Knee Pain

Knee Sprains and Strains

The definitions of sprains and strains are similar, and both tend to result in pain and swelling. A sprain is the stretching or tearing of a ligament, which attaches bone to bone; astrain is a tear to the muscle itself. Sprains to the knee ligaments are often caused by sudden or abrupt movements or from contact while playing sports. Strains result from activities that cause the muscles to suddenly stretch or contract; the "pulling" of the hamstring muscle is an example. Be sure to determine what caused the sprain/strain and discontinue that activity - and be seen by a Health Care Professional for a proper diagnosis and treatment.

The R.I.C.E. protocol (rest, ice, compress, elevate) is often recommended immediately after sustaining a mild to moderate sprain or strain, perhaps accompanied by an anti-inflammatory medication such as ibuprofen. But if the sprain or strain is more serious, your Health Care Professional may prescribe immobilizing the knee with a splint or brace.

You can help reduce your risk of injury (or of re-injury) of sprains and strains by committing to an overall physical conditioning program that includes stretching and strengthening and stability exercises for the muscles surrounding the knee. It pays to pace oneself, building up to participating in new activities (or getting back to favorite sports you haven't participated in recently).

This is where the "P" for protection come into the emerging P.R.I.C.E. protocol. Protect your knees while healing from an injury, and for some time afterwards by supporting the injured joint with a brace, wrap, taping or bandaging. And wear proper shoes for your activities, whether you're a runner, walker, or participate in any high impact activity.

Osteoarthritis - a degenerative condition that affects the joints - is the most common type of arthritis that affects the knees. It is caused by the, mostly age-related, degeneration of the knee joint. Arthritis of the knee is not limited to older people, but may also manifest following an injury or result from overuse, such as carrying heavy loads, and high impact activities. Other types of arthritis - rheumatoid, inflammatory and psoriatic - though less common, may also affect the knees.

Arthritis of the knee joint can limit your activity and be seriously painful, particularly since your knees support the rest of your body when standing and are involved in walking and numerous other daily activities. You may also bend your knee joints many times as you sit or kneel - to garden, play with small children, do carpentry or participate in numerous other activities.

The primary treatment goal for those with arthritis of the knee is to alleviate pain to help you remain active. Always consult your Health Care Professional for a proper diagnosis, treatment and pain management recommendations.

Heat is a natural antidote to help ease arthritis pain, relax tense, painful muscles and increase the flow of blood to the area. The application of heat can be especially helpful prior to exercise - which is considered my many to be an important pain management strategy for those with arthritis. As your Health Care Professional will tell you, don't use heat if you have poor circulation or skin sensation

If you occasionally have a flare-up of your arthritis, the application of cold during the first couple of days may help dull the pain, but be careful not to overdo it. If you have poor circulation or numbness, do not apply cold.

Runners Knee

Also know as chrondromalacia, Runner's Knee, occurs when the usually smooth cartilage of the underside of the kneecap (patella) becomes irritated, which is often caused by an unstable kneecap. The primary symptom is pain around and sometimes behind the knee cap, that gets worse when climbing stairs or walking uphill. This change in the surface of the cartilage more closely resembles "blistering" than the pattern of degeneration more typical of arthritis. Unlike arthritis, this condition is more likely to be reversible, and often affects younger, otherwise healthy people (also, more women than men).

If you are experiencing serious knee pain, be sure to see a Health Care Professional for a proper diagnosis. Treatment for Runner's Knee varies, but often includes rest, avoiding painful activities for several weeks, followed by a gradual return to activity, and physical therapy to strengthen the quadriceps and hamstring muscles. And, increasingly rare, surgery.

Preventive measures - beyond strengthening exercises to create a "natural brace" for your knee and wearing a brace or wrap to help support the knee structure and stabilize the patella.

