression of the disease and prevent fractures.
WHAT CAUSES THIS CONDITION?
Osgood-Schlatter’s disease is caused by overloading of the quadriceps tendon and the knee. The repetitive activity slowly begins to pull the growing bone away from the shin as it hasn’t completely fused together at such a young age.
This includes;
- High physical and sporting activities involving repetitive running, jumping and sprinting.
- Tightness of the quadricep muscle
- Worn out or old exercise footwear
- Flat feet and poor ankle and knee posture
WHO DOES IT AFFECT?
Osgood-Schlatters disease is most prominent in children between the ages of 10-15, especially extremely active children.
Common sports include;
- Basketball
- Soccer
- Football
- Gymnastics
- Martial Arts
- Runners
SYMPTOMS
- Tenderness of the upper shin area
- Pain just below the knee cap which increases with physical activity
- Increased size of the tibial tuberosity
BAKER’S CYST
WHAT IS THE CONDITION?
A Baker’s cyst is a type of swelling that occurs behind the knee. The swelling slowly builds over a long period of time with varying amounts of pain, depending on the types of exercise people partake in. Uncovering the causative factor for the Baker’s cyst is important to managing the condition properly. Incorrect management can result in years of frustrating knee pain or rupture of the cyst.
WHAT CAUSES THIS CONDITION?
Generally Baker’s cysts occur when there is underlying damage to cartilage or ligaments within the knee. In some scenarios the cyst can form even without knee damage, this has been thought to be linked to a separate cyst forming behind the knee.
WHO DOES IT AFFECT?
Baker’s Cysts can occur in athletic individuals with internal knee damage and in elderly people who suffer from osteoarthritis.
SYMPTOMS
- Pain at the back of the knee
- Swelling at the back of the knee
- Limited flexibility when bending and straightening the knee
- Tightness or stiffness at the back of the knee
MUSCLE STRAINS AND TEARS
WHAT IS THE CONDITION?
- Grade 1 for mild strains
- Grade 2 for moderate strains with swelling, bruising and weakness
- Grade 3 for full rupture (the muscle ripping into two separate pieces)
The most common muscles injured around the knee include the quadriceps, hamstrings and calves.
WHAT CAUSES THIS CONDITION?
Muscle strains and tears happen for two reasons;
- The muscle has been overstretched
- The muscle has been forced to contract too strongly.
WHO DOES IT AFFECT?
Muscle strains can occur in anyone whether they are sedentary or active but there is a high risk associated with people that partake in sports and recreational exercise.
SYMPTOMS
- Sharp pain and tenderness over the strain area
- Swelling
- Bruising
- Pain on usage of the muscle
- Weakness on usage of the muscle
LIGAMENT SPRAIN & RUPTURE
WHAT IS THE CONDITION?
Ligaments are the main supporting structures of joints. There are a number of important ligaments that support the knee joint and can be found internally and externally of the knee joint. These include the ACL (anterior cruciate), PCL (posterior cruciate), MCL and LCL (medial and lateral collateral ligaments).
These ligaments can be damaged from activities or incidents that place excessive strain on them, this can range from minor strains to complete ruptures. Most commonly knee ligaments are damaged during traumatic incidents (sports, falls or contact).
WHAT CAUSES THIS CONDITION?
Depending on the direction of the fall or force, different ligaments can be damaged. Each individual case will be examined properly to come to a conclusion. Direct contact at speed can force the knee in a certain direction, placing excessive strain on a ligament and cause it to be overstretched.
WHO DOES IT AFFECT?
Ligament sprains can happen to people of all ages but are most commonly seen in athletic individuals.
SYMPTOMS
- Sharp pain at the time of the injury
- Pain while walking, twisting or bending the knee
- Swelling of the knee
- Instability or looseness of the knee
MENISCAL TEAR
WHAT IS THE CONDITION?
The knee has a meniscus on the inner and outer aspects, which act as cushions for the knee joint. We commonly call menisci shock absorbers, therefore they are important for protecting our knee joint and bones while we walk, run, jump and play sports. A tear can occur to these important cushions which then alters the way people walk, bend, twist and climb stairs. Initially meniscal issues are managed conservatively with treatment and exercise, which if fails, results in referral to knee specialists.
WHAT CAUSES THIS CONDITION?
Meniscal tears are often seen in athletes as a result of a sports injury or fall but can be caused by wear and tear in the knee (Osteoarthritis). There are different severity and types of meniscal tears and these are treated differently on a case by case basis.
SYMPTOMS
- Popping or clicking of the knee
- Pain with bending the knee
- Pain when weight bearing
- Pain on squatting and kneeling
- Tenderness of the knee joint
PATELLOFEMORAL INSTABILITY/DISLOCATION
WHAT IS THE CONDITION?
Patellofemoral instability is instability of the knee cap. This can be a common cause of pain, instability or giving way of the knee.
WHAT CAUSES THIS CONDITION?
Patellofemoral instability can be caused by;
- Dislocation of the kneecap due to trauma
- Incomplete development of bone that supports the knee
- Flat feet
- Weakness of the quadriceps muscles
WHO DOES IT AFFECT?
Patellofemoral instability can present in people of all ages but is most common in developing children and teenagers.
SYMPTOMS
- Looseness of the knee cap on the thigh bone
- Sensation of the knee giving way
- Pain on lunging, squatting or climbing stairs
- Swelling around the knee cap after activity
TREATMENT FOR KNEE PAIN
The team at Excel Body & Health are highly skilled practitioners that will assist in determining the cause, treatment and management of your knee pain. Your treatment plan will be tailored to you and will focus on reducing pain, restoring normal function and preventing re-injury of your knee.
Treatment may include soft tissue massage, muscle energy techniques, stretching, joint mobilisation, articulation, manipulation, dry needling, taping and/or exercise prescription.A personalised treatment plan will aid in managing the injury and associated pain in the short and long term.
