The knee is an important weight bearing joint that is most prone to acute injuries as well as wear and tear related osteo–arthritis. Pain in the knee could be due to any of the following components:
- Osteoarthritis: Wear and tear of the cartilage between joint surfaces
- Ligament Sprains or Tear: (four major ligaments – ACL, PCL, MCL and LCL) leading to instability.
- Meniscus Tears: (Quadriceps, the front thigh muscle and Hamstrings; the posterior thigh muscle)
- Fractures: of the knee bones
- Dislocation or Shifting of Patella i.e. the Knee Cap
- Baker’s Cyst is a swelling at the back of the knee
- Knee joint swelling/pain on touch along the knee joint line
- Stiffness of the knee
- Deformity of the joint like knock-knees and bow legs
- Clicking, locking and pain with certain twisting activities like getting out of car or rolling over in bed
- Increase of pain in damp weather or after periods of inactivity, for example sitting in the cinema
- Instability of the knee, where the knee feels wobbly on weight bearing
- Difficulty in going up and down the stairs
CAUSES OF KNEE PAIN
- Trauma: to the ligaments or meniscus of the knee during high impact sports like soccer, long-distance running and tennis.
- Repetitive Stress Injuries: like inflammation of the tendon of the knee cap, etc. are usually common with certain occupations involving kneeling or squatting, prolonged standing everyday, excessive stair-climbing or lifting heavy weights regularly.
- Inflammation of the cartilage of the kneecap: common in youngsters
- Heredity: There is some evidence it can be linked to heredity.
- Weight: Weight increases pressure on joints such as the knee.
- Age: The ability of cartilage to heal itself decreases as people age
- Arthritis: When the joint cartilage is gone, the bone ends up rubbing against each other and wears away. This results in an arthritic knee.
- Other illnesses: Repeated episodes of gout, metabolic disorders and some congenital conditions.
- Poor posture or bone alignment: Poor general fitness and muscle weakness.
TREATMENT OF PAINFUL KNEE
- Medical Help – Your doctor may prescribe some anti-inflammatories and pain-killers.
A physiotherapist will make a detailed assessment of your condition and put together a treatment programme for your specific problems.
This may include:
- Mobilization & Manual Therapy: This aids to reduce pain, muscle spasm and stiffness of the knee joint.
- Shortwave Diathermy: High frequency heat energy to reduce swelling and increase circulation
- Radial Shockwave Therapy: Used for chronic Jumper’s knee or Ilio-tibial band pain. This therapy makes use of high energy acoustic waves travelling faster than the speed of sound which initiate a healing response in the deep inflamed tissue.
- Interferential Therapy: Mild electric pulses to nerve endings that lie beneath the skin to reduce pain and inflammation.
- Electrical Stimulation: Re-educate and strengthen the thigh muscle (quadriceps) through electrical stimulation. This reinforces stability.
- Ultrasound: For localised pain/swelling.
- Exercise Therapy: Exercises emphasizing on various therapy goals will be taught. This may include stretches, gait re-education, exercises to improve knee movement, strength, stability and stamina. Also Omnibands are used for strength training besides ankle weights.
- Win Plate Vibration Unit: Used for improving strength on specific muscles groups of the knee and balance training.
TIPS TO PROTECT YOUR JOINTS
- Warm-up/cool down before and after exercising
- Pace yourself by alternating heavy or repeated tasks with easier tasks or breaks
- Wearing proper shoes and using aids such as canes or walkers can also take off some of the strain.
- Weight control can reduce stress on weight-bearing joints.