Most of us don’t realise how much we rely on our knees until something goes wrong with them.
Usually, simple tasks, like crouching down, walking downstairs and jumping can become unachievable when we are suffering from knee pain. But don’t panic!! Most types of knee pain can be resolved quickly, without the pain, cost, and inconvenience of knee surgery. At Wisdom Physiotherapy, our first step is to work out the root cause of your knee pain.
What is the cause of your pain?
There are a few common types of knee pain that we see in our practice on a daily basis, mostly with great outcomes. These include:
“Runners Knee” (Patellofemoral joint pain)
This knee pain is generally felt in the front of the knee or under the kneecap (patella), and it can be felt as sharp pain or as a dull ache. There can occasionally be swelling around the patella, but this is not always the case. This pain usually increases gradually over time but can occasionally be caused by trauma, for example, a fall directly onto the knee.
Generally, the pain is worsened by running, walking up/down stairs and hills and by squatting down. A feeling of giving way is sometimes reported with patellofemoral joint pain. The knee pain you are experiencing is caused by the patella not “tracking” correctly when you bend and straighten your knee. This causes inflammation underneath your patella.
This is most noticeable when the quadricep muscles are activated (stairs, squatting, running). The poor tracking is often a result of tightness and/or weakness in your pelvis, hips or ankle (hopefully not all of them!). This leads to tightness on the outside of your thigh which pulls your patella out of line.
The meniscus is a small lip of cartilage that sits inside your knee joint. When this cartilage becomes irritated or torn, it can be very painful. The pain is normally felt deep in the knee and can be felt on either the inside or the outside of the knee. There will often be a pocket of swelling behind your knee. When the meniscus is torn, it can result in the knee becoming “locked”. If you have a meniscal issue, you will find it hard to crouch down or sit with your feet under your bottom. Spending long periods on your feet or carrying a heavy weight can make the pain worse.
Meniscal pain can be caused by a traumatic injury (eg twisting while the knee is carrying the body’s weight) or by gradual irritation. Similar to runner’s knee, this is a result of poor mechanics and strength around your pelvis, hip, knee or foot.
Ligament injuries are almost exclusively the result of an acute injury. There are 4 primary ligaments in the knee. These are the medial and lateral ligaments (MCL and LCL) on the sides of the knee and two cruciate ligaments deep inside the knee (ACL and PCL). The direction and severity of the injury will determine which of these ligaments will be injured.
When you injure a knee ligament, you will know about it!! It will be sore, there may be a cracking sound and often you will struggle to put weight on the leg immediately after. Often your knee will swell, and unfortunately, the more it swells, then the worse it is. A ruptured ACL normally swells a lot, and very quickly (first 1-2 hours).
The vast majority of ligament injuries will resolve with physiotherapy treatment that correctly diagnoses and treats the injury. If your pain does not tick any of these boxes, there is still hope for you. Through a comprehensive assessment, we will be able to diagnose exactly what is causing your knee pain and set out a treatment plan which will lead to your recovery.
Our focus at Wisdom physiotherapy is to see the body as a whole. Knee pain is very often a symptom of long-standing issues in other parts of your lower limbs. Our assessment will look at how you move, if you are tight where you shouldn’t be, and if you have areas of weakness that are causing you problems. We use a combination of skilled manual therapy (hands-on treatment) and personalised Clinical Pilates programs to correct any faulty movement patterns and to strengthen and lengthen your body to support your joints.
We find this combination provides the best results for people with knee pain.