What is knee pain: Knee pain – Symptoms and causes
Hyperextended knee: Cause of serious injury?
A hyperextended knee occurs when the knee is bent backward, often as a result of landing wrong after a jump. A hyperextended knee can damage ligaments, cartilage and other stabilizing structures in the knee.
Young children have softer bones because they’re still growing, so a hyperextended knee can result in a chip of bone being pulled away from the main bone when the ligaments stretch too far. In older children and adults, forceful hyperextension may tear one of the knee ligaments, particularly the anterior cruciate ligament (ACL).
If the knee injury is severe enough to cause swelling, pain or instability, see a doctor immediately. Even if the injury doesn’t need surgical repair, physical therapy may be needed to help restore leg strength and stability.
- Glucosamine: Does it protect cartilage in osteoarthritis?
July 14, 2020
- Mencio GA, et al. Skeletal trauma in young athletes. In: Skeletal Trauma in Children. 5th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed April 24, 2015.
- DeLee JC, et al. Knee injuries in skeletally immature athletes. In: DeLee & Drez’s Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed April 24, 2015.
- Marx JA, et al. Knee and lower leg. In: Rosen’s Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Mosby Elsevier; 2014. http://www.clinicalkey.com. Accessed April 24, 2015.
- Brooks GP, et al. Treatment of knee injuries in the young athlete. http://www.uptodate.com/home. Accessed April 24, 2015.
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11 Knee Pain Dos and Don’ts
You can do many things to help knee pain, whether it’s due to a recent injury or arthritis you’ve had for years.
Follow these 11 dos and don’ts to help your knees feel their best.
Don’t rest too much. Too much rest can weaken your muscles, which can worsen joint pain. Find an exercise program that is safe for your knees and stick with it. If you’re not sure which motions are safe or how much you can do, talk with your doctor or a physical therapist.
Do exercise. Cardio exercises strengthen the muscles that support your knee and increase flexibility. Weight training and stretching do, too. For cardio, some good choices include walking, swimming, water aerobics, stationary cycling, and elliptical machines. Tai chi may also help ease stiffness and improve balance.
Don’t risk a fall. A painful or unstable knee can make a fall more likely, which can cause more knee damage. Curb your risk of falling by making sure your home is well lit, using handrails on staircases, and using a sturdy ladder or foot stool if you need to reach something from a high shelf.
Do use “RICE. ” Rest, ice, compression, and elevation (RICE) is good for knee pain caused by a minor injury or an arthritis flare. Give your knee some rest, apply ice to reduce swelling, wear a compressive bandage, and keep your knee elevated.
Don’t overlook your weight. If you’re overweight, losing weight reduces the stress on your knee. You don’t even need to get to your “ideal” weight. Smaller changes still make a difference.
Don’t be shy about using a walking aid. A crutch or cane can take the stress off of your knee. Knee splints and braces can also help you stay stable.
Do consider acupuncture. This form of traditional Chinese medicine, which involves inserting fine needles at certain points on the body, is widely used to relieve many types of pain and may help knee pain.
Don’t let your shoes make matters worse. Cushioned insoles can reduce stress on your knees. For knee osteoarthritis, doctors often recommend special insoles that you put in your shoe. To find the appropriate insole, speak with your doctor or a physical therapist.
Do play with temperature. For the first 48 to 72 hours after a knee injury, use a cold pack to ease swelling and numb the pain. A plastic bag of ice or frozen peas works well. Use it for 15 to 20 minutes three or four times a day. Wrap your ice pack in a towel to be kind to your skin. After that, you can heat things up with a warm bath, heating pad, or warm towel for 15 to 20 minutes, three or four times a day.
Don’t jar your joint(s). High-impact exercises can further injure painful knees. Avoid jarring exercises such as running, jumping, and kickboxing. Also avoid doing exercises such as lunges and deep squats that put a lot of stress on your knees. These can worsen pain and, if not done correctly, cause injury.
Do get expert advice. If your knee pain is new, get a doctor to check it out. It’s best to know what you’re dealing with ASAP so you can prevent any more damage.
Knee Pain: Causes, Treatments, Prevention
Introduction to Knee Pain
Knee pain is the most common musculoskeletal complaint that brings people to their doctor. With today’s increasingly active society, the number of knee problems is increasing. Knee pain has a wide variety of specific causes and treatments.
Anatomy of the Knee
The knee joint’s main function is to bend, straighten, and bear the weight of the body, along with the ankles and hips. The knee, more than just a simple hinged joint, however, also twists and rotates. In order to perform all of these actions and to support the entire body while doing so, the knee relies on a number of structures including bones, ligaments, tendons, and cartilage.
- The knee joint involves four bones.
- The thighbone or femur comprises the top portion of the joint.
- One of the bones in the lower leg (or calf area), the tibia, provides the bottom weight-bearing portion of the joint.
- The kneecap or patella rides along the front of the femur.
- The remaining bone in the calf, the fibula, is not involved in the weight-bearing portion of the knee joint but provides ligament attachments for stability.
- Ligaments are dense fibrous bands that connect bones to each other.
- The knee includes four important ligaments, all of which connect the femur to the tibia:
- The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) provide front and back (anterior and posterior) and rotational stability to the knee.
- The medial collateral ligament (MCL) and lateral collateral ligament (LCL) located along the inner (medial) and outer (lateral) sides of the knee provide medial and lateral stability to the knee.
- Tendons are fibrous bands similar to ligaments.
- Instead of connecting bones to other bones as ligaments do, tendons connect muscles to bones.
- The two important tendons in the knee are (1) the quadriceps tendon connecting the quadriceps muscle, which lies on the front of the thigh, to the patella and (2) the patellar tendon connecting the patella to the tibia (technically, this is a ligament because it connects two bones).
- The quadriceps and patellar tendons are sometimes called the extensor mechanism, and together with the quadriceps muscle they facilitate leg extension (straightening).
- Cartilaginous structures called menisci (singular form is “meniscus”) line the top of the tibia and lie between the tibia and the 2 knuckles at the bottom of the femur (called the femoral condyles).
- The menisci’s primary job is to provide cushioning for the knee joint.
- Bursae (one is a bursa) are fluid-filled sacs that help to cushion the knee. The knee contains 3 important groups of bursae:
- The prepatellar bursae lie in front of the patella.
- The Pes anserine bursae is located on the inner side of the knee about 2 inches below the joint.
- The infrapatellar bursae are located underneath the patella.
Home Care for Knee Pain
Inflammation is the body’s physiologic response to an injury. In treating many types of knee pain, a common goal is to break the inflammatory cycle. The inflammatory cycle starts with an injury. After an injury, substances that cause inflammation invade the knee to assist in healing. However, if the injury and subsequent inflammation is not resolved, inflammation can become a chronic issue, leading to further inflammation and additional injury. This cycle of inflammation leads to continued or progressive knee pain. The cycle can be broken by controlling the substances that cause inflammation, and by limiting further injury to tissue.
Some common home care techniques for knee pain that control inflammation and help to break the inflammatory cycle are protection, rest, ice, compression, and elevation. This regimen is summarized by the memory device PRICE.
PROTECT the knee from further trauma.
- This can be done with knee padding or splinting.
- A pad over the kneecap, for example, helps to control the symptoms of some knee injuries (an example is a form of bursitis sometimes called housemaid’s knee) by preventing further repetitive injury to the prepatellar bursae.
REST the knee.
- Rest reduces the repetitive strain placed on the knee by activity.
- Rest both gives the knee time to heal and helps to prevent further injury.
ICE the knee.
- Icing the knee reduces swelling and can be used for both acute and chronic knee injuries.
- Most authorities recommend icing the knee 2 to 3 times a day for 20-30 minutes each time.
- Use an ice bag or a bag of frozen vegetables placed on the knee.
COMPRESS the knee with a knee brace or wrap.
- Compression reduces swelling.
- In some knee injuries, compression can be used to keep the patella aligned and to keep joint mechanics intact.
ELEVATE the knee.
- Elevation also helps reduce swelling.
- Elevation works with gravity to help fluid that would otherwise accumulate in the knee flow back to the central circulation.
- Prop your leg up when you are sitting, or use a recliner, which naturally elevates the legs. Elevation works best when the knee — or any other injured body part — is higher than the level of the heart.
Over-the-counter pain medicine: Commonly used pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve or Naprosyn) and ibuprofen (Advil or Motrin), also play a role in the treatment of knee pain.
- These drugs directly control pain and, at higher doses, act as anti-inflammatory agents, helping to break the inflammatory cycle. Like all medications, however, these drugs have side effects.
- You should not use NSAIDs if you have a problem with bleeding or stomach ulcers or some types of kidney disease.
- Acetaminophen (Tylenol) can also be used to control knee pain but does not have the anti-inflammatory properties of the NSAIDs. Still, this treatment is remarkably useful in many types of knee pain, such as osteoarthritis.
