The knee joint is a hinge joint, meaning that it is a synovial joint made up of two or more bones where the joint can be moved in one axis to either flex or extend. The knee joint comprises of the shin (also known as the tibia) and the femur bones. The knee cap or the patella bone is situated in front of the knee joint. The knee is supported by four ligaments called cruciate ligaments. Menisci are structures found within the knee that absorb shock.
Knee pain is a very common complaint among many of individuals, especially in the middle aged and elderly population. It can be a result of repetitive trauma, overuse of the joint or strain of the knee joint. Sometimes knee pain has no apparent reason. Knee pain can be mild in some and very severe in others. When severe, it may disrupt the daily tasks of individuals due to the functional limitation of the knee joint. This may cause difficulty in walking, climbing stairs or even standing up from a sitting position.
Assessing the type of knee pain you have
Depending on the duration of your knee pain, you can determine if your knee pain is acute, sub-acute or chronic in nature. This helps your doctor to diagnose the cause for the knee pain and also to plan the appropriate treatment.
What is acute knee pain?
This type of knee pain is the most severe and occurs about one to seven days after the injury or insult to the knee joint. However, this type of pain will only last for a short period of time and tends to go away without treatment. It is important that you rest the knee and allow the injured structures of the knee joint to heal with time.
What is sub-acute knee pain?
Sub-acute knee pain begins after about two to six weeks after trauma is experienced.
What is chronic knee pain?
Chronic knee pain is when the pain lasts for a longer time, usually more than eight to 12 weeks duration. If your knee pain has been lasting for this long, then it definitely needs to be assessed by your doctor. This type of knee pain rarely disappears without treatment.
Where exactly is the pain?
The location of the symptoms is very important in order to determine what structures have been damaged. This allows your doctor to come to an accurate diagnosis. Making an accurate diagnosis is the key to successful treatment plan