Knee Injury & Pain


Common Problems

Knee problems are very common and even more so in active people. There are a range of disorders we treat through active rehabilitation. Even though there are various conditions presented in knee patients, some of the more common disorders are:

  • Arthritis: Arthritis involvs degeneration of joints. Wear and tear is a part of the natural aging process and normally starts in our 20’s. There are two types of cells in the bones, one which break bone and the others which regenerate it. When we are younger, these cells work equally which ensures that the bones are strong and continuously being renewed. With age, the degenerative cells tend to work more and therefore there is joint degeneration. Contitions such as Osteoarthritis are painful as they involve degeneration of articular cartilage aswell. This is usually seen after the age of 40-45 years, is more common in women than men and has been shown to be worse in people who are over weight.

  • Patellofemoral Pain: A common pain syndrome seen in active individuals, specially with people who run. The pain is normally felt on the inside or under the knee cap while running, stair climbing or even standing up from a seated position. This disorder is not an injury, but more of a symptom of improper biomechanics around the knee. The knee can follows a certain path in the knee which is disrupted by muscle imbalances around the knee, causing it to come in contact with the femur bone. This leads to pain as continues friction during the activity builds up into pain. The symptoms will normally subside once the activity is stopped. Application of ice and over the counter pain medication can be used to manage any long lasting pain till you see your health professional.

  • Ligament Injury: Ligaments help stabilize joints. The knee has a number of ligaments, some of which are commonly injured during sports and tend to be very troublesome. Of all the ligaments in the knee, the Anterior Cruciate Ligament, more popularly known as the ACL is one of the more commonly injured ligaments. Depending on the severity, the individual often experiences extreme pain and swelling at the time of the injury. Swelling after 24- 48 hours is a response of inflammation, however, a swelling immidiately or within 2-3 hours of the injury is often a more concerning issue as it is a sign of bleeding within the joint. It is recommended to see a health care professional as soon as possible to get a proper assessment and management plan for the injury.

  • Muscle Injury: Muscles around the knee are the Quadriceps, the hamstrings, hip abductor/ITB. Muscle injuries are very common in individuals involved in sports and a seen in the Quads and Hamstrings predominantly. Mechanisms of a hamstring injury involves sprinting and over stretching as seen in kicking a ball. Similarly, quadriceps tears are also seen with kicking, overstretching and even direct blow to the muscle. The direct injury is commonly known as a ‘Corky’ and is associated with bruising. It is not advisable to undergo any form of deep tissue massage following a Corky as it hinders the healing process and can lead to an extremely painful condition called myositis ossificans where there is bone formation within the muscle.

  • Tendon Injury: Tendon injuries in the knee are see in the patellar tendon which is the thick structure felt below the knee cap. Patellar tendinopathy is seen in active individuals and the pain would be present prior to undertaking any activity. However, once the activity is started and the knee is warmed up the pain will most likely subside until after you have ceased the activity again. Tendon overload is the common mechanism and the management plan involved activity modifications and strengthening.

  • Meniscus Injury: Meniscus are the shock absorbers of the knee. They are two disk like structures located within the knee on the medial side (inner side) and lateral side (outer side). The medial meniscus is very commonly injured with the ACL depending on the severity on the injury. People usually feel a sharp stabbing pain deep in the joint with meniscus injuries and even experience knee locking. Additionally, they may experience flicking within their knee which feel like a loose body within the joint.

  • Osgood Schlatter Syndrome: Osgood Schlatter Syndrome is a disorder that involves small micro fractures in the top of the tibia (shin bone) due to overuse and constant traction from the quadriceps muscle. The disorder is seen in active teenagers and presents with pain and swelling at the top front aspect of the tibia. As it heals it forms a solid lump which will most likely be present throughout the individuals life time. Occasionally knee pain in these patients is refered to as a ‘flare up’ of an old osgood schlatter injury by the individuals themelves. This in fact is a common misconception as an old micro fracture does not flare up. It is recommended to see a health care professional to get a proper diagnosis of the condition casuing knee pain.

  • Osteochondritis Dissicans (OCD): This condition is seen in active teenagers and involves a bone lesion deep in the knee joint. The injured individual will show signs of knee swelling and pain on standing on the affected leg. It is highly recommended to seek professional assistance in order to manage it correctly.


Common Signs & Symptoms

Pain:

Swelling:

Strength:

Instability:


What can be done…..

Depending on the severity of the injury,