When to Call the Doctor for Knee Pain
When you are deciding whether to call the doctor about your knee pain, a good rule of thumb exists for most long-term knee injuries. If your symptoms have not gone away after trying a week of PRICE therapy and over-the-counter anti-inflammatory pain meds, you should set up an appointment with your doctor, physical therapist, or a sports medicine orthopaedic (bone and muscle) specialist to further evaluate the pain. This rule can also be applied to new knee injuries that are not disabling. Remember, however, that this rule should only serve as a guide. If you are concerned about the pain, you should call the doctor.
When to Go to the Hospital for Knee Pain
If you cannot put weight on your knee, feel sick, or have a fever or if your knee is red and hot, you should consider going to the ER to be evaluated by a doctor because of the possibility of a fracture or infection.
- Many fractures may require immobilization in a specific position or surgery.
- Infections need immediate attention. They can be managed but require prompt care.
- Putting off seeing a doctor may hinder healing.
Other signs and symptoms that demand emergency evaluation:
- Unbearable pain
- Pain that does not improve with rest
- Pain that wakes you
- Large wounds
- Puncture wounds
- Swelling, if you are on a blood thinner (warfarin or Coumadin) or have a bleeding disorder (such as hemophilia)
Getting a Knee Pain Diagnosis
History: Even in today’s world of technology, doctors rely on a detailed history and physical exam more than any single test.
The doctor will typically want to know the exact nature of the pain.
- Where in the knee is your pain?
- What does the pain feel like?
- How long has the pain been present?
- Has it happened before?
- Describe any injuries to the knee.
- What makes it better or worse?
- Does the knee pain wake you up at night?
- Does the knee feel unstable?
- Have you been limping?
The doctor will also want to know a bit about you.
- Do you have any major medical problems?
- How active is your lifestyle?
- What are the names of the medications you are taking?
The doctor will want to know about any related symptoms.
- Do you still have normal sensation in your foot and lower leg?
- Have you been having fevers?
- The doctor will likely have you disrobe to completely expose the knee. If possible, wear shorts to your appointment.
- The doctor will then inspect the knee and press around the knee to see exactly where it is tender.
- In addition, the doctor may perform a number of maneuvers to stress the ligaments, tendons, and menisci of the knee and evaluate the integrity of each of these.
X-rays, CT scans, and other tests
- Depending on your particular history and exam, the doctor may suggest X-rays of the knee. X-rays show fractures (broken bones) and dislocations of bones in the knee as well as arthritis and abnormally large or small joint spaces.
- Rarely, the doctor may order a CT scan (a 3-dimensional X-ray) of the knee to precisely define a fracture or deformity.
- Both X-rays and CT scans are excellent for diagnosing fractures. They both are also poor, however, at evaluating soft tissue structures of the knee, such as ligaments, tendons, and the menisci.
- Magnetic resonance imaging (MRI) uses large magnets to create a 3-dimensional image of the knee.
- In contrast to CT scans, MRIs do not image bones and fractures. However, they are excellent for evaluating ligaments and tendons.
- The knee and all bursae of the knee are filled with fluid.
- If your symptoms suggest infection or crystalline arthritis, such as gout, your physician may remove fluid, with a needle, from the knee.
- This fluid will then be analyzed to better clarify the diagnosis.
- Crystals, which suggest crystalline arthritis, often can be seen under the microscope. Infection may also be detected under a microscope by finding bacteria and pus in the fluid.
- The doctor may also elect to perform certain blood tests to evaluate for signs of infection or diseases such as rheumatoid arthritis, lupus, and diabetes.
- The orthopedic surgeon may elect to perform arthroscopy if you have chronic knee pain.
- This is a surgical procedure where the doctor will place a fiber optic telescope within the knee joint. The arthroscope is attached to a camera that relays real-time images to a video monitor.
- By doing so, the surgeon may be able to see small particles in the knee or to look more closely at damaged menisci or cartilage.
- The doctor may also be able to treat damage by shaving down torn cartilage or removing particles from the knee while looking at the inside of your knee on a video monitor.
Types of Knee Pain
The nerves that provide sensation to the knee come from the lower back and also provide hip, leg, and ankle sensation. Pain from a deeper injury (called referred pain) can be passed along the nerve to be felt on the surface. Knee pain, therefore, can arise from the knee itself or be referred from conditions of the hip, ankle, or lower back. All of the following sources of knee pain arise from the knee joint itself.
In general, knee pain is either immediate (acute) or long-term (chronic). Acute knee pains can be caused by an acute injury or infection. Chronic knee pain is often from injuries or inflammation (such as arthritis) but can also be caused by infection.
Acute Knee Pain
Sprained and Torn Cruciate Ligaments
- Description: An anterior cruciate ligament (ACL) injury is a common sports injury generally caused by a hard stop or a violent twisting of the knee. The posterior cruciate ligament (PCL) is stronger than the ACL and much less commonly torn. A PCL injury may happen with a serious blow, such as when the knee strikes the dashboard in a car accident; this is why a PCL injury is often associated with other ligament and bone injuries.
- Symptoms: If you tear your ACL, you may hear a pop. You will also notice your knee give way or become unstable and feel pain that is bad enough that you might feel like vomiting. This will, almost always, be followed by marked knee swelling over the next couple of hours because the ACL bleeds briskly when torn.
- Treatment: Surgical repair is often recommended for high-level athletes who demand optimal outcomes. Conservative treatment and knee braces may prove sufficient for those who do not demand quite so much from their knees.
- Description: Both the quadriceps and patellar tendons may rupture partially or completely. A quadriceps tendon rupture typically occurs in recreational athletes older than 40 years (this is the injury former President Clinton suffered while jogging), and a patellar tendon rupture typically occurs in younger people who have had previous tendonitis or steroid injections to the knee.
- Symptoms: Rupture of either the quadriceps or patellar tendon causes pain (especially when trying to kick or extend the knee). Those people with complete ruptures are unable to extend the knee. The patella is also often out of place either upward (with patellar tendon rupture) or downward (with quadriceps tendon rupture).
- Treatment: Tendon ruptures require urgent care. They typically need surgical repair, while a partial rupture may be treated with splinting alone.
- Description: Injuries to the meniscus are typically traumatic injuries but can also be due to overuse. Often, a piece of the meniscus will tear off and float in the knee joint.
- Symptoms: Meniscal injuries may cause the knee to lock in a particular position, or either click or grind through its range of motion. Meniscal injuries may also cause the knee to give way. Swelling typically accompanies these symptoms, although the swelling may be much less severe than with an ACL injury.
- Treatment: Meniscal injuries often require arthroscopic surgical repair. A locking knee or a knee that “gives” should be evaluated for arthroscopic repair.
- Description: Knee dislocation is a medical emergency. Dislocation of the knee is caused by a particularly powerful blow to the knee. The lower leg becomes completely displaced with relation to the upper leg. This displacement stretches and frequently tears not only the ligaments of the knee but also arteries and nerves. Untreated arterial injuries leave the lower leg without a blood supply. If circulation is not restored, amputation may be required. Nerve injuries, on the other hand, may leave the lower leg viable but without strength or sensation.
- Symptoms: Knee dislocations are severely painful and produce an obvious deformity of the knee. Many dislocations are reduced — or put back into alignment — on their own. As this occurs, many will report feeling a dull clunk.
- Treatment: If the knee dislocation has not been put back into place on its own, the doctor will immediately reduce the dislocation. Medical treatment, however, does not stop here. Whether a dislocation reduces by itself or is put back into place in the hospital, it requires further evaluation and care. After reduction, people with these injuries are observed in the hospital where they usually do a number of tests to ensure that no arterial or nerve injury has occurred. If such an injury is found, it must be repaired immediately in the operating room.
Dislocated Kneecap (patella)
- Description: A common injury caused by direct trauma or forceful straightening of the leg, such as an injury that happens when serving in volleyball or tennis. Kneecap dislocation is more common in women, the obese, knock-kneed people, and in those with high-riding kneecaps.
- Symptoms: If you have this injury, you will notice the patella being out of place and may have difficulty flexing or extending your knee.
- Treatment: The doctor will move the patella back into place (reduce the dislocation). Even if the patella goes back into place by itself, it needs to be X-rayed for a fracture. After reducing the dislocation and ensuring the absence of a fracture, the doctors will treat these injuries by splinting the knee to allow the soft tissues around the patella to heal followed by strengthening exercises to keep the patella in line. This injury often causes damage to the cartilage on the back of the patella.
Chronic Knee Pain
Arthritis: Arthritis of the knee is an inflammatory disorder of the knee joint that is often painful. Arthritis has many causes.
- Description: Osteoarthritis (OA) is caused by degeneration of cartilage in the knee. In its extreme form, the menisci (cartilage) will be completely eroded, and the femur will rub on the tibia, bone on bone.
- Symptoms: Osteoarthritis causes a chronically painful knee that is often more painful with activity.
