What You Need To Know
- The most common causes of knee pain are related to aging, injury or repeated stress on the knee.
- Common knee problems include sprained or strained ligaments, cartilage tears, tendonitis and arthritis.
- Diagnosing a knee injury or problem includes a medical examination and usually the use of a diagnostic procedure such as an x-ray, MRI, CT scan or arthroscopy.
- Both non-operative and surgical treatment options are available to treat knee pain and problems depending on the type and severity of the condition.
What Is Pain Behind The Knee
Since the knee is the largest and most complex joint in the body, it makes sense that it might hurt sometimes. Although knee pain is a common complaint, it is less common behind the knee.
Possible Causes Of Pain
Quadriceps tendonitis this is caused by the irritation, strain or injury to the quadriceps tendon.
This affects the underside of the kneecap and the trochlear groove in the femur in which it moves. When the articular cartilage covering the surfaces of the bone wears away and becomes inflamed the bones come into contact with each other resulting in pain.
A plica is the fold in the thin synovial membrane that lines the knee joint. There were four of these folds in the knee joint originally, but they often become absorbed during foetal development. About 50% of the population is thought to have the remains of the embryonic plicae. When a plica becomes inflamed, perhaps because of repetitive knee movement, trauma or twisting, it causes pain and weakness in the knee.
Lateral patellar facet overload syndrome
This refers to dull aching pain underneath, around the sides or below kneecap. It is caused by increased pressure on the lateral facet of the patella. The reason for this is improper tracking, poor alignment or dislocation of the kneecap. The condition is often apparent during repetitive exercise such as climbing stairs.
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How Are Knee Problems Diagnosed
In addition to a complete medical history and physical exam, other tests for knee problems may include:
X-ray. This test uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.
Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body can often determine damage or disease in a surrounding ligament or muscle.
Computed tomography scan . This test uses X-rays and computer technology to make horizontal, or axial, images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Arthroscopy. A minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube , which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen used to evaluate any degenerative or arthritic changes in the joint to detect bone diseases and tumors to determine the cause of bone pain and inflammation.
Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patients bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
How To Get Moving
Within the first 24 to 48 hours after your knee problem has started you should try to:
- reduce your activities but move as much as your symptoms allow
- put your leg in an elevated position, when resting
- move your knee gently for 10 to 20 seconds every hour when you’re awake
- avoid long periods on your feet
When using stairs it may help to:
- lead with your good leg when going upstairs to reduce the strain on your knee
- lead with your problem leg when going downstairs to reduce the strain on your knee
- use a handrail when going up and downstairs
After 48 hours:
- try to use your leg more – exercise really helps your knee and can relieve pain
- do whatever you normally would and stay at, or return to work – this is important and is the best way to get better
It’s beneficial to do specific exercises that can help in your recovery. They may be challenging at the beginning so just do what you can and try to build it up over time.
Keeping active’s the single best thing you can do for your general health.
Being physically active can:
- maintain your current levels of fitness even if you have to modify what you normally do, any activity is better than none
- keep your other muscles and joints strong and flexible
- prevent a recurrence of the problem
Avoid sports or heavy lifting until you have less discomfort and good movement. Remember to warm up fully before you start sporting activities.
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Knee Strengthening Exercises For Seniors With Bad Knees
Strength training is the best way to build muscle and increase flexibility to help you complete daily activities more efficiently. TheU.S. Centers for Disease Control and Prevention recommends that older adults complete at least two weekly strength training workouts. This doesn’t mean you must start weight training in the gym you can complete gentle exercises at home to strengthen the muscles that support your knee joints. The following are some of the best knee-strengthening exercises to include in your workouts:
Five Common Reasons For Inside Knee Pain
Pain on the inside of the knee can happen to anyone, whether youre a runner, footballer or casual gym-goer. Today, Bodyset Senior MSK Physiotherapist, Matt looks in detail at five of the most common causes of medial knee pain. He also shares tips on how to avoid a knee injury and what to do if you it happens to you.
Medial collateral ligament strain
The MCL is one of the four major ligaments of the knee. The others are the ACL , PCL and LCL . The role of these ligaments is to maintain the stability of the knee joint and prevent forces from moving the thigh and shin bones apart. The MCL runs vertically along the inside of the knee from the thigh bone , across the knee joint to the shin bone . Ligament injuries often occur due to an obvious mechanism of injury, such as a twist or a force hitting the outside of the knee . Dependent on the severity of the injury, there may be swelling, bruising and pain on the inside of the knee. You may also experience difficulty walking and a feeling of instability in the knee.
