Knee Pain / Injury

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Knee pain can be attributed to biomechanical deficits (issues) from the ankle or hip causing overload at the knee. Through proper history and assessment, we can determine the cause of pain or dysfunction and provide management and care to get you back to the activities you enjoy. 

 

Knee pain can also be caused by various musculoskeletal conditions, and some common causes include:

 

Osteoarthritis of the Knee

Knee arthritis signifies the wearing of the knee's protective coating, prevalent in over one-third of adults over 65, particularly affecting women. Contrary to popular belief, runners do not face an elevated risk of knee arthritis.

 

Symptoms include an aggravated deep ache during activity, relieved by rest, morning stiffness, popping sounds, and difficulty with squatting, bending, or stairs. Weather changes may exacerbate symptoms. While no cure exists for irreversible wearing in osteoarthritis, options can alleviate symptoms and enhance function.

 

Maintaining a healthy weight, staying active, and performing home exercises are crucial. Low-impact exercises like walking, stationary cycling, elliptical workouts, water walking, or swimming are recommended.

 

Frequent breaks from prolonged sitting and avoiding overly painful activities are advised. Our clinic may prescribe arch supports or orthotics, particularly for flat feet, doubling the chance of knee arthritis.

 

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS), is a painful irritation of the cartilage behind the kneecap, often termed runner's knee due to its association with repetitive running or jumping. Imbalances among muscles guiding the kneecap in its groove contribute to PFPS.

 

Symptoms include dull pain worsened by specific activities like walking, running, squatting, climbing stairs, or rising from a chair. Prolonged misalignment may lead to cartilage damage, causing grinding or popping sensations.

 

Treatment involves hands-on therapy, along with hip and foot exercises to realign the kneecap. Initially, modifying activities causing significant pain, like running or jumping, and considering alternatives such as swimming or biking is recommended.

 

Meniscal Tears

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Each knee joint features a cartilage structure comprising of an inner (medial) and outer (lateral) meniscus, acting as shock-absorbent guides for the thigh bone. In children, meniscal tears often result from forceful twisting, while aging increases the likelihood of degenerative tears, often triggered by simple or unnoticed events.

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Symptoms vary based on the damage type and severity, worsening with movement and particularly discomforting during deep squatting. Clicking, catching, locking, or giving way may occur.

 

Most meniscal injuries can be treated conservatively. Temporary activity limitation may be necessary, to avoid harmful twisting on a weight-bearing, flexed knee. Substituting lower-impact activities like water walking for higher-energy sports can be beneficial.

 

Anterior Cruciate Ligament (ACL) Injuries

An ACL tear refers to a tear or rupture of the anterior cruciate ligament (ACL), which is a crucial ligament in the knee joint responsible for providing stability and preventing excessive forward movement of the tibia (shin bone) relative to the femur (thigh bone). ACL tears often occur during sports activities that involve sudden stops, changes in direction, or direct impact on the knee.

 

Conservative treatment for an ACL tear typically involves nonsurgical approaches to manage symptoms and rehabilitate the knee. A structured rehab program helps strengthen the surrounding muscles, improve knee stability, and restore range of motion. Specific exercises target the quadriceps, hamstrings, and other supporting muscles.

 

The use of a knee brace may be recommended to provide additional support and stability to the knee during daily activities and sports. Temporarily modifying or avoiding activities that can stress the knee and worsen symptoms is important during the initial phase of conservative treatment.

 

Iliotibial Band Syndrome

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The iliotibial band, a fibrous tissue running from hip to knee, can lead to iliotibial band syndrome if excessively compressed over the knee's outer aspect. This condition manifests as outer knee pain aggravated by repetitive flexion or extension. Weak gluteal muscles or leg length discrepancy often contribute.

 

Recovery involves avoiding pain-inducing activities, wearing appropriate footwear, and considering arch supports or orthotic inserts. Runners should replace shoes every 500-800 kilometres, minimize downhill running, avoid banked surfaces, and wet/icy terrain, and reverse directions on circular tracks. Stair climbers, squats, and deadlifts should be avoided.

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Remedial Massage targets the muscles surrounding the knee joint, helping to release tension, reduce inflammation, and improve circulation. By addressing muscle imbalances and tightness, massage therapy can alleviate pain and enhance flexibility in the knee.

 

Assisted Stretching therapy focuses on increasing the range of motion in the knee joint, promoting better mobility and reducing strain on the surrounding muscles and ligaments.