Ligament Injury

A ligament is the tough, ropelike fiber that connects one bone to another. Torn ligaments are serious, and may be caused by a direct blow to a joint, from sudden force or smashing, or from a deep cut. Symptoms may include a wobbly joint, limited movement, pain and swelling; a pop or snap may be felt or heard at the time of the tear. Torn ligaments frequently occur in the foot, ankle, knee, and shoulder joints. If you suspect that you have a torn ligament, seek immediate medical attention.

Treatment for a torn ligament varies, depending on several factors: the location (the knee is especially complex) and severity of the tear, the presence of other injuries, and the person's overall health and age. A partial tear may heal in several weeks with the use of a splint, while a complete tear may require surgery.

Whatever the cause or the treatment, because of the critical role ligaments play in the stability and alignment of joints, patience is required when healing. To protect yourself from further injury, as part of your rehab program and going forward, consider providing additional support to the knee with a brace or wrap.

Patellar Subluxation

Patellar subluxation is also known as an unstable kneecap (patella), and often affects adolescents and younger children, though it can also occur in adults. Normally, as the knee bends, the knee cap, slides up and down in a groove, called the Trochlear Groove, on the end of the large thigh bone (femur). The kneecap is designed to fit in the center of this groove, and slide evenly within it, but in some individuals, the kneecap is pulled towards the outside of the knee, resulting in a knee cap which cannot track properly within the groove.

This may - but does not always - lead to the dislocation of the patella from the knee joint. Pain may extend beyond the knee cap itself, and can be quite uncomfortable with activity. If this occurs, always see a Health Care Professional for a proper diagnosis, treatment and proper follow-up care.

Preventive measures include wearing a patella strap or knee wrap to support your knee cap and the surrounding tissues during activity.

Jumper's Knee or Patellar Tendinitis

tendinitis (also spelled "tendonitis") typically presents as pain and tenderness at the site of the tendon - the sheath of tissue that links your muscle to your bone - just below the knee cap. One of the major differences between Jumper's Knee and Runner's Knee is the ability to pin-point the pain.

"Jumper's knee" is one example of patellar tendinitis, and is usually caused by inflammation of the tendon through overuse, direct injury or strain - or by a small tear in it. It is commonly caused by repetitive jumping, running, jogging, walking, bicycling, but any repetitive motion to the knee may cause patellar tendinitis. It may also result from the misalignment of the hips, legs and feet. Or may be caused by an inflammatory disease such as rheumatoid arthritis.

Symptoms include pain, swelling, tenderness and restricted movement of the knee - especially where the knee cap meets the shin at the front of the leg, though it can also occur behind the knee cap. Pain usually intensifies with activity and is often worse at night. If you suspect that you have this ailment, be sure to consult a doctor for a proper diagnosis and treatment recommendations.

Tendinitis is typically treated by application of the R.I.C.E. protocol (Rest, Ice, Compression, and Elevation) by wearing a patellar strap, stabilizing the knee with a brace, and though the use of antinflammatory medications. Once past the acute stage, the tissues in and around the tendon may be rehabilitated by exercise and physical therapy. Properly warming up before exercise and providing support to the knee when active, and not overusing the knee may help prevent such injuries.

Preventive measures include wearing proper - and properly fitting - footwear for the activity you are engaged in, a patellar strap or knee brace, wearing orthotics to support your arches, and warming up before exercise.

Rehab Support

Rehab is an absolutely essential component in the healing of an injured knee; without it, your knee may remain weak and stiff, hampering your return to full activity.

Rehab pros design and supervise exercise programs with the goal of reducing swelling and inflammation, rebuilding muscle and endurance and restoring range of motion. They employ tools ranging from braces, crutches and splints - as well as positioning pillows and icing systems - which can make a real difference in the success of your rehab.

Just a note: it's a known fact that the more committed you are to your rehab program, the better by far, the outcome - you may have seen quite a variation in levels of success in those around you who have been either half- or whole-hearted in rehab. We suggest using someone you know who has come back strong as a source of inspiration and support.