More on Knee Pain

Knee pain is a common complaint.  The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia). The smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) are the other bones that make up the knee joint.

Tendons connect the knee bones to the leg muscles that move the knee joint. Ligaments join the knee bones together and provide stability to the knee:

  • The anterior cruciate ligament prevents the femur from sliding backward on the tibia (or the tibia sliding forward on the femur).
  • The posterior cruciate ligament prevents the femur from sliding forward on the tibia (or the tibia from sliding backward on the femur).
  • The medial and lateral collateral ligaments prevent the femur from sliding side to side.

Two C-shaped pieces of cartilage called the medial and lateral menisci act as shock absorbers between the femur and tibia.  Numerous bursae, or fluid-filled sacs, help the knee move smoothly.

Unknown

 

Knee pain can be caused by injuries, mechanical problems, types of arthritis and other problems. This article is an overview, since each of these conditions would require an entire article to cover.

Symptoms

The location and severity of knee pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include:

  • Swelling and stiffness
  • Redness and warmth to the touch
  • Weakness or instability
  • Popping or crunching noises
  • Inability to fully straighten the knee
  • Injuries

Injuries

A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursae) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Some of the more common knee injuries include:

  • ACL injury. 
  • Torn meniscus. 
  • Knee bursitis. 
  • Patellar tendinitis. 
  • Mechanical problems

Mechanical Problems

Some examples of mechanical problems that can cause knee pain include:

  • Loose body. 
  • Iliotibial band syndrome. 
  • Dislocated kneecap. 
  • Hip or foot pain. 

Arthritis

More than 100 different types of arthritis exist. The varieties most likely to affect the knee include:

  • Osteoarthritis. .
  • Rheumatoid arthritis. 
  • Gout. 
  • Pseudogout. 
  • Septic arthritis.  

Other problems

Chondromalacia patellae (patellofemoral pain syndrome) is a general term that refers to pain arising between your patella and the underlying thighbone (femur). It’s common in athletes; in young adults, especially those who have a slight misalignment of the kneecap; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.

Risk Factors for Knee Pain.

A number of factors can increase your risk of having knee problems, including:

  • Excess weight. Being overweight or obese increases stress on your knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.
  • Biomechanical problems. Certain structural abnormalities — such as having one leg shorter than the other, misaligned knees and even flat feet — can make you more prone to knee problems.
  • Lack of muscle flexibility or strength. A lack of strength and flexibility are among the leading causes of knee injuries. Tight or weak muscles offer less support for your knee because they don’t absorb enough of the stress exerted on the joint.
  • Certain sports. Some sports put greater stress on your knees than do others. Alpine skiing with its rigid ski boots and potential for falls, basketball’s jumps and pivots, and the repeated pounding your knees take when you run or jog all increase your risk of knee injury.
  • Previous injury. Having a previous knee injury makes it more likely that you’ll injure your knee again.

Complications

Not all knee pain is serious. But some knee injuries and medical conditions, such as osteoarthritis, can lead to increasing pain, joint damage and disability if left untreated. And having a knee injury — even a minor one — makes it more likely that you’ll have similar injuries in the future.

See a doctor if

  • the pain is severe 
  • there is paralysis
  • there is numbness or constant pins and needles in the arms, hands, legs or feet
  • the area is swollen
  • a snapping sound or tearing sensation accompanied the injury
  • there is weakness of the injured body part
  • there is extreme limitation of movement or inability to use the injured area
  • there is malfunction of the bladder or bowel
  • there is associated nausea, vomiting or blurred vision 
  • the person is disoriented, dizzy or cannot perform normal activities because of the injury

 

As an afternote, I have a fun little story to relate:  A couple of years ago, a regular client came in for her regularly scheduled appointment on a day when Tuli (my Airedale Terrier) was with me at the office.  Tuli’s ‘degree’ is in detecting health problems.  Tuli immediately alerted on my client’s knee.  I ran a battery of tests to determine that, indeed, Tuli was correct, even though the client was feeling no pain.  I sent her to an orthopedist for an evaluation, which came back as a meniscus tear requiring surgery.  Following surgery and recovery, my client asked Tuli to recheck her knee.  She passed with flying colors!