Medial meniscus injury
Wear and tear
Pes anserine bursitis
What can you do to reduce knee pain?
What can we do to help?
Need some support?
If you are in pain and would like to consult a physiotherapist, book in for a 45-minute assessment. Call 033 0333 0435 or book online below.
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Making A Diagnosis Of Pain In Outer Side Of Knee
You should see a specialist sports medicine doctor for a diagnosis and management plan.
Your doctor will ask you questions about your condition. Next, they will examine limb alignment, the knees range of movement, and the ligaments stability related to lateral knee pain. In addition, careful palpation of all the relevant anatomy, such as the joints and tendons, is vital. Finally, your doctor may want to perform investigations to confirm a diagnosis. Weight-bearing x-rays will assess the degree of arthritis. MRI scans use strong magnets to examine joint, tendon, and ligament structures. Sometimes, ultrasound is used to view the structure of tendons in more detail.
Patellar Instability And Dislocation
Patellar instability and patellar dislocation may occur from a direct blow, tight lateral structures , or ligamentous laxity . It presents with knee instability with anterior knee pain.
Mechanism of InjuryThis is typically a noncontact twisting injury with the knee extended and foot externally rotated. Patient will usually reflexively contract quadriceps subsequently reducing the patella. Osteochondral fractures frequently occur as the patella relocates.
Direct blow is a less common mechanism. Examples include knee to knee collision in basketball, or football helmet to the side of the knee.
- Acute dislocation is usually associated with a large hemarthrosis. Absence of swelling supports ligamentous laxity and habitual dislocation mechanism
- Medial-sided tenderness
- Patellar apprehension: passive lateral translation results in guarding and a sense of apprehension
- J-sign: Examiner observes patellar deviation laterally in the shape of the letter “J” with knee extension which “pops” into groove as the patella engages the trochlea early in flexion. It is associated with patella alta .
- X-rays: are indicated to rule out associated fractures, which most commonly involve the medial patellar facet or lateral femoral condyle.
- AP view is best to evaluate lower extremity alignment
- Lateral view is best to evaluate trochlear dysplasia and patellar height
- Sunrise view or Merchant view assesses lateral patellar tilt
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Tendon And Muscle Injuries Causing Pain Behind Knee
Tendon injuries often occur in runners due to overload. The tendons most likely to be affected include the hamstring on the inside or outside . Rarely, a small tendon called the popliteus wrapping around the outside of the knee joint can become swollen and painful.
In addition, hamstring muscle tears can occur close to the outside of the knee. Usually, these tears occur about 5cm above the knee joint. It is important to define the exact location of the tear, as location determines the time to return to sport.
Finally, a pulled calf muscle near the knee can also cause pain in this area.
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Lump On The Side Of Knee: Is It A Meniscal Cyst
A lump on the side of knee either inside or outside- is most likely a meniscal cyst. A meniscal cyst is a collection of thick fluid arising from a tear of the meniscal cartilage, which is the cushioning of the knee. However, not all lumps in the knee are meniscal cysts. So, how do we diagnose a meniscal cyst, and what do we do about them?
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When Will My Kneecap Start To Feel Better
One broad caveat to keep in the back of your mind. Many of you are thinking that a few weeks are enough time to start to see improvements with treatments such as exercise or physical therapy. Sadly thats not going to happen. It is not unusual for it to take 3-4 months before you start to see significant improvement in your pain. Furthermore, it is not uncommon for it to take 8-12 months for a complete resolution of your symptoms. This is important I wouldnt want to seek a surgeons consultation because 4-6 weeks of therapy and exercise left you with persistent pain.
Down below.. under coping strategies, we list a few things to try that can calm down your pain while we give the exercise time to work.
Osteonecrosis Of The Knee
Osteonecrosis is a condition in which bone tissue dies due to a lack of adequate blood supply. People typically notice severe pain on the inside of the knee with tenderness and joint swelling as well as pain when bending or straightening the knee. These symptoms may cause a person to limp when walking.
Osteonecrosis in the knee is not common. It is most likely to occur after an injury, but it can also develop gradually in absence of a trauma. Older women who have osteoporosis are at the greatest risk for osteonecrosis.
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Urgent Advice: Get Advice From 111 Now If:
- your knee is very painful
- you cannot move your knee or put any weight on it
- your knee is badly swollen or has changed shape
- you have a very high temperature, feel hot and shivery, and have redness or heat around your knee this can be a sign of infection
111 will tell you what to do. They can tell you the right place to get help if you need to see someone.
