Have you ever had a cold and suddenly wished you had appreciated your ability to breathe easily before your nose was congested? Waking up with knee pain can be a similar experience, and you might suddenly wish you could return to a blissful time when simple activities such as walking, kneeling to play with their pets, getting out of the car and playing sport were easy and pain-free.
Knee pain can turn simple, everyday tasks into frustrating and uncomfortable challenges. It can be a debilitating pain to experience, but there are many strategies to reduce pain and improve flexibility and function in the knee – and physiotherapist and exercise physiologist are here to help.
How your knee works
Your knee is the largest joint in your body, and has several complicated moving elements.
It has four main parts:
• Bones
• Tendons
• Ligaments
• Cartilage
Your knee joint connects four bones, your femur (thighbone) your two shinbones, and your kneecap. Tendons connect all of these bones to the muscles in your legs. The bones are then all held together by ligaments, which are a type of very strong connective tissue. These bones are covered by a firm, thick, slippery tissue called cartilage, which acts as a shock absorber and supports the bones to glide smoothly against each other as you bend your knee.
You begin to experience that frustrating knee pain when one of these structures has an issue – there can be many possible causes of injury or illness, and the type of pain that you experience will be affected by the structure in your knee that is affected.
Causes of knee pain
Knee discomfort or pain may feel like sharp pain, stiffness, throbbing pain or tenderness. Knee pain is most frequently caused by injuries such as a dislocation or torn ligament, or by a medical condition such as arthritis. Common knee injuries include:
• Sprains
• Strains
• Tears
• Dislocations
• Fractures
Common conditions that cause knee pain include:
Osgood-Schlatter’s disease
This condition affects children and adolescents, usually during growth spurts. It causes inflammation underneath the kneecap, which can become swollen and painful after exercise. It typically resolves on its own, unlike other common conditions – but it is still worth seeing a physiotherapist because this disease can benefit from pain management and strategies that provide relief in the meantime.
Osteoarthritis
This is one of the most common causes of knee pain and is a type of degenerative joint disease wear and tear on the joint. It occurs when the cartilage in your joints deteriorates and it can be very painful, because the bones grate against each other without the adequate protection that cartilage provides. This mostly affects people aged 50+ and can cause tenderness, stiffness and pain.
Tendonitis
Tendonitis refers to inflammation of tendons. When the tendons in your knees become inflamed, they can become very painful when you move your knee. This inflammation is often caused by overuse, leading to conditions such as jumper’s knees in people who regularly jump for sport.
Bursitis
There is a small fluid-filled sac in your knee called a bursa. This reduces friction and supports the joint as it moved. This sac can become inflamed as a result of overexercising, infection or injury, leading to pain, swelling and inflammation.
Diagnosis of knee pain
There are many potential causes of knee pain, so it is important to see a professional for a formal diagnosis. They can perform an assessment, speak to you about your medical history in order to investigate your symptoms to arrive at an accurate diagnosis. Once the underlying cause of your knee pain has been identified, you can begin treating the pain and discomfort at its root cause, rather than simply treating the symptoms.
Management and pain relief
Management of knee pain will vary according to the individual diagnosis that you have received, however many common causes of knee pain can be successfully addressed by physiotherapy and exercise physiology services. Some common methods to treat and manage knee pain include:
• Assistive technology such as a cane, knee brace or walker
• Medication to reduce pain, swelling and inflammation
• Heat and cold therapy
• Weight loss
• Stretches designed by a physio to improve mobility
• Alternative therapies such as acupuncture
• Exercises to improve strength and mobility
• RICE, known as Rest, Ice, Compression and Elevation
In some severe cases, surgery may be recommended, but it is usually done as a last resort. It’s important to note that you do not have to accept just living with knee pain – there is a lot that can be done to relieve pain, and support you to get back to more of what you love. Your recovery goals will be unique to you.
Physiotherapists are able to conduct thorough assessments to diagnose knee pain, and then devise an individualised treatment plan for you. They can advise on the use of assistive technology, rehabilitation and explore alternative therapies.
Our exercise physiologists are also often an essential part of the treatment team for a client who is looking to stay active while managing their pain and reducing the risk of further injury. An exercise physiologist can support you once you have your diagnosis and can develop exercise plans that build strength and mobility and that allow you to continue enjoying movement and building up fitness.