Adding regular sessions of hands-on therapies to your healthcare routine before your body starts complaining will help to keep injuries at bay, improve your musculoskeletal health, and help you maintain a state of homeostasis (or the ability to maintain a stable environment in your body).  You can even request a body scan by Tuli!  And, don’t worry, Tuli is 100% hypoallergenic!

 

Advertisements

Treating Knee Pain with Bodywork Therapies

The formation of adhesive scar tissue in the tendons, ligaments and joints is often the primary culprit in long-term pain. Although muscles get injured most frequently, they also heal more easily. Tendons, ligaments and joints, on the other hand, often take months or years to heal and often stay injured for a lifetime.

An injury is present when there is tissue damage. The damage could manifest as a swelling in a bursa or a joint; pinching of a nerve or a tendon; micro-tears in a muscle, tendon, ligament or fascia; or a major disruption of tissue like a broken bone or a ruptured tendon. When there is an injury, a part of the body has lost its structural integrity and is broken in some way.

Knee pain

When musculo-skeletal structures are damaged or torn, the body’s wisdom ensures that the damage, whenever possible, will be repaired. However, to a large extent the degree and quality of this repair depend upon our own participation. The natural mechanisms of inflammation and wound healing are usually excessive for the job at hand. The body over-compensates when it responds to injury. More plasma, red and white cells, blood platelets and chemical mediators are released than are actually needed to allow full healing to occur. Therefore, additional scar tissue is likely to form. This scar tissue often binds together damaged and undamaged structures, resulting in adhesions that can lead to re-injury and to chronic pain.

There are several methods by which we can help the body limit the formation of adhesive scar tissue and/or recover from adhesions that have already formed. Friction and range of motion exercises allow healthy tissue to grow without the reformation of adhesions.  If the injured person is able to collaborate with the body’s healing processes by adequate physical movement, complete healing is more likely. If the person is unable to perform the required exercises by him or herself, it is important to have a therapist assist the person in a full range of motion of the injured part.

Even knee replacement surgery doesn’t guarantee complete knee pain relief. Before and after surgery, sufferers may notice stiffness, decreased mobility and other painful symptoms in their knees. Massage techniques can alleviate some of these symptoms and increase flexibility, both before and after knee replacement surgery.

Recovery after surgery

Knee replacement surgery recovery varies for everyone. The length of time it takes to recover from this jarring procedure depends upon many different factors, not the least of which is the type of surgery performed. New technologies provide lots of different knee replacement surgery options, and many physicians perform partial knee replacement surgeries that are less invasive than total replacement procedures. But even the most effective surgeries will not provide total and permanent knee pain relief, and ongoing therapy may be necessary for many sufferers.

Massaging the pain away

Massage techniques can help to provide knee pain relief when utilized on a regular basis to keep the new joint mobile, flexible and comfortable, and will compliment any other therapies you are receiving, such as physical therapy.

Yoga to help your knees heal

Years of compensation patterns coupled with the lack of proper stretching (and of course, neglecting the scar tissue) result in limitations of movement.

Many people engage in habitual physical activities that contribute to pain. The love for a sport may override the initial whisper of a pain, until that whisper becomes a scream.

When addressing any injury, it is valuable to also address the joints above and below. Nothing could be truer than with the knee. Opening and strengthening the hips in every direction is important for even distribution of weight. After just a few short sessions range of motion and functionality increases while pain decreases, and you may even choose to sit cross-legged!

One of my greatest rewards as both a Board Certified Bodywork Therapist and a Yoga instructor is assisting clients to keep their sport of choice in their lives by prepping their bodies with sport specific healing movements and self-care strategies.