B2LCARE'S Physiotherapist guide to knee pain
What is knee pain?
The knee joint is a hinge joint that connects the tibia (shin bone), and the femur (thigh bone) at the patella (knee cap). There are 4 main ligaments that support the knee joint. They are the anterior cruciate ligament (ACL); posterior cruciate ligament (PCL); medial collateral ligament (MCL); and lateral collateral ligament (LCL). There are also 2 rings of cartilage that act as shock absorbers in the knee, called the medial and lateral meniscus.
The most common cause of knee pain is osteoarthritis, a condition that occurs when the cartilage that protects the inside surfaces of the tibia and femur bones called articular cartilage gradually wears away, resulting in pain and swelling in the knee.
How doe's it feel?
Knee pain can occur suddenly for no apparent reason or develop slowly, as the result of repetitive trauma. Knee pain occurs in different parts of the knee, depending on what structures in the knee are involved. Below is a general breakdown of the areas in which knee pain may occur and the structures of the knee that may be involved:
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Anterior knee pain, also referred to as patellofemoral pain, is pain around the kneecap (patella) in front of the knee, caused when the kneecap shifts out of position. This condition commonly affects younger females, and may be due to overuse injury. Pain often occurs when performing activities like squats or stair-climbing.
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Lateral knee pain is pain that occurs on the outside of the knee. It is a type of overuse injury that commonly occurs in runners when the tendon called the iliotibial band (ITB) becomes irritated. Pain is often felt when performing activities such as climbing stairs, or when walking or running.
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Medial knee pain is pain that occurs along the inside of the knee when the MCL or the medial meniscus become irritated due to direct injury or overuse. Pain is felt when squatting, walking up or down an incline, or going down stairs.
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Pain caused by a ligament tear may result from a direct blow to the knee, or when twisting or pivoting the knee while the foot is planted on the ground. Immediate pain and swelling usually occur, and the knee may feel unstable—like it will "give out"—when an individual attempts to put weight on the involved leg.
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Pain caused by osteoarthritis may occur anywhere in the knee where cartilage has broken down. This type of knee pain may begin as mild and progressively worsen. It can become increasingly difficult to walk long distances, fully bend and straighten the knee, climb stairs, or squat to sit in a chair. The knee also may swell intermittently with increased activity.
How can B2LCARE'S physiotherapist help?
Based on the findings of your evaluation, your physical therapist will develop a customized rehabilitation program to ensure a safe return to your desired activities. Some general treatment techniques may include:
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Pain management. Your physical therapist may provide treatments using different "modalities" such as ice, heat, ultrasound, IFT or electrical stimulation to help decrease pain and swelling.
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Manual therapy. Your therapist will apply manual (hands-on) therapy to gently guide movement of the knee area to restore joint and tissue mobility.
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Therapeutic exercises. Your physical therapist will prescribe specific strengthening, flexibility, and endurance exercises to address your specific needs and goals.
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Functional exercises. You will learn individualized exercises designed to help you return to your home, work, and sport activities. These also may include balance and coordination exercises.
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Self-care instruction. Your physical therapist will teach you ways to manage your pain at home, and design a safe and effective home-exercise program based on your specific condition, which you can continue long after your formal physical therapy sessions have ended. You also will learn how to avoid placing unnecessary forces on the knee during your daily activities for years to come.