Knee Pain – What’s Wrong With Your Knee?

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“I’m Limping About Like My Grandma”

 

If you have ever had knee pain, or a swollen knee you will know how much it affects all of your movement.

 

This could be just when you are walking, or whether it’s stopping you doing something you love such as running or cycling.

 

As an osteopath I believe it’s vital to get your knee problem diagnosed and back to health as quickly as possible.

 

This is not just for the sake of your knee, but also because sometimes the back and neck problems I see in people, are actually being caused by knee issues.

 

Their body is compensating for their unhappy knees causing problems elsewhere.

 

 

Knobbly knees? Who Cares – Knees Are Why We Can Walk Straight.

 

The knee is a ‘hinge’ joint, which allows us to walk in a straight line. This fact may sound like stating the obvious, but it’s thanks to the knees that we can walk in a straight line at all, instead of going around in circles.

 

When you walk, your body rotates through your chest and hips as your arms swing, and you knees have to be able to take that twisting momentum, and convert it to forward movement in a straight line.

 

Because of this, it means that the knee isn’t a simple hinge joint, but has a tiny amount of rotation passing through it too.

 

The knees also have to cope with the angle change, where our hips are wider apart than our feet normally are.

 

But all these forces through the knee can lead to problems, especially if they are not looked after properly, leading to pain.

 

 

 

 

 

 

 

What Causes Knee Pain?

 

When taking a detailed case history for knee pain, it’s important to find out the type of pain, where it is, how long it’s been around, and if there is any clicking, locking or giving way in the knee. These all give important clues as to what’s causing the issue.

 

Then with examination and orthopaedic testing, the problem can be diagnosed. The following are some of the common causes of knee pain I see as an osteopath.

 

  1. Meniscal (cartilage) tear
  2. Runner’s knee (Patellofemoral syndrome)
  3. Bursitis
  4. Arthritis
  5. Osgood Schlatters
  6. Hip/low back referred pain

 

 

 

  1. Meniscal (cartilage) Tear

 

Did you know – Each knee has two cushions of cartilage in each which lie horizontally within the knee joint. These sit between your thigh bone (femur) and shin bone (tibia).

 

These ‘menisci’ are often referred to as ‘cartilages’, and act to cushion the joint every time you take a step, or straighten your knee.

 

 

What happens with a meniscal tear – The menisci are vulnerable to compression and tearing forces, which can often occur during turning suddenly e.g. in basketball, or just from overuse if the knee isn’t working properly.

 

 

  1. Runner’s knee (Patellofemoral Pain Syndrome)

 

Did you know – The knee cap (patella) rests over the front of the thigh bone (femur) and sits within the tendon of the thigh muscle (quadriceps muscle, or commonly called ‘quads’ who act to extend the knee).

 

What happens with Runner’s knee – Tight quads squash the patella against the femur and tibia. Also if there is imbalance it means the patella doesn’t ‘track’ correctly. It should move straight up and down, but often weakness in the muscles can cause it to deviate to one side, causing pain.

 

It is called runner’s knee because it’s commonly seen in runners.

 

 

  1. Bursitis

 

Did you know – A bursa is a slippery sack of tissue found in joints where tendons (where muscles attach to bones) run, to help lubricate the tendon movement.

 

Incredibly there are upto 11 bursae in each knee.

 

What happens with bursitis – The bursae can become inflamed by tight tendons squashing them, and then they cause swelling and pain, often accompanied by heat over the area.

 

 

  1. Arthritis

 

Did you know – The surfaces of the femur (thigh bone) and tibia (shin bone) and the back of the patella (knee cap) are covered in a smooth cartilage, which helps the surfaces glide when you are moving about.

 

What happens in Arthritis – With age and use, this cartilage can wear away. Often the phrase ‘wear and tear’ is used, but what this means is that the smooth covering becomes rough and in some areas bone is exposed.

 

Then the bone can start to remodel, as it responds to the new forces being put through the knee. This causes bits of bone to grow where they shouldn’t be causing pain as the surfaces rub together.

 

  1. Osgood Schlatters

 

Did you know – The quadriceps muscles (the front thigh muscles) attach to the front of your shin. This tendon pulls on the tibia every time you straighten your knee.

 

What Happens In Osgood Schlatters – This is commonly seen in sporty teenagers. Because they are using their quads muscles a lot, it means that the bone of the shin becomes swollen and painful just below the knee cap. Sometimes a bony lump can form.

 

 

  1. Referred Pain From the Hip/Low Back

 

Did You Know – That the hip and low back have nerve supplies that can also send pain down the leg to the knee. This is called referred pain.

 

What Happens in hip/low back pain – If you have a problem in the hip, it can then refer pain to the knee. If you have a nerve being trapped in the low back (lumbar spine), it means that the nerve can send pain down the leg to the knee. This is why a thorough case history and examination are needed to work out your problem.

 

 

Other Causes Of Knee Pain

 

There are other causes of knee pain, which need to be considered including rheumatoid arthritis, osteomyelitis, osteosarcoma, Ewings tumour, popliteal thrombosis, popliteal aneurysm, reactive arthritis.

 

 

Thank you for taking the time to read this article – I hope you have enjoyed it. If you found this article interesting and you know someone who may benefit from it, please do pass it on.

 

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