- Treatment: Treatment is aimed at pain control with over-the-counter pain relievers. Anti-inflammatory medications, either over-the-counter or by prescription, can be helpful. Hyaluronic acid, a lubricating gel, often injected into the knee over a course of 3-6 weeks, can provide substantial relief for one year or more. Severe OA can be treated with narcotic pain medicines or a knee joint replacement in which a synthetic joint replaces your knee joint. Additionally, physical therapy to manage OA pain and knee function can be beneficial.
Rheumatoid Arthritis of the Knee
- Description: Rheumatoid arthritis (RA) is a connective tissue disease of the whole body that affects many joints, often the knee.
- Symptoms: In addition to knee pain, rheumatoid arthritis may produce morning stiffness and pain in other joints.
- Treatment: Treatment includes pain medications, anti-inflammatory medications, and prescription drugs (such as Rheumatrex) that are aimed at slowing disease progression.
Crystalline Arthritis (gout and pseudogout)
- Description: These severely painful forms of arthritis are caused by sharp crystals that form in the knee and other joints. These crystals can form as a result of defects in the absorption or metabolism of various natural substances such as uric acid (which produces gout) and calcium pyrophosphate (pseudogout).
- Treatment: Treatment is aimed at controlling inflammation with anti-inflammatory medications, and at aiding the metabolism of the various chemicals that may lead to crystal formation.
- Description: As a result of trauma, infection, or crystalline deposits, the various bursae of the knee may become inflamed.
- Symptoms: Acute or chronic trauma causes a painful and often swollen knee from the inflammation of the bursae. A particularly common bursitis is prepatellar bursitis. This type of bursitis occurs in people who work on their knees. It is often referred to as housemaid’s knee or carpet layer’s knee. Another type of bursitis is anserine bursitis. The anserine bursa is located about 2 inches below the knee along the medial side of the knee. More commonly occurring in the overweight and in women, but also affecting athletes and others, anserine bursitis often causes pain in the region of the bursa and is often worse with bending the knee or at night with sleep.
- Treatment: Treatment will usually include home care with PRICE therapy and NSAIDs. Severe forms, however, can be treated with periodic steroid injections.
Infection (or infectious arthritis)
- Description: Many organisms may infect the knee. Gonorrhea, a common sexually transmitted disease, can infect the knee, as can common organisms residing on normal skin.
- Symptoms: Infection of the knee causes painful knee swelling. In addition, people who develop such infection typically complain of fevers and chills. Less severe infections may not have associated fevers.
- Treatment: New swelling and pain in the knee must be evaluated for infection by a doctor. Treatment usually includes intensive antibiotic therapy. Aspiration of the joint or surgical drainage may also be recommended.
Patellofemoral Syndrome and Chondromalacia Patella
- Description: These two conditions represent a continuum of diseases caused by patellar mistracking.
- Symptoms: The conditions typically occur in young women, in athletes of both sexes, and in older people. In patellofemoral syndrome, the patella rubs against the inner or outer femur rather than tracking straight down the middle. As a result, the patellofemoral joint on either the inner or outer side may become inflamed, causing pain that is worse with activity or prolonged sitting. As the condition progresses, softening and roughening of the articular cartilage on the underside of the patella occurs, leading to chondromalacia patella.
- Treatment: Home care with PRICE therapy, NSAIDs, and exercises (such as straight leg raises) that balance the muscles around the patella work for most people. Physical therapy to assess factors that may contribute to the disease process guides management to include exercise, bracing or taping of the patella, commercial arch supports (for the arch of the foot), or orthotic supports that correct foot mechanics and may reduce abnormal forces on the knee. Severe cases of patellofemoral syndrome or chondromalacia may be treated surgically through a variety of procedures.
- Description: Tendonitis (inflammation of the tendon) of the quadriceps tendon at the upper point of the patella, where it inserts, or tendonitis of the patellar tendon either at the lower point of the patella, or at the place where it inserts on the tibia (called the tibial tuberosity, the bump is about 2 inches below the knee on the front side). Jumper’s knee is so named because it is typically seen in basketball players, volleyball players, and people doing other jumping sports.
- Symptoms: Jumper’s knee causes localized pain that is worse with activity. It usually hurts more as you jump up than when you land, because jumping puts more stress on tendons of the knee.
- Treatment: Home therapy with the PRICE regimen, along with anti-inflammatory drugs, is the basis of treatment to manage the acute phase. Particularly important are rest, ice, and NSAID drugs, which will help stop the pain and break the cycle of inflammation. After controlling the pain, you should slowly start an exercise regimen to strengthen the quadriceps, hamstrings, hip, and calf muscles before resuming your sport of choice a few weeks down the line. Also, bracing of the extensor mechanism may help remove stress from the tendons.
Knee Pain Prevention
Knee pain has a host of causes. Many types of pain are difficult to prevent, but you can do some general things to reduce the likelihood of sustaining a knee injury.
- Staying slim reduces the forces placed on the knee during both athletics and everyday walking and may, according to some medical research, reduce osteoarthritis.
- Keeping your weight down may also reduce the number of ligament and tendon injuries for similar reasons.
Keep Limber, Keep Fit
- Many knee problems are caused by tight or imbalanced musculature. Stretching and strengthening, therefore, also help to prevent knee pain.
- Stretching keeps your knee from being too tight and aids in preventing both patellofemoral syndrome and iliotibial band syndrome.
- Strengthening exercises, particularly of the quadriceps (straight leg raises and leg extensions are among the prescribed exercises), can help prevent knee injury and are essential to reducing arthritis and associated complications.
- If you have chronic knee pain, consider swimming or water exercises. In water, the force of buoyancy supports some of our weight so our knees aren’t burdened.
- If you don’t have access to a pool or do not enjoy water activities, at least try to limit hard pounding and twisting activities such as basketball, tennis, or jogging.
- You may find that your aching knees will act up if you play basketball or tennis every day but will not if you limit your pounding sports to twice a week.
- Whatever you do, respect and listen to your body. If it hurts, change what you are doing.
- If you are fatigued, consider stopping — many injuries occur when people are tired.
Protect the Knee
- Wearing proper protection for the activity at hand can help avoid knee injuries.
- When playing volleyball or when laying carpet, protecting your knees may include kneepads.
- When driving, knee protection may include wearing a seatbelt to avoid the knee-versus-dashboard injuries as well as injuries to other parts of your body.
Symptoms, Pain, Causes, and Treatment
First, it isn’t just for runners. Also, it isn’t really a specific injury. Runner’s knee is a broad term used to describe the pain you feel if you have one of several knee problems. You might hear a doctor call it patellofemoral pain syndrome.
Several things can bring it on:
- Overuse. Bending your knee again and again or doing a lot of high-stress exercises, like lunges and plyometrics (training that uses the way your muscles lengthen and shorten to boost their power), can irritate tissues in and around your kneecap.
- A direct hit to the knee, like from a fall or blow
- Your bones aren’t lined up (your doctor will call this malalignment). If any of the bones from your hips to your ankles are out of their correct position, including the kneecap, that can put too much pressure on certain spots. Then your kneecap won’t move smoothly through its groove, which can cause pain.
- Problems with your feet, like hypermobile feet (when the joints in and around them move more than they should), fallen arches (flat feet), or overpronation (which means your foot rolls down and inward when you step). These often change the way you walk, which can lead to knee pain.
- Weak or unbalanced thigh muscles. The quadriceps, those big muscles in the front of your thigh, keep your kneecap in place when you bend or stretch the joint. If they’re weak or tight, your kneecap may not stay in the right spot.
- Chondromalacia patella, a condition in which the cartilage under your kneecap breaks down
What Are the Symptoms?
The main thing is pain. You might notice it:
- Usually in front of your kneecap, though it could be around or behind it
- When you bend your knee to walk, squat, kneel, run, or even get up from a chair
- Getting worse when you walk downstairs or downhill
The area around your knee could swell, or you might hear popping or have a grinding feeling in the knee.
How Is It Diagnosed?
The doctor will give you a thorough physical exam. They might also do tests that can give them a closer look inside your joint, like X-rays.
How Is It Treated?
For most people, runner’s knee gets better on its own with time and treatments to address the problem that’s causing your pain. To help relieve your pain and speed recovery, you can:
- Rest your knee. As much as possible, try to avoid things that make it hurt worse, like running, squatting, lunging, or sitting and standing for long periods of time.
- Ice your knee to ease pain and swelling. Do it for 20-30 minutes every 3-4 hours for 2-3 days, or until the pain is gone.
- Wrap your knee. Use an elastic bandage, patellar straps, or sleeves to give it extra support.
- Elevate your leg on a pillow when you sit or lie down.
- Take NSAIDs, if needed, like ibuprofen or naproxen. These drugs help with pain and swelling. But they can have side effects, like a higher risk of bleeding and ulcers. Use as directed on the label, unless your doctor says otherwise.
- Do stretching and strengthening exercises, especially for your quadriceps muscles. Your doctor can recommend a physical therapist to teach you what to do.
- Try arch supports or orthotics for your shoes. They may help with the position of your feet. You can buy them at the store or get them custom-made.
