Knee Pain

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It’s an all too common issue which we all may suffer from at some point – knee pain! As a child you may have heard your parents or grandparents talk about their bad knees or some of your friends referring to their bad knee or good knee. You may even have even experienced knee pain as a child.

Knee pain can happen to anyone and everyone, the best way to protect yourself is to learn about the knee and all of its varying aches and ailments! Learn how to take care of your knee and ultimately prevent this from happening.

Our guide to knee pain starts with the anatomy of the knee.

 

General Anatomy

 

The knee is a simple hinge joint and gaining further understanding of this can help you to self-analyse any pain you have in your knee or help other people out with theirs.

The knee joint is made up of 3 different bones which are the femur (thigh), tibia (shin) and the patella (kneecap). These bones fit together to make two separate joints.

 

The Tibiofemoral Joint

 

This is the largest joint in the knee and it is a hinge joint which moves to bend and straighten the knee. The knee joint does allow 15 degrees of rotation each way but no more than that – if the knee twists outside of that range then it can possibly cause damage to the internal structures. This is the largest joint in the body and as well as facilitating movements such as squatting, lunging and jumping it helps to absorb shock from all of the weight-bearing movements placed through it.

 

The Patello Femoral Joint

 

Is the smaller of the joints in the knee and it is created when the patella sits in a little groove at the end of the femur and glides up and down when the knee bends and straightens.

The kneecap is held in place by small ligaments and the thigh muscles which sit around it. Dislocation of the patella is common in people who have weak quadriceps muscles and if they have a shallow groove on the end of the femur it may cause frequent discolouration.

 

Cartilage

 

Connective tissue which in nature is smooth but firm and allows for shock absorption, pain-free movement and healthy joint function. The end of the femur which forms the knee joint has two large rounded ends called femoral condyles and they lined with smooth cartilage and the top of the tibia has two discs of cartilage called meniscus.

The two bones contact each other to form joint and the function of the cartilage acts to provide the shock absorption which is so important for the knee. Smooth surfaces of this firm, yet spongy material help with regulating knee pain and maintaining full movement and performance of the knee.

 

Ligaments

 

Bones are held together by strong pieces of connective tissue called ligaments. Bone to bone connection from ligaments helps the knee to become secure along with muscles and tendons. Ligaments main role is to provide structural security. Ligaments can be injured with trauma when the knee is taken to its extremes so having strong muscles to support your knee helps to protect your ligaments from suffering injuries.

The main ligaments of the knee are the medial and lateral collateral ligaments which sit on the inner side and outer side of your knee respectively. The cruciate ligaments form a cross at the back of the knee which help to connect the femur and tibia to each other – they are central within the knee and help to stop the tibia moving forward and the tibia moving backwards. The knee cap has its own ligaments which help to secure it.

 

Tendons

 

The attachment tissue from muscles to bone – a muscle merges into tendon tissue and then attaches to the bone. The function of the tendon is to generate force into a muscle and help to move a joint.

Important tendons that help to operate the knee are the quadriceps tendon sitting above the knee cap coming from the thigh muscles and the patella tendon which leads from the kneecap into the shin. These two tendons combined with the hamstring tendons have a major role to play in the flexion and extension of the knee.

 

Muscles

 

The muscles of the knee help to move the knee when it bends and straightens. The quadriceps help to extend the knee and make it secure when it is straight. The hamstrings flex the knee, extend the hip but also they help to prevent forward excess movement of the shin by pulling it back and preventing injury and they have also help to prevent pain at the front of the knee.

The muscles around the glute area also have an effect on the knee as they help to rotate the femur and this controls knee rotation – ensuring the knee remains well controlled and stable.

Symptoms

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Depending on what is the exact cause of your knee pain then you experience different symptoms but let’s outline the main symptoms of knee pain.

Loss of joint range of movement is common – lacking full extension or flexion can happen and this may be accompanied with feelings of tightness or stiffness. If the knee is swollen then this will certainly impede your ability to gain full range of motion.

Pain can be experienced in the knee as a whole or in smaller specific areas. If your injury is to the inside of the knee then this will become more apparent with weight-bearing exercises such as standing and walking. If you have any pain at the knee cap or from knee tendons then the pain can be more superficial and you will be able to press upon it.

Loss of strength will always come with any knee pain – if you have pain then it can limit how you normally use your knee. This means the strength will reduce and it can affect how you walk and run and move.

