Knee pain is an extremely common complaint, and there are many causes. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause. If you have knee pain, some common causes include:
Osteoarthritis is the most common type of knee arthritis.
Also called wear-and-tear arthritis or degenerative joint disease,
osteoarthritis is characterized by progressive wearing away of the
cartilage of the joint. As the protective cartilage is worn away by knee
arthritis, bare bone is exposed within the joint. Knee arthritis typically affects patients over 50 years of age. It is
more common in patients who are overweight, and weight loss tends to
reduce the symptoms associated with knee arthritis.
There are two menisci in your knee; each rests between the thigh bone
(femur) and shin bone (tibia). The menisci are made of tough cartilage
and conform to the surfaces of the bones upon which they rest. One
meniscus is on the inside of your knee; this is the medial meniscus. The
other meniscus rests on the outside of your knee, the lateral meniscus. These meniscus functions to distribute your body weight across the knee
joint. Without the meniscus present, the weight of your body would be
unevenly applied to the bones in your legs (the femur and tibia). This
uneven weight distribution would cause excessive forces in specific
areas of bone leading to early arthritis of knee joint. Therefore, the function of the meniscus is critical to the health of your knee. The two most common causes of a meniscus tear are due to traumatic
injury (often seen in athletes) and degenerative processes (seen in
older patients who have more brittle cartilage). The most common
mechanism of a traumatic meniscus tear occurs when the knee joint is
bent and the knee is then twisted.
Anterior Cruciate Ligament
The anterior cruciate ligament, or ACL, is one of four major knee
ligaments. The ACL is critical to knee stability, and people who injure
their ACL often complain of symptoms of their knee giving-out from
under them. Therefore, many patients who sustain an ACL tear opt to
have surgical treatment of this injury. The diagnosis of an ACL tear is made by several methods. Patients who
have an ACL tear often have sustained an injury to the knee. The injury
is often sports-related. They may have felt a "pop" in their knee, and
the knee usually gives-out from under them
Rehab is one of the most important, yet too often neglected, aspect of ACL reconstruction surgery. Rehab following ACL surgery focuses on restoring motion and strength, and improving the stability of the joint to prevent future injuries.
While general guidelines exist for ACL rehab, it is critically important
that each individual progress through their rehab as their knee allows. Progressing too quickly or too slowly can be detrimental to overall results from surgery,
therefore it is important to ensure your therapist and physician are
guiding your rehab.
Treatment of PCL tears is controversial, and, unlike treatment of an ACL tear,
there is little agreement as how best to proceed. Initial treatment of
the pain and swelling consists of the use of crutches, ice, and
elevation. Once these symptoms have settled, physical therapy is
beneficial to improve knee motion and strength. Nonoperative treatment
is recommended for most grade I and grade II PCL tears.
Treatment for Patellar Tendinitis may include stretching the quadriceps, hamstring, and calf muscles prior to activity
is very important once you do resume activities. Getting into a good
stretching habit, even once the symptoms resolve, will help prevent a
recurrence of the problem.
The treatment of Chondromalacia remains controversial, but most
individuals can undergo effective treatment by resting the knee and
adhering to a proper physical therapy program.
Traditionally, patients with Patellar Subluxation were sent to physical therapy to strengthen
their VMO (part of the quadriceps muscle) to realign the pull on the
kneecap. More recent research has shown that this is probably not the
critical factor in eliminating kneecap problems. Focusing instead on
strengthening of the hip abductors and hip flexors (so-called pelvic
stabilization exercises) offers better control of the kneecap.
Call Campus Physical Therapy Center to schedule your appointment to treat this or many other conditions.
Posterior Cruciate Ligament
The posterior cruciate ligament, or PCL, is one of four ligaments important to the stability of the knee joint. The anterior cruciate ligament, or ACL, sits just in front of the PCL. The ACL is much better known, in part because injuries to the ACL are much more commonly diagnosed than injuries to the PCL.
Interestingly, it is thought that PCL injuries account for about 20 of
knee ligament injuries, however, the PCL is seldom talked about because
these injuries are often left undiagnosed.
The patellar tendon connects the kneecap (the patella) to the shin bone.
This is part of the 'extensor mechanism' of the knee, and together
with the quadriceps muscle and the quadriceps tendon, these structures
allow your knee to straighten out, and provide strength for this motion.
The patellar tendon, like other tendons, is made of tough string-like
bands. These bands are surrounded by a vascular tissue lining that
provides nutrition to the tendon. Patellar tendonitis usually causes pain directly over the patellar tendon.
Chondromalacia patella is a common cause of kneecap pain or anterior
knee pain. Often called "Runner's Knee," this condition often affects
young, otherwise healthy athletes.
Chondromalacia is due to an irritation of the undersurface of the
kneecap. The undersurface of the kneecap, or patella, is covered with a
layer of smooth cartilage. This cartilage normally glides effortlessly
across the knee during bending of the joint. However, in some
individuals, the kneecap tends to rub against one side of the knee
joint, and the cartilage surface become irritated, and knee pain is the
result. The treatment in physical therapy program should emphasize strengthening and flexibility of the muscles of the hips and thighs. Use of nonsteroidal anti-inflammatory medication is also helpful to minimize the pain associated with chondromalacia.
Prepatellar bursitis, also known as housemaid's knee, is a common cause
of swelling and pain on top of the kneecap. The name "housemaid's knee"
comes from the association of this condition with individuals whose work
necessitates kneeling for extended periods of time. Prepatellar
bursitis is common in professions such as carpet layers and gardeners. A bursa is a thin sack filled with the body's own natural lubricating
fluid. This slippery sack allows different tissues such as muscle,
tendon, and skin slide over bony surfaces without catching. These bursa
are normally very thin (like a plastic bag with the air sucked out of
it), but they do present a potential space that can become inflamed and
irritated. This is what is known as bursitis
The kneecap slides up and down a groove on the end of the thigh bone as
the knee bends. This groove is called the trochlea. The kneecap is
designed to fit in the center of this groove, and slide evenly within
the groove. In some people, the kneecap is pulled towards the outside of
the knee. As this happens, the kneecap does not slide centrally within