- If you try these techniques and your knee still hurts, ask your doctor if you need to see a specialist, like an orthopedic surgeon. It’s rare, but you may need surgery for severe cases of runner’s knee. An orthopedic surgeon can remove or replace damaged cartilage and, in extreme cases, correct the position of your kneecap to send stress through the joint more evenly.
When Will My Knee Feel Better?
People heal at different rates. Your recovery time depends on your body and your injury.
While you get better, you need to take it easy on your knee. That doesn’t mean you have to give up exercise. Just try something new that won’t hurt your joint. If you’re a jogger, swim laps in a pool instead.
Whatever you do, don’t rush things. If you try to get back to your workouts before you’re healed, you could damage the joint for good. Don’t return to your old level of physical activity until:
- You can fully bend and straighten your knee without pain.
- You feel no pain in your knee when you walk, jog, sprint, or jump.
- Your knee is as strong as your uninjured knee.
Anterior Cruciate Ligament (ACL) Reconstruction Surgery
What Is ACL Surgery?
ACL surgery is a procedure that doctors use to replace a torn ligament in your knee.
The ACL (anterior cruciate ligament) is a band of tissue inside your knee. It gets damaged when it stretches or tears. ACL injuries are common among people who play sports because they make movements that can put a lot of stress on the knee, like:
- Changing direction quickly (cutting)
- Stopping suddenly
- Planting your foot and pivoting
- Landing wrong after a jump
When your ACL is healthy, it helps to hold together the bones of your knee. It also helps to keep your knee stable. If it gets damaged, you may have trouble putting pressure on your knee, walking, or playing sports.
If you strain or slightly tear your ACL, it may heal over time with your doctor’s help and physical therapy. But if it’s completely torn, you may need to have it replaced — especially if you’re young and active or an athlete who wants to keep playing sports. If you’re older or less active, your doctor might recommend treatments that don’t require surgery.
Types of ACL Surgery
When your doctor removes your torn ACL, they put a tendon in its place. (Tendons connect muscle to bone.) The goal is to get your knee stable again and give it the full range of motion it had before you got hurt.
When the tendon is put into your knee, it’s known as a graft. Three types of grafts can be used with ACL surgery:
- Autograft. Your doctor uses a tendon from somewhere else in your body (like your other knee, hamstring, or thigh).
- Allograft. This type of graft uses tissue from someone else (a deceased donor).
- Synthetic graft. This is when artificial materials replace the tendon. Silver fibers and silk were among the first ones used (in the early part of the 20th century). More advanced options are available now, like carbon fiber and Teflon, but researchers are still working to find the best material for ACL replacement.
ACL Surgery Procedure
Doctors typically use arthroscopic surgery on your ACL. This means they insert tiny tools and a camera through small cuts around your knee. This method causes less scarring of the skin than open-knee surgery does.
The procedure takes about an hour. You may have general anesthesia, which puts you to sleep through the surgery, or you may have regional anesthesia, when your doctor puts medicine in your back so you won’t feel anything in your legs for a few hours. If you have regional anesthesia, you probably will also get medicine that helps you relax during the procedure.
The first step is to place the graft at the right spot. Then, your doctor will drill two holes, called “tunnels.” They’ll put one in the bone above your knee and another in the bone below it. They’ll place screws in the tunnels to hold the graft in place. It serves as a sort of bridge that a new ligament will grow on as you heal. It can take months for a new ACL to grow in fully.
After surgery, most people are able to go home the same day. Your doctor will have you stay off your leg, rest your knee, and wear a brace to protect the joint.
Doctors are also involved in research to see if a new type of ACL surgery is better than the standard care. It’s called bridge-enhanced ACL repair (BEAR).
Unlike standard ACL surgery, BEAR helps the torn ACL heal itself so it doesn’t need to be replaced. Doctors insert a special tiny sponge into your knee between the torn ends of the ACL. They then inject the sponge with your own blood and stitch the loose, torn ends of the ACL into the sponge. It becomes a support for the ACL. Over time, the torn ends heal and become new, healthy ACL tissue.
ACL Surgery Risks
As with any type of surgery, there are risks with ACL surgery. In general, surgery may cause:
- Bleeding at the wound
- Blood clots
- Breathing issues
- Trouble peeing
- Reaction to anesthesia
With ACL surgery in particular, the risks include:
- Knee pain
- Stiffness in your kee
- A graft not healing well
- A graft failing after you return to physical activity
ACL Surgery Recovery
Before you leave the hospital, you’ll learn how to change the dressing on your wound. Your medical team may tell you to keep your knee raised on pillows, put ice on it, and wrap it in a bandage to keep it compressed. You’ll probably have to use crutches to keep the pressure off your knee.
Your doctor may recommend medication to help with pain, including:
- Over-the-counter medicine like acetaminophen, ibuprofen, or naproxen
- Prescription drugs like meloxicam (Mobic, Vivlodex) or gabapentin (Neurontin)
As your ACL begins to heal, your doctor should send you for progressive physical therapy. That will help to strengthen the muscles and ligaments. After that, you should be back to doing the things you like to do within about 9 months. For athletes, it can take up to 12 months to be able to play again.
Knee Pain and Problems | Johns Hopkins Medicine
Knee pain is a common complaint among adults and most often associated with general wear and tear from daily activities like walking, bending, standing and lifting. Athletes who run or play sports that involve jumping or quick pivoting are also more likely to experience knee pain and problems. But whether an individual’s knee pain is caused by aging or injury, it can be a nuisance and even debilitating in some circumstances.
Brief anatomy of the knee
The knee is a vulnerable joint that bears a great deal of stress from everyday activities, such as lifting and kneeling, and from high-impact activities, such as jogging and aerobics.
The knee is formed by the following parts:
Tibia. This is the shin bone or larger bone of the lower leg.
Femur. This is the thighbone or upper leg bone.
Patella. This is the kneecap.
Each bone end is covered with a layer of cartilage that absorbs shock and protects the knee. Basically, the knee is 2 long leg bones held together by muscles, ligaments, and tendons.
There are 2 groups of muscles involved in the knee, including the quadriceps muscles (located on the front of the thighs), which straighten the legs, and the hamstring muscles (located on the back of the thighs), which bend the leg at the knee.
Tendons are tough cords of tissue that connect muscles to bones. Ligaments are elastic bands of tissue that connect bone to bone. Some ligaments on the knee provide stability and protection of the joints, while other ligaments limit forward and backward movement of the tibia (shin bone).
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 (MRI). 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 (also called a CT or CAT scan). This test uses X-rays and computer technology to make horizontal, or axial, images (often called slices) 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 (arthroscope), 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.
Treatment for knee problems
If initial treatment methods do not provide relief, and X-rays show destruction of the joint, the orthopaedist may recommend total joint replacement for the knee, also referred to as knee replacement.
4 Common Types of Knee Pain (and What You Can Do About Them)
For many people—especially those who are overweight or lead a sedentary lifestyle—knee pain is practically inevitable—but it doesn’t have to be a lifelong affliction. The first step in combating knee pain is to understand where it is coming from. That means a proper diagnosis from a qualified medical professional is crucial in treating knee pain and preventing it from getting worse.
As a weight-bearing joint, the knee can take quite a beating. In addition to the normal wear and tear experienced by all joints, the knee is also acted upon by the force of gravity, which is compounded by any excess weight a person may be carrying.
Parts of the Knee
The knee is a hinge-type joint—not a ball-and-socket joint like the hip or shoulder. This means it has a fairly limited range of motion, but it doesn’t mean it is not complex.
The knee joint is a meeting of three bones—the tibia (lower leg bone), the femur (thigh bone) and the patella (kneecap). The ends of both the tibia and the femur are wrapped in articular cartilage to enable them to glide smoothly together. The underside of the patella is also surfaced with cartilage, and two more pads of cartilage called menisci (singular meniscus) sit between the femur and tibia and act as shock absorbers.
Four main ligaments keep the bones of the knee in place. They are:
- Anterior cruciate ligament (ACL)
- Posterior cruciate ligament (PCL)
- Lateral collateral ligament (LCL)
- Medial collateral ligament (MCL)
Finally, the quadriceps tendon attaches the quadriceps muscle to the kneecap, and the patellar tendon (actually a ligament since it connects two bones, instead of attaching muscles to bones like a true tendon) attaches the kneecap to the tibia.
Common Knee Pain Sources
With all that bone, cartilage and connective tissue, the potential is high for something to go wrong in the knee. The result of damage to any of these tissues? Typically pain, and often instability of the knee, limited range of motion or inability to bear weight.
Problems affecting different parts of the knee are treated differently, which is why it is so important to know the root cause of knee pain. Learn about some of the most common forms of knee pain—and their treatments.
Knee osteoarthritis is the wear-and-tear damage to articular cartilage. Osteoarthritis is the most common form of arthritis, and the knee is one of the most common sites of osteoarthritis. Cases of knee osteoarthritis have doubled since the mid-20th century.
Over time, the cartilage that wraps the ends of bones breaks down due to osteoarthritis. Eventually the articular cartilage will wear away entirely, leaving bones to grind painfully against each other.