Night pain is also quite common as it is sometimes difficult to position the knee in a place where it is comfortable. Placing pillows behind your knees to support the joint can help to get better sleep.

 

A safety note

 

If you have suffered an injury to the knee involving a loud clicking, clunking or popping injury which has resulted in immediate swelling – be aware of the knee locking and becoming blocked and / or the knee being unstable and giving way. You should contact the doctor if you have any of these signs as it may indicate damage to cartilage or ligaments.

Causes

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Osteoarthritis – is a wearing of the knee joint which happens over time – typically as we pass 50 years of age. The cartilage in our knees can become uneven leading to a loss of a smooth surface which can cause flares of pain in the knee.

Patella Tendinitis – is a common injury in the younger population which is often accompanied by athletic activity or sudden increases in exercise amount. The tendon at the front of the knee becomes painful and it can affect how we exercise.

Bursitis – bursa are fluid-filled sacks which sit around joints to provide cushioning and support. Patella bursitis can come with excess kneeling or Impact to the knee – this causes the bursa to swell and increase in size causing pain and swelling.

ITB Syndrome – this problem actually originates up at the hip and buttock region but because the IT band inserts below the lateral line of the left knee. When it becomes dysfunctional, it increases in tightness and causes the outside of the knee to become painful as its structures are being compressed more tightly. ITB syndrome is common in people who run a lot.

Anterior knee pain – is an umbrella term for any pain that is experienced at the front of the knee which can include bursitis, tendinitis but also weakness of the knee typically causes pressure to build in the front of the knee resulting in pain as the joint is trying to deal with too much pressure.

Trauma to the knee can result in a selection of injuries – falling on to the knee directly can cause issues with the knee cap and bursa. Impact from the outside of the knee inwards has the potential to damage the joints and ligaments and sporting injuries such as twisting injuries can result in serious ligament injuries to the anterior cruciate ligament or meniscus structures.

Supplements

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If you are suffering from pain in the knee then considering some form of pain relief would be a sensible option, including an anti-inflammatory if you are able to use them. Make sure you consult your doctor if you have any other pre-existing medical issues. If you want to be more proactive about your knee health then try these options out.

Glucosamine and chondroitin have had promising results in research for helping to maintain cartilage which will ensure a healthy knee joint.

Turmeric and ginger have anti-inflammatory properties at high doses – consider adding more of these foods to your diet or looking for supplement versions.

Cod liver oil has always been a mainstay in the supplement world due to its properties of maintaining healthy, well-lubricated joints.

Exercises

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Here are the top 5 exercises for knee pain, starting with the most simple and progressing to some more advanced options.

 

Static Quadriceps

 

In a sitting position or lying down – this exercise is as simple as they come. Perform a still contraction of the knee and attempt to straighten it and hold for around 5-10 seconds. Repeat until tired. This exercise is great anytime, especially helpful if you have just hurt your knee. The more strength you have in the knee the less pain you will experience.

 

Heel Slides

 

This is a basic exercise if you have swelling or reduced movement in the knee. In order to get your knee healthy, you must restore its full range. In a long sitting position, ensure you have a surface your heel can slide on, such as a hard floor. Gently extend the knee as far as you can, then bend the knee as far as you can. Repeat and take the knee as far as your comfort allows each time.

 

Squat

 

A classic exercise which is great for the knees and quadriceps. Squatting is the motion of rising from sitting and repeating. There are many ways to perform the squat ranging from partial squats from a raised seat, bodyweight squats and then different ways to add weight to squats as well as single-leg squats.

 

Hamstring and Glute bridging

 

As mentioned in the article, earlier, the knee is supported by the hamstrings and the glutes. Strengthening these areas are vital to maintaining a healthy knee. Bridging can be done lying on your back using just bodyweight. With the knees bent and back flat on the floor pushing your hips into the air. There are different variations such as elevated single leg bridges and glute master machines at the gym which you can add weight to.

 

Knee Extension

 

The knee extension machine at the gym is the only machine that can isolate the quadriceps muscle. Having strong quadriceps are a great way to protect the knees. There is a way to do the exercise at home if you have elastics to use. The exercise is simple – in a sitting position, simply straighten the knee against resistance and control it back to the start.

 

That concludes our guide to knee pain! Make sure you exercise regularly, strengthen the knees and ensure you use any supplements to help maintain a healthy knee!