Where Is Your Pain
The hunt for the cause of knee pain is like the search for a home:Location matters.
For example, pain below your kneecap might be a sign of patellar tendinitis, or inflammation in the tendon that connects the kneecap to the shinbone, says rheumatologist Scott Burg, DO. Pain above the kneecap often means quadriceps tendinitis.
Pain on the inside or outside of your knee could be a sign of a torn ligament , Dr. Burg says. But it also could indicate a torn or degenerative meniscus, which is the cartilage that lines and cushions your knee joint.
Those are just a couple of causes, not including various types of arthritis. Location is important, but we also ask other questions, Dr. Burg explains.
Pain On The Inside Of The Knee: 4 Causes
Pain on the inside of the knee is one of the most common musculoskeletal pains reported. It is the cause of approximately 6 % of adults visits to their primary care doctors. For those involved in athletics, it is a larger concern.
Probably the 4 most common sources of pain on the inside of the knee include:
Pain that is a few centimeters below the inside joint line, in many cases is due to Anserine Syndrome. The pes anserinus is 3 tendons that join together and attached on the top inside of the tibia . It has been reported that this is the most common cause of pain on the inside of the knee.
Medial Collateral Ligament Injury
Injury to the medial collateral ligament typically happens when a force strikes the outside of the knee. Examples would be a tackle in football that impacts the outside of the knee. These injuries can potentially affect the stability of the knee joint.
Medial Meniscus Tear
Medial plica syndrome
The word plica means fold and is essentially a fold that is left over from the days of embryological growth. This plica can cause pain on the inside of the knee when it repetitive bending of the knee causes friction and interferes with normal knee movement.
How Alignment Impacts Pain
If you have pain on the inner side of your knees, it could be due to your knees being bowed . Bowed leg alignment, known as varus alignment, could be something that has always been or may have developed more recently.
First, lets define a normal alignment so that we can compare the two. A normal knee alignment tends to be slightly valgus, where the knees are slightly angled in toward the other. With a normal alignment, your body weight is putting an appropriate amount of pressure on the inner side of the knee where the bone, cartilage, and meniscus are able to withstand it. But in a varus alignment, your knees shift outward, away from your midline, meaning your body weight puts much more pressure on the inner side of the knee, and this is what can result in inner knee pain.
A varus alignment alone isnt always an indicator of a problem, but it can point to ongoing excess pressure on the inner side of the knee. The pressure may cause the cartilage, or even the meniscus to flatten, further perpetuating the bowing out of the knee and accelerating arthritis.
Some people, on the other hand, may have too much of a valgus or knock-knee alignment that can cause pressure and pain on the outer side of the knee.
A trained physical therapist can assess your alignment and determine if it is normal, or if it is contributing to your pain and needs to be modified.
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Why Does My Knee Hurt Without Injury
Either rheumatoid arthritis or osteoarthritis can cause leave you with severe knee pain, even without a fall or injury. Osteoarthritis can be characterized by the pain and swelling you continue to feel as you age. Your joints are not indestructible, and the structure inevitably wears down over time.
When Should You Go To The Doctor
Knee injuries are prevalent, and you do not need to see a doctor immediately after an accident. Try not to bend your leg, don’t put pressure on it, and use an ice pack to reduce swelling. Rest for three days and do the following:
- Cover area with an elastic compression bandage
- Try walking with crutches for three days
- Ice the affected area three or four times a day for twenty minutes
- Do not bend your legs while sitting, and do not climb stairs
- Keep your knee slightly higher than your body when you sleep
- Take anti-inflammatory medications, such as Ibuprofen or Naproxen
However, if your pain does not decrease after three days and you have one or more of the following conditions, see your doctor.
- Severe pain and numbness in the legs even when there is no weight on it
- Swelling, redness, and deformity of the affected area
- Fever and bluish discoloration in your calf
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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 patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
Diagnosing Inner Knee Pain
If you experience consistent pain, speak to your doctor as soon as possible. Your doctor will ask questions about the pain and other symptoms and will perform a physical examination with special tests specifically for the knee.
He or she may also order a diagnostic test, such as an MRI or X-ray for more conclusive results or ruling out certain injuries. It is also important for your doctor to rule out other possible issues such as a low back injury-known as lumbar radiculopathy.
Exercise Program For Pain In The Front Of Your Knee :
Many of you are afraid to exercise. Yes, some of you may have pain with a few of these exercises. You can start with quadriceps isometric exercises, or simply dont go too low with the squat, lunge or wall sit until your strength improves. Most of you will find that after doing these exercises 3 days/week for two weeks that your pain will start to improve. As I mentioned previously, this is a program that can take 6-12 months to fully correct the weakness pattern that led to pain in the front of your knee. So stick with it.
Squat: I like the variations that this group throws in. You do not and should not start with 100 if you are just starting out.
Chair Squats are the place to start if you dont have the strength or confidence.
Wall Sits: A great quadriceps exercise. This video is a little mechanical, but it contains the dos and donts of how to perform a wall sit.
Reverse Lunges: Easier than forward lunges. Dont lunge back further than you can handle. That distance will get further over time. Focus on your front knee so it doesnt wobble back and forth.
Planks: This video includes a good description of the proper technique, and it gives you 10 different variations to try.
Hamstring bridge exercise. If this is too easy you can rest a barbell across your pelvis, or a kettlebell on your lower abdomen.
Treatment Options For Inner Knee Pain
The first step in treating inner knee pain involves at-home remedies, such as resting and icing the joint for a few days. You can also try over-the-counter anti-inflammatory medications such as aspirin or ibuprofen.
If the pain persists, an orthopedic specialist may prescribe corticosteroid injections to lessen your discomfort. Only in the most severe cases will a doctor recommend surgery. For example, minimally invasive arthroscopic surgery may be required to repair or reattach the ligament in the case of an MCL tear.