Treatment: There is no cure for knee osteoarthritis, but the condition can be slowed and managed. Treatments include:
A total knee replacement is the only treatment option for advanced osteoarthritis. Debridement surgery to remove damaged tissue can be an option for cases that are less advanced.
The menisci are crescent-shaped pads of cartilage that act as the knee’s shock absorbers and secondary stabilizers. These tissues can become frayed and torn due to age, weight or injury. Tears can be painful and cause a feeling of instability in the knee. A lack of blood supply to most of the meniscus make tears difficult or impossible to heal on their own.
Treatment: Physical therapy can increase knee function and reduce pain. For particularly painful or debilitating tears, meniscectomies and meniscal repair surgeries may be necessary.
The ACL is the most often damaged ligament in the knee. It is responsible for keeping the tibia from sliding out in front of the kneecap, and for keeping the knee together during rotational movement. It is one of the prime stabilizers of the knee.
Treatment: The goal of treatment for minor ACL injuries (injuries to ligaments are called sprains) is to minimize pain and swelling. Treatments include:
- Activity modification
- Pain relievers
For complete ACL tears, an ACL reconstruction will be necessary. An ACL reconstruction involves placing a similar tissue—either a tendon from a cadaver (called an allograft) or from the patient’s own body (an autograft)—as a scaffold and creating an environment where new connective tissue grows.
Patellofemoral Pain Syndrome and Chondromalacia
Patellofemoral pain syndrome, also known as runner’s knee or jumper’s knee, is a condition that causes pain in the front of or around the knee. Chondromalacia, which is also sometimes called runner’s knee, is a similar condition that can cause patellofemoral pain syndrome. Chondromalacia occurs when the cartilage on the underside of the patella wears away, possibly due to misalignment of the knee joint.
Treatment: Both conditions are usually treated nonsurgically. Surgical treatment can include a tendon release if a tight patellar tendon is pulling the kneecap out of proper alignment, or debridement surgery, where damaged cartilage is surgically removed from the patella.
Knee Pain Prevention
While knee pain is common, especially as you get older, it is not inevitable. Here are some tips to keep knee pain from affecting your quality of life.
Maintain a healthy weight. Being overweight and obese are the main risk factors for many types of knee pain. Your knees have to work harder the more weight they have to carry. Keep your body mass index (BMI) between 18.5 kg/m2 and 24.5 kg/m2 for a healthy weight.
Move more… Counterintuitively, the more you do, the better your knees will feel. There’s a reason why physical therapy is almost always a treatment option for knee pain. Aim to get at least 30 minutes of moderate exercise five times a week, according to the Centers for Disease Control and Prevention.
…but move correctly. For knee pain, aim for low-impact activity like swimming or bicycling, rather than high-impact activity such as running and some forms of aerobics. Low-impact activities stress your knees less, giving you the benefits of exercise without the impact to your knees.
If you are experiencing knee pain, we can help. Request an appointment and one of our orthopedics specialists will diagnose the cause of your knee pain and suggest a treatment plan that’s right for you.
90,000 causes, symptoms, diagnosis and treatment
Pain under the knee, sharp and cutting or, on the contrary, aching and intrusive, significantly impairs the quality of life and in most cases requires referral to a specialist. The inability to walk or run quickly, lameness, increased swelling are just some of the side effects of the symptom, and in order to get rid of them, you need to understand what caused it.
Causes of knee pain
There are many reasons why the knee hurts.The most common are:
Injuries of a physical nature:
- Fracture of the knee joint, may be accompanied by a displacement of the knee disc. With a fracture, the patient experiences unbearable pain, which increases with pressure on the affected area; the knee cannot be bent, as the joint swells and fills with blood;
- dislocation – displacement of the position of the bones. Symptoms are similar to a fracture: the knee also swells and hurts;
- rupture or sprain of ligaments and tendons.Often, knees hurt and crunch, while walking, the victim can hear uncharacteristic clicks, observe swelling and excessive joint mobility. The pain is most often cutting or shooting;
- bursitis – inflammation of the knee. Puffiness appears, especially knees hurt at night and with excessive physical exertion;
- meniscus rupture – occurs as a result of abnormal development of cartilage or injury (impact, displacement, etc.). The victim has severe pain in the knee joints, there is increased swelling, and activity decreases.
Diseases of the joints:
- rheumatism – the disease is characterized by alternating discomfort, i.e. first the right knee hurts, and then the left, and vice versa. Most of all, adolescents, as well as people who have recently suffered streptococcal diseases, are susceptible to it;
- reactive arthritis is an inflammation of the joint, which appears mainly in persons 25-35 years old. With it, the knee may hurt from the inside, front, back, side or bottom, there is swelling, redness of the affected area, it may be accompanied by conjunctivitis;
- Reiter’s syndrome – the symptoms are completely similar to reactive arthritis, however, in addition to them, urethritis and intestinal malfunction are noted;
- Osteoarthritis is a disease that affects older people.Characterized by aching knee pain, aggravated during bad weather, knee also hurts at night and when walking;
- Osgood-Schlatter disease – knee pain when bending, walking up stairs, squatting;
- Rheumatoid arthritis is a still not fully understood autoimmune disease. It manifests itself in the form of increased puffiness. The patient has an unbearable pain in the front knee, especially at night;
- gout – appears as a result of an unbalanced diet, excessive consumption of junk food and alcohol.The patient experiences obsessive aching pain in the kneecap region.
What to do?
If knee pain is present, a doctor should treat it. Nevertheless, everyone should be able to competently react and provide first aid in case of injury to a designated area, because the salvation of the patella itself may depend on this.
So, it is necessary to completely immobilize the affected limb together with the joint and apply a cold compress to it, and then seek qualified medical help by calling an ambulance.
The specialist will first of all conduct an examination and prescribe medications that relieve pain in the back of the knee or in the front, after which treatment will be carried out depending on the cause of the discomfort.
Varieties of arthritis are treated with drugs that relieve inflammation and kill germs. They are prescribed exclusively by a doctor. Arthrosis requires heat, so experts prescribe warming herbal compresses and ointments to patients that increase the protective properties of cartilage.
JSC “Medicine” (Clinic of Academician Rotiberg) has the most advanced equipment that allows for quick and accurate examination of the knee joints.The specialists of the medical center will make the necessary diagnostics, after which they will prescribe the required treatment.
To get help at the highest level, it is enough to make an appointment with a therapist who will determine the exact cause of the pain. Also, in our clinic in the center of Moscow, the best traumatologists, rheumatologists, surgeons and neurologists are waiting for you.
You can make an appointment by calling the round-the-clock phone +7 (495) 775-73-60 or through the feedback form on the clinic’s official website.The medical center is located at Moscow, 2nd Tverskoy-Yamskaya lane, 10. Geographically, we are located near the metro stations Mayakovskaya, Belorusskaya, Novoslobodskaya, Chekhovskaya, Tverskaya.
Home treatment of knee pain
Treatment of a symptom at home is reduced to regular preventive measures. Follows:
- Eat a healthy diet with a balanced amount of proteins, fats and carbohydrates;
- Limit consumption of spicy, salty, fatty and sweet foods;
- reduce physical activity;
- regularly do exercises and engage in physiotherapy exercises.
If knee pain occurs when walking or at rest, then alternative methods of treatment include applying cabbage leaves, mustard compress, gelatin compress to the affected area of the skin, as well as lubricating it with an ointment for knee pain based on propolis tincture.
90,000 Knee pain | Symptoms, complications, diagnosis and treatment
Knee pain is a common complaint that affects people of all ages.Knee pain can be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions – including arthritis, gout, and infections – can also cause knee pain.
Many types of minor knee pain respond well to personal care measures. Physical therapy and knee braces can also help relieve knee pain. In some cases, however, the knee may require surgery.
The location and severity of knee pain can vary depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include:
- Redness and warmth to the touch
- Weakness or instability
- Failure to fully straighten the knee
Call your doctor if:
- Can’t carry weight on knee
- Severe swelling of the knee
- Cannot fully stretch or bend knee
- Obvious deformity in a leg or knee
- Feeling as if the knee is unstable or “falling out”
Knee pain can be caused by trauma, mechanical problems, various types of arthritis and other problems.
Knee injury can affect any ligaments, tendons, or fluid-filled sacs (bursa) that surround the knee joint, as well as the bones, cartilage, and ligaments that form the joint itself. Some of the more common knee injuries include:
Disorder of the anterior cruciate ligament. Especially common in people who play basketball, soccer, or other sports that require sudden changes in direction.
Fractures. Knee bones, including the patella, can be damaged in collisions or falls. People whose bones have been weakened by osteoporosis can sometimes break a knee just by staggering.
Torn meniscus. The meniscus is formed from tough, rubbery cartilage and acts as a shock absorber between your lower leg and femur. It can be torn apart if you suddenly twist your knee while carrying the weight.
Knee bursitis. Some knee injuries cause inflammation in bursae, small sacs of fluid that soften the outside of your knee so that the tendons and ligaments slide smoothly over the joint.