Go to 111.nhs.uk or .
You can also go to an urgent treatment centre if you need to see someone now.
They’re also called walk-in centres or minor injuries units.
You may be seen quicker than you would at A& E.
Bursitis In The Knees
Knee bursitis, which can affect any knee area, is another common cause of excruciating pain in the knee. Knee bursa are fluid-filled sacs that sit between soft tissues and bone to minimize friction and pressure on the knee structures.
An irritated bursa that is then squished can cause excruciating pain in the knee.
The bursa impacted by the pain is easy to identify by its position. In such a case, the sharp stabbing pain could be coming from:
- Knee Cap: Prepatellar bursitis or housemaid’s knee, as it’s more often known
- Back of the Knee: It most likely is a Baker Cist.
- The inner side of the knee: Pes Anserine bursitis often produces this pain.
- The outer side of the knee: common among runners because of iliotibial bursitis.
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Why Do I Have Pain In The Front Of The Knee
The most common cause of anterior knee pain is often felt to come from a muscular imbalance or a particular pattern of weakness. This will be the case for the majority of you reading this. At least thats what we think is the most common cause. We have come a long way in evaluating runners and other people who present with pain in the front of their knees. They often show the same findings when we use high-speed cameras to videotape them while running or walking. Now, this might be a chicken vs. the egg thing. Right? Which came first, the weakness pattern or the pain? We like to think it was the weakness that came first. We are still working on proving that.
If you are a runner or cyclist, etc then your training may influence your anterior knee pain. If you train too hard, too fast, and too often then you are at a higher risk of developing anterior knee pain. Most amateur runners run too fast on their easy days and too slow on their hard days. Proper base building, for strength, endurance and conditioning our joints to adapt to distance is of paramount importance. Zone 2 running programs are extremely important even for elite runners. Try to keep your training at a continuously progressive pace. You should be slowly increasing the load, distance, or speed over time. Try not to increase your load, eg. distance, speed, etc more than 10% per week. Most runners overuse injuries are training errors.
Types Of Outer Knee Pain
There are several health conditions that may cause outer knee pain.
Iliotibial band syndrome develops if a band of connective tissue rubs on the outside of your knee. The iliotibial band is a thick band of fibrous tissue that runs from your hip to below your knee on the outside of your leg. If you bend and straighten your leg a lot, it can cause this tissue to become sore and inflamed where it passes over the bottom of your thigh bone and meets your knee. This type of problem is most common in runners and cyclists.
Lateral collateral ligament injury is caused by a blow to the inside of your knee, which stretches the outside of your knee and injures the ligament. A ligament is a band of tissue that connects one bone to another. The lateral collateral ligament runs down the outer side of your knee.
Meniscal injury is damage to the meniscal cartilages inside your knee. These cartilages act like shock absorbers and may tear when you twist your knee with your foot still on the ground. This type of injury is common in sports where you have to change direction suddenly for example, football and skiing. It can also happen in jobs that involve lifting and twisting for example, construction or manual labour. The meniscus can tear without any particular injury as you get older because of wear and tear.
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Other Knee Injuries And Conditions
Because the knee is the largest joint in your body, it is prone to injury and strain. If you fall or bump your knee, you may experience pain from bruising. If youve fractured any of the three bones in your knee, you may experience weakness, sharp pain, or deep throbbing sensations.
Rheumatoid arthritis can present similar symptoms to osteoarthritis, but this autoimmune condition may require different treatments than joint damage caused by the typical wear and tear of aging.
Anterior Knee Pain In Middle
Osteoarthritis : Arthritis of the patella causes pain because the cartilage under the kneecap is thinning. Arthritis, which only involves the patella in your knee, is more common in women. Physical therapy can be very effective in the early stages of osteoarthritis of the patella. Injections and over the counter medications may have a role in some patients. In some situations, when the arthritis is severe, a patient will need to consider a tibial tubercle osteotomy, replacement of the patella, or a total knee replacement if the arthritis is elsewhere within the knee.
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Lateral Cartilage Meniscus Injury
A lateral meniscus tear is an injury to the cartilage meniscus. These are semi-circular discs found in the joint. A torn meniscus can be sudden onset, acute knee injury, or it can develop gradually from wear and tear. Symptoms include:
- Pain on the outside of your knee, along the joint line.
- Pain may be worse when squatting, especially deep squats.
- More often than not your knee will be swollen and may also lock or give way.
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