Physical therapy exercises to strengthen the muscles encasing the knee are another common treatment option. A quad stretch, for example, helps reduce stress on the knee. For this exercise, use a chair for balance and support. Then, standing with your feet shoulder-width apart, step back with your right foot, maintaining a straight posture. Bend your knees slightly so you feel a stretch in the front of your legs. Hold the stretch for 10 seconds and then repeat with the other leg.
If youre experiencing chronic pain in your inner knee, the orthopedic doctors and physical therapists at New York Bone & Joint Specialists can help you find the treatment thats right for you. Book an appointment today for a personalized consultation.
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How Do You Treat Anterior Knee Pain
Pain in the front of the knee is usually treated successfully without surgery. This may take some time. It is not unusual for the pain to last for many months. Many of you will respond to physical therapy, which should focus on your hips, yes, your hips and pelvic muscles as much as it focuses on your thigh muscles. Runners who focus on a strengthening program might repeat might have a lower incidence of anterior knee pain.
Can You Prevent Knee Pain
There can be many reasons for knee pain. Therefore, there are different strategies to prevent the pain depending on the underlying cause. Running on soft surfaces or decreasing the amount of running can help if the pain is due to overuse. Avoiding any direct injuries to the knee including wearing a seatbelt can prevent traumatic injuries. Weight loss can be helpful for many different forms of knee pain.
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What Procedures And Tests Diagnose Knee Pain
A health care professional will begin by asking questions related to the person’s general health and then specifically to the nature of the knee pain .
Next, an examination of the knee will be performed. This will include bending the knee through the full range of motion, checking for stability of the ligaments, and evaluating for any tenderness and swelling. It is often helpful to compare the results of the examination of the painful knee with the other knee. Frequently, this is all that is required to make a diagnosis and start treatment. In several research studies, it has been found that an experienced examiner is as reliable as X-ray examination.
Sometimes the doctor might want to do further studies such as the following tests.
Plain X-ray can establish fractures and degenerative changes of the knee.
MRI is used to evaluate the soft tissues of the knee for ligament tears or cartilage and muscle injuries.
If gout, arthritis, or other medical conditions are suspected, a health care professional might order blood tests.
Removal of joint fluid
What Natural Home Remedies Relieve Knee Pain
Over-the-counter pain medications can frequently alleviate the pain. If someone is taking these medications on a regular basis, he or she should see a health care professional to evaluate the knee pain for proper diagnosis and to avoid the potential side effects of chronic medication use.
The RICE mnemonic is often helpful, especially for minor injuries:
Rest: Rest the joint, and take a break from your usually activities involving the knee joint.
Ice: Applying ice can help with pain and inflammation.
Compress: A compression bandage can help prevent swelling and help knee alignment. It should not be tight and should be removed at night.
Elevate: Elevation can help with swelling and resting of the knee.
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Medial Collateral Ligament Injury
The medial collateral ligament runs along the outside of your inner knee to stabilize the joint. If the ligament overstretches, you may have an MCL sprain.
The MCL can also tear partially or fully. An MCL injury most commonly occurs after force is applied to the outer knee, such as in contact sports.
Symptoms of an MCL injury include:
Common Causes Of Knee Pain Without Injury
Of all the joints, our knees are arguably the ones most likely to feel pain. Lots of injuries can cause knee pain. Car accidents, falls and sports accidents are some of the most common causes of knee injuries, like fractures, torn ligaments and sprains. Even though its never fun to experience knee pain, when it follows an injury, at least you have a pretty good idea whats causing your discomfort. And that can make it a little easier to seek and receive proper treatment.
Sometimes though, knee pain occurs without a preceding injury. In those cases, it can be tempting to ignore the pain at first to see if it subsides on its own. The problem is, even though you might not have had an accident, the issue causing your pain can still be serious. And delaying care can wind up prolonging your symptoms and even making them worse.
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Diagnosis Of Inner Knee Pain
If you see your doctor with knee pain, theyll examine your knee and are likely to ask:
- when your pain started and if theres anything that makes it worse
- if theres any activity, accident or injury that could have caused it
- if you have any other symptoms such as your knee giving way or clicking, or pain in any other joints
If you have cartilage or ligament damage, your doctor may suggest a procedure to look inside your knee. This is called an arthroscopy . It involves making a small cut in your knee and inserting a thin tube and a camera. As well as helping with diagnosis, damaged tissue can be repaired or removed during the procedure.
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.
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Why Is Medial Knee Pain So Common
Medial knee injuries are really common because muscle weakness and/or tightness, which is very common, can subtly change the way the knee moves.
This causes more force to go through the inner side of the joint, rather than distributing weight evenly through the whole joint, which results in damage to the inner side of the knee and therefore results in medial knee pain. For example, it is much more common to get osteoarthritis on the inner side of the knee than the outer side.
When To See The Doctor
Sure, its tempting to use an online knee pain symptom checker to try to figure out whats causing your pain. The problem is, because joints are complex, knee pain self-diagnosis is very difficult. Like all your joints, your knees are designed to function without pain or stiffness. No amount of pain or stiffness is normal.If you notice any type of discomfort in or around your knee joint, its always a good idea to schedule an office visit with Dr. Van Thiel.
As a leading orthopedic surgeon in Rockford and Crystal Lake, Dr. Van Thiel uses advanced diagnostic methods to make sure you receive the best, most appropriate care for meaningful pain relief. To find out whats causing your knee pain, call OrthoIllinois at 398-9491 or schedule an appointment online today.
Dr. Van Thiel treats patients from all over Wisconsin and Illinois including Rockford, Elgin, Huntley, Dekalb, Crystal Lake, Barrington, McHenry, Beloit and Algonquin.
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