Pallinal tendonitis. Tendonitis is an irritation and inflammation of one or more tendons, which are thick, fibrous tissues that attach muscles to bones. Runners, skiers, cyclists, and those who participate in competitive sports and jumping are prone to developing inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the chinbon.
A number of factors can increase the risk of knee problems, including:
- Overweight. Being overweight or obese increases pressure on the knee joints, even with normal activities such as walking or moving up and down stairs. It also increases the risk of osteoarthritis by accelerating the breakdown of articular cartilage.
- Lack of muscle flexibility or strength. Lack of strength and flexibility are among the leading causes of knee injuries.Tight or weak muscles provide less support for your knee because they don’t drown out enough stress on the joint.
- Specific sports. Some sports put more pressure on the knees than others. Alpine skiing with hard ski boots and the ability to fall, jumping and basketball hinges, and repetitive knee kicks when you run or run increase your risk of knee injury.
- Previous damage. Having a previous knee injury is more likely to injure your knee again.
CAUSES OF KNEE PAIN
Osteoarthritis is a degenerative disease of the knee joint (it can affect any joint), which is associated with general aging of the body and is usually observed in people after 50 years. When the cartilage of the joint wears out, they no longer protect the bones of the joint from direct bone contact.
Direct bone contact causes pain and inflammation.
One of the first signs of osteoarthritis is the loss of the ability to rotate the knee joint. Symptoms include pain on movement, joint stiffness, and lameness. The intensity of symptoms can vary, sometimes there is a feeling of complete recovery, and at times – very pronounced disorders.
Osteoarthritis does not go away, but it is possible to limit the development of this disease and maximize the quality of life.
To do this, you need to take care of your weight, under the supervision of a physiotherapist, study and regularly do a set of exercises to strengthen the ligaments and muscles of the thigh, protect the knee joint from heavy load, and also take anti-inflammatory and analgesic drugs after consulting a doctor.In some cases, knee arthroplasty is necessary.
Meniscus tears. Each knee has two menisci – cartilaginous structures in the shape of a crescent. Both menisci together form a kind of ring between the heads of the bones of the lower leg and thigh. In the front and back of the knee, the menisci are connected to each other by ligaments that provide them with a small range of motion. Compared to the heads of the two massive bones of the leg – the tibia and the femur, which form the knee joint, the meniscus is soft and fragile.Although the menisci anatomically follow and support knee movements, they sometimes deviate from a safe trajectory and can be severely pinched or torn between the ends of the knee bones in motion, causing the meniscus to rupture.
The sensations caused by damage to the meniscus are characterized by the fact that it hurts, aches and pulls exactly where the meniscus is anatomically located – along the perimeter around the knee joint. After serious meniscus injuries, when a fragment comes off, inflammation often occurs in the knee, which can cause more severe pain and swelling in the knee joint.Edema may be indicated not only by visually noticeable edema, but also by a pressing unpleasant sensation in the knee.
If the meniscus tear is smooth and located in the body of the meniscus, it most likely will not cause significant discomfort and can be reconciled with it. However, if a fragment of the meniscus comes off and floats freely in the fluid in the knee joint, such an injury is likely to cause such a strong feeling of discomfort or even limitation of knee movement that you will have to seek help from an orthopedic traumatologist.
Torn fragments are usually indicative for meniscus surgery.
Knee Ligament Injuries The knee joint is stabilized by several ligaments. Injury or rupture of the ligaments usually causes immediate pain that is aggravated by moving the knee, jumping, or walking.
Types of injuries and ruptures of ligaments:
- Cruciate ligament injury is the most common knee ligament injury. It causes a feeling of instability in the knee joint and rapidly progressive edema.Cruciate ligament injuries are often treated with surgery.
- Injury to the internal lateral ligaments of the knee is caused by an injury caused by inward movement of the knee. It can be caused, for example, by mechanical shock to the outside of the knee joint. Such damage is usually treated without surgery.
- Injury to the posterior cruciate ligament of the knee is very rare. It can be caused, for example, by a strong blow to the front of the knee joint, directed towards the posterior ligaments.Damage can also occur if a person trips over. As with injuries to the internal ligaments, injuries to the posterior cruciate ligaments result in rapidly progressive swelling and a feeling of instability in the knee joint. Injury to the posterior cruciate ligament of the knee usually occurs concurrently with other injuries of the knee, such as damage to the anterior cruciate ligaments. If only the posterior cruciate ligaments of the knee are damaged, surgery is usually not required.However, if several parts of the knee are damaged, the doctor may recommend surgery.
- Injury to the lateral lateral ligament of the knee is usually the result of a serious injury such as a car accident. This damage is treated with surgery.
Damage to the knee cartilage Chialine cartilage is a very smooth and strong structure that sits between the surfaces of the bones of any joint and protects them from friction and damage.Damage to the cartilage of the knee joint occurs as a consequence of trauma, degenerative wear of the joint surface (for example, as a result of osteoarthritis), as well as as a result of other joint diseases. There are no nerves or blood vessels in the cartilage, so the cartilage cannot repair itself. The damage can go unnoticed until the moment when the cartilage is significantly worn out and can no longer protect the bones of the joint from direct contact with each other. This causes pain and inflammation. Joint bones are sensitive, and the sharp pain that occurs in such situations is caused by irritation of the nerve endings of the bones.
Torn pieces of damaged cartilage that move freely within the capsule of the knee joint can also cause pain, swelling, a “hook” feeling and sharp, sharp pain.
In the treatment of damage to the cartilage of the knee joint, both non-surgical and surgical methods of treatment are used, depending on the severity of the damage and the disorders caused.
Knee tendinitis (inflammation of the muscle tendon) . Often the cause of inflammation is degenerative processes in the tendon itself, which loses its natural elasticity as a result of aging.Inflammation can also be caused by trauma or repeated trauma. In the case of certain diseases, such as rheumatoid arthritis, gout, psoriatic arthritis or diabetes, inflammation in the tendons of the knee joint can occur without previous injury.
Tendon inflammation is usually felt as a burning pain in a specific area of the knee joint. The pain increases with movement. Symptoms can usually be effectively treated by reducing stress on the knee and using physical therapy.Protein injection – the injection of platelet-rich plasma into the injured joint – is recognized worldwide as an effective treatment for knee tendon inflammation. In rare cases, the inflamed tissue is surgically removed from the knee.
Knee dislocation is a rare but serious injury to the knee joint that can occur after a car accident, fall from a height, or a sports injury. At the moment of dislocation, the ends of the bones of the knee joint momentarily touch and are incorrectly positioned relative to each other.Knee ligaments are overly tense. Depending on the force with which the movement takes place, some of the ligaments (usually the anterior and posterior cruciate ligaments) are torn. In everyday life, this injury is called dislocation. In medicine, it is called knee ligament injury.
A dislocated knee can damage the meniscus and cartilage. Large nerves and blood vessels may also be affected. If the damage is significant, it is treated surgically by reconstructing the damaged tissue. Dislocations of the knee joint can be confused with a dislocation of the patella, therefore, when diagnosing and treating such rare injuries of the knee joint, it is important to entrust your health to the experienced traumatologists-orthopedists, whom ORTO clinic has assembled.
Dislocation of the patella (patella) is a much more common and less traumatic injury to the knee joint than a dislocated knee.
As the knee flexes, the patella slides up and down along the end of the thigh bone or groove. In some people, the movement of this cartilage is not stably fixed, so the kneecap in movement can slip out anatomically incorrectly. This may not be harmful, but it can cause the patella to dislocate when it slips completely out of the groove of the femur.Usually, after such a dislocation, the patella itself returns to its place, however, after such an injury, it is important to undergo a course of physiotherapy to strengthen the ligaments of the joint and muscles, protecting the knee from repeated dislocation of the patella. In some cases, surgical intervention is required.
Knee bursitis is an inflammation that occurs in the bag of the knee joint (mucous bag). Signs of inflammation include pain, swelling, limited knee movement, and pain when moving.Symptoms are worse when squatting or going up or down stairs. Inflammation can occur after a bruised knee, when overloading while running, jumping, or after standing for a long time. Bursitis can be caused by poor posture.
Often, after an injury in the knee joint, simultaneously with the inflammation process, fluid accumulates intensively, which doctors remove with a syringe.
Nonsteroidal anti-inflammatory drugs, pain relievers, and injections of corticosteroids and growth factor in the knee joint are used to treat inflammation of the knee joint.Corticosteroid injections quickly reduce pain and swelling, which is why they are often given when NSAIDs fail or the person has an intolerance to these drugs. Growth factor injections in the case of knee inflammation help reduce inflammation and repair tissue.
After consulting an orthopedic traumatologist, it is recommended to attend physical therapy to strengthen the ligaments and muscles of the knee joint and reduce the likelihood of re-inflammation.
90,000 reasons to which doctor to contact in Irkutsk at the Expert Clinic
Knee pain can have many causes. Alexey Yuryevich Krasovsky, a traumatologist-orthopedist of the Expert Clinic, Irkutsk, told us about why it occurs, whether it is possible to cope with it on our own, what preventive measures exist and much more.
– Alexey Yuryevich, why do knees hurt? What are the most common causes of pain?
– The causes of pain can be degenerative-dystrophic changes in the knee joint, trauma, arthrosis, arthritis.Pain can be associated with both systemic rheumatic diseases and instability of the lumbosacral spine, the so-called reflected pain. This is a violation of the statodynamic function of the muscle attached to the upper third of the inner surface of the tibia. People think that they have pain in the knee joint, but in fact it is just tension in the adductor group of the thigh muscles and the muscles of the attachment point to the inner surface of the upper third of the lower leg. The so-called tendinitis of the tendon “crow’s feet”.
– In what cases should you consult a doctor for pain in your knee, and in what cases can you endure?
– If pains appeared and disappeared within a few hours without any treatment, then this may be associated with any neurological symptomatology or physical exertion. That is, these are muscle pains or in the area of attachment of muscles, tendons and ligaments. They usually go away on their own within two to three days.
If, for example, your knees hurt and swell, i.e.That is, there is edema in the area of the knee joint, then it is necessary to look for some kind of pathology. And the edema does not have to be large, it can be insignificant. In this case, an appeal to a specialist is required to prescribe an examination.
– Which doctor should I see if my knee hurts?
– In the absence of such a specialist as an orthopedic traumatologist, it is necessary to contact a surgeon. If there is no surgeon, then to a general practitioner or general practitioner.
– What is the diagnosis for knee pain?
– If the knee hurts, then the main thing is the clinical picture (examination and taking anamnesis).The doctor finds out when the pains appeared, with what the patient associates their appearance.
An experienced orthopedic traumatologist makes a diagnosis based on the clinical picture already, let’s say, with 70-80% confidence. And additional research methods are confirming according to the principles of evidence-based medicine. For example, for cases of inspection of insurance companies or examination of the quality of care.
If the knee hurts, the patient may also be prescribed diagnostic methods such as MRI or CT.Magnetic resonance imaging is performed if the soft tissue component (cartilage, ligaments, joint capsule, menisci) is examined. And if we want to see the bone structure and clarify the spatial location of some pathological formation or process, then a computed tomography or X-ray is done.
– What treatment is prescribed for knee pain?
– First you need to make a diagnosis in order to understand which pathology is a manifestation of knee pain.If the knees hurt for reasons related to trauma, then first of all, this is immobilization (immobilization) with the help of a splint, orthosis or plaster cast, and analgesics.
As for arthritis, it can be infectious and non-infectious, purulent and non-purulent. Because these are different pathologies, then the treatment, respectively, is different. If it is arthritis that is not associated with any infectious agent, then anti-inflammatory therapy is performed. And this treatment is usually handled by both a general practitioner and a rheumatologist.
In the case when the disease is associated with a purulent inflammatory process, then it is necessary to contact purulent surgeons. If purulent arthritis is started in time to treat with the help of arthroscopic technology, then we get very good results, completely washing all corners of the joint with saline. After such treatment, a person is less susceptible to disability. And, as a rule, it recovers quite well.
For arthrosis, intra-articular injections of glucocorticoids and, in some cases, plasmolifting, PRP-therapy (enriched platelet plasma therapy) are used. The doctor can also try to eliminate conflicts in the joint and maintain range of motion by removing the intra-articular chondromic bodies, injuries. That is, it performs the so-called debridement of the joint, and thereby creates smooth movement in the joint, prolonging its life. With arthroscopic treatment, intra-articular injection of chondroprotectors is mandatory in the postoperative period.If patients live where there is no opportunity to receive intra-articular injections, then they receive chondroprotectors intramuscularly or take orally.
Despite the above measures taken in case of arthrosis, their effectiveness may be insufficient. In such cases, the question is raised about performing total joint replacement, i.e. when the joint is replaced with an endoprosthesis.
Well, the main thing is the motor regime, the use of exercise therapy and rehabilitation. This makes it possible to support the joints.
However, in any case, a complete examination is necessary. For this, the clinical picture and additional research methods, which I have listed above, are used.
– Alexey Yuryevich, what will happen if you do not heal your knees or treat them yourself, using some folk remedies?
– This will lead to a sharp decrease in the quality of human life, violation of the statodynamic function of the limb. And then to diseases of the adjacent joints (hip, ankle), to the defeat of the lumbosacral spine.In the future, an increase in the number of health problems is possible. If you do not consult a doctor in time, then ignoring the situation can lead to the replacement of the joint with an artificial one.
– Can knee pain be avoided? Tell us about prevention methods.
– Firstly, it is an active lifestyle. If a person did not move for a long time, and then gave a load, this is very bad for the joints. It is imperative that you need a constant supporting, let’s say, range of motion, and certain physical activity.
Second, using the right footwear. Very often, knee pain is associated with wearing the wrong shoes. These are sneakers, moccasins, ballet flats, etc. That is, shoes that lack the criteria for healthy shoes. What belongs to them? This is without fail a classic heel (2-3 cm), a firm block, rigid in the middle, and the use of an instep support. Earlier, back in the Soviet Union, these criteria were met, and all shoes that were produced in factories were clearly standardized.If you take apart a sample of shoes that were made in those days, then you can find a metal plate in the last. It was an instep support that supported the arch of the foot and contributed to the fact that shock absorption (reduction of impact force) occurred when walking and running.
To make an appointment with a traumatologist-orthopedist at the “Clinic Expert” Irkutsk, please click here
More information about the services of a traumatologist at the “Clinic Expert” Irkutsk can be found here and here
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Krasovsky Alexey Yurievich
In 1995 he graduated from the medical faculty of the Irkutsk State Medical University (ISMU).
1995 – 1996 – internship at the Department of Traumatology and Orthopedics, ISMU.
1996–98 – Clinical residency in the specialty “Traumatology and Orthopedics”.
More than 15 years engaged in arthroscopy of joints.
For 12 years he was the chief traumatologist of Irkutsk.
For 2 years he was the chief freelance traumatologist-orthopedist of the Ministry of Health of the Irkutsk region.
At the present time – a traumatologist-orthopedist of the highest category “Clinic Expert” Irkutsk.
Reception takes place at the address: st. Kozhova, 9a.
90,000 Knee pain: causes, treatment, why knees hurt, what to do, which doctor to go to
Movement is life.But on straight legs you will not go far. One in three people on the planet face pain in the knee, regardless of age. Medical statistics are disappointing:
- the number of causes of knee discomfort exceeds 200;
- 80% of people over 50 have problems with the musculoskeletal system;
- The percentage of patients with arthritis in Russia is increasing by 1% per year.
The knee is a complex mechanism. Thanks to him, a person makes dozens of different movements.We walk, we run, we go downstairs, we go to the gym. At the same time, the knees are under stress. With age, the cartilaginous surface of the joint wears out, inflammation and pain occurs. If you gain extra pounds, move a little, do not drink enough clean water, overcool, then accelerate the natural process of wear and tear. Injuries with increased physical exertion and chronic pathologies of the musculoskeletal system are additional risk factors.
Knee pain is very uncomfortable.It is difficult to walk, it is painful to bend the leg. Joints crunch and swell, discomfort does not allow sleep, anesthetics do not help. These symptoms poison life, make a person suffer, and interfere with normal movement and sports.
If you suffer from knee pain that you are tired of putting up with, contact the Innovative Medical Center – our doctors will restore the mobility of the knee joint and help you return to your usual physical activity, to movement without pain!
Why contact the Innovative Medical Center?
The principle of the Center’s work is an integrated approach to diagnosis and treatment, which is as follows:
The decision on treatment is made not by one highly specialized doctor, but by a team: traumatologist, neurologist, surgeon, osteopath, chiropractor.They develop a comprehensive patient recovery program and jointly monitor the patient’s recovery dynamics.
A unique method of treatment combines kinesitherapy with physiotherapy, osteopathy, manual and shock wave therapy, acupuncture. How does this technique work?
Our doctors find the cause, block pain and remove edema. For this, the clinic uses: the blockade method, the introduction of hyaluronic acids and platelet-rich plasma into the shoulder joint, as well as the unique apparatus Khivamat-200.It acts on the source of inflammation by an electrostatic field, improves lymph flow, stimulates tissue nutrition, and has an anti-inflammatory effect.
One of the stages of knee joint recovery is training in the Center’s hall, with an area of 250 m2, which is equipped with modern decompression machines. All classes are supervised by a physician-kinesitherapist and experienced instructors.
The result of this approach to treatment is a positive effect after the first procedures, quick recovery and return to life without surgery.
Employees of the Center
The main advantage of the clinic is a team of highly qualified specialists:
Bogdanov Vadim Yurievich Chief physician, traumatologist-orthopedist
Experience 15 years
More details Ronamiich Valery Gusseinovich 40 Professor, Doctor of Medical Sciences
Experience 35 years
Patient reviews confirm the quality of the Center’s team – read and watch reviews
Our treatments for knee pain
What diseases do we treat?
Pain in the knee joint can be the cause of the following diseases:
- Periarthritis of the knee tendons
- Chondropathy of the patella
- Baker’s cyst
- Pathologies in which pain penetrates into the knee area, and the source is in another part of the body: coxarthrosis of the hip joint, sciatic nerve neuropathy, fibromyalgia
- Post-traumatic recovery
You should not engage in self-diagnosis by comparing the symptoms on the Internet with those you have.This approach will complicate the treatment process and lengthen the recovery time for your joints. In our Medical Center, you can immediately start treatment correctly using the most modern techniques.
How is the treatment process going?
1. At the initial appointment, on the basis of examination, questions to you, medical history, as well as data from existing examinations (ultrasound, MRI, X-ray), the doctor makes a diagnosis, and, if necessary, prescribes additional examinations. They can be done the same day in our center on a modern ultrasound machine, which allows you to diagnose various knee pathologies (meniscus injuries, ligament ruptures, etc.)).
2. Having established the exact cause of knee pain, the doctors of our Center jointly develop an individual recovery program depending on your diagnosis.
3. The first stage focuses on techniques aimed at relieving pain and reducing inflammation. According to reviews, most of our patients feel that the pain is receding after the first procedures.
4. Then efforts are concentrated on restoring the mobility of the knee joint. At this stage, our Center uses: kinesitherapy – treatment with movement on decompression simulators, as well as methods of physiotherapy, osteopathy, manual and shock wave therapy.
5. The course of treatment is analyzed at the daily morning meeting with the Chief Physician: the attending physician outlines the current situation for each patient and, together with colleagues, analyzes the dynamics of recovery. If necessary, the treatment program is adjusted.
6. At the end of the course of treatment, the patient must be given personal recommendations and a set of exercises that he can perform at home or in our gym under the supervision of a doctor and instructors.
Every day patients come to the clinic for rehabilitation treatment after injuries, with chronic diseases of the knee joints, professional athletes, to whom we have returned the joy of movement without pain.
Come to the Innovative Medical Center. We will help you!
KNEE PAIN | orto.lv
Most common causes of knee pain:
- injury that caused inflammation,
- process of degeneration or aging of the knee joint,
Knee pain is not always indicative of knee disease. It can be caused by damage to the hip joint. Pain can also be caused by infectious and rheumatoid arthritis, or an immune system disorder that affects various tissues in the body.
Where does it hurt?
A place that hurts in the knee can help to find out the cause of the pain:
- Pain in the front of the knee joint can be caused by inflammation of the knee capsule, tendons, or arthritis.
- Pain in the side of the knee joint is usually caused by a ligament injury or a torn meniscus. In older people, pain can be caused by natural wear and tear of the articular surfaces, as well as osteoarthritis.
- Pain in the back of the knee is usually associated with a ruptured meniscus and Baker’s cyst (formed by collecting fluid in the joint, usually caused by other knee problems such as arthritis or ruptured knee cartilage).
- General knee pain can cause inflammation of the joint capsule, arthritis, ligament rupture, osteoarthritis.
Swelling in the knee joint – a symptom common to many knee problems:
- Edema that develops rapidly (within about an hour) after a knee injury may indicate damage to the cruciate ligament or joint cartilage.
- If the edema develops gradually, over several days, the meniscus may be damaged or there is a sprain.
- Edema, which occurs suddenly without injury, can cause various causes – osteoarthritis, meniscus ruptures, synovitis of the knee joint (inflammation of the synovial membrane of the articular sac), gout, rheumatic diseases, including septic arthritis.
Sense of “hold” in the knee joint makes it difficult to squat or try to fully straighten the knee. Usually, the feeling of being “hooked” can cause:
- Mechanical violation.It occurs when a detached fragment of the meniscus or patella mechanically interferes with bending the knee.
- Traffic restrictions. They can appear as a reaction to knee pain. The cause may be infectious arthritis, gout, or septic arthritis.
If you have a feeling of “catch” in the knee joint, seek immediate help from an orthopedic traumatologist.
Knee stiffness reduces the normal range of motion of the knee.Most arthritis patients feel stiffness in the affected joint. The feeling of stiffness is more pronounced in the morning. In patients with osteoarthritis, joint stiffness occurs with movement and exertion – especially after long walks.
Stiffness in the knee joint is one of the first signs of arthritis, so if you notice that it recurs, see an orthopedic traumatologist or rheumatologist.
Feeling of instability in the knee joint. The most common cause is damage to the knee ligaments.If one or more ligaments are damaged or torn, the knee joint may feel unstable.
Transient knee instability, accompanied by sudden, acute pain, may be due to damage to the cartilage of the joint, which becomes stuck between the surfaces of the knee bones as a result of movement.
There may be other reasons for the feeling of instability in the knee joint, so consult an orthopedic traumatologist for an accurate diagnosis and appropriate treatment.
90,000 Knee pain | ortoped-klinik.com
Knee pain © Fotolia.com
Knee pain is a signal of danger
and this is a “popular” disease: from five to ten million people in Germany suffer from this disease. There are different types of knee pain. Its possible causes are also varied. A thorough medical examination is necessary to determine the exact cause in each individual case.
Both the flashing red light of the engine oil level warning light and the knee pain should be assessed not as an enemy, but as a necessary warning.She indicates that something is wrong in the knee. And if you react to this warning in time and eliminate the causes, then you can solve many problems. More dangerous are painless defects, such as small cracks in the meniscus or incipient destruction of cartilage, which can imperceptibly lead to arthrosis of the knee.
There are two main reasons that cause the vast majority of knee complaints: trauma and arthrosis of the knee joint.
List of treatment methods (the appropriate method is determined according to individual indications):
Conservative treatment methods
- Special injections
- Training and muscle building
- Weight loss
- Arch support
Operative methods of treatment
Various types of knee pain
How does it hurt?
Depending on the cause of the occurrence, knee pain makes itself felt in different ways.Outwardly, bruising, redness, swelling, fever, and limited mobility are common.
Knee pains can be pulling, stitching, pressing, as well as continuous dull or convulsive.
Where does it hurt?
It is also very important where the main source of pain is located in the knee: inside or outside, on the front or back of the knee, or in the entire knee region.
When does it hurt?
In many cases, knee pain begins when running or climbing stairs.Sometimes symptoms appear only after heavy or prolonged exertion. Some knee disorders are characterized by pain even at rest or in a sitting position: knee pain during prolonged sitting can be a sign of damage to the cartilage under the patella, which the earlier it is detected, the more effectively it can be treated.
Frequent crackling of the knee can also signal joint damage – although it is usually not painful. In the same way, by the way, so is the feeling of instability in the knee with cruciate ligament injuries.
Causes and consequences
Knee pain after external injury (trauma).
Although the knee can withstand up to 1.5 tonnes for a short time, it is very prone to injury as it is not surrounded by a protective layer of muscle. Bruises, bumps from sports or from traffic accidents occur directly on the joint.
In an acute injury or accident, knee pain usually occurs immediately after the accident. Often, at rest, pain after injury diminishes, but returns with exertion.As a rule, after an injury in the joint, an inflammatory process begins and, therefore, night pains at rest.
When the cruciate ligament of the knee is injured, a feeling of lack of stability in the joint is typical.
Knee pain due to joint wear (arthrosis)
With age, more and more people suffer from joint wear and tear. The reason is the wear of the cartilage layer, which provides easy sliding of the joint and the subsequent damage to the cartilage. In diseases associated with wear and tear, gradually increasing pain is usually observed, which increases with exertion.Initial pains are also characteristic during the first movements after a period of rest. Since there is usually no inflammatory process with arthrosis, then, as a rule, no pain is observed at night or at rest, unless it was preceded by severe overload.
Osteoarthritis sometimes progresses from continuous (chronic) irritation to inflammatory arthritis, resulting in edema and effusion.
Other reasons are:
overload in sports or at work
- congenital deformities of the legs (e.g. X and O legs)
- rheumatoid arthritis
- ligament injuries
- meniscus injury
- patella dislocation
- degenerative wear
- Baker’s cyst
Knee pain can also occur after overload with harmless short-term irritation.In addition, a radiating pain from another affected joint can cause knee pain. Typical of these “shifting pains” is that in addition to knee pain, there is also pain in other joints.
Pain in the knee with inflammation in the joint (arthritis)
Characteristic features are joint stiffness in the morning, severe pain in resting position and pain relief during exercise. The pain is usually worse at night.
Knee pain due to cartilage damage
A painful change in the cartilage of the patella (chondromalacia of the patella) manifests itself in severe pain during prolonged sitting or climbing stairs.It is often seen in adolescents. Damage to the cartilage on the surface of the sliding part of the joint often makes itself felt at later stages of the development of the disease.
What to do with knee pain?
In any case, if you have persistent knee pain, you need to consult a specialist. With the help of the necessary diagnostic measures, he can determine the source of the pain, as it can be radiating pain from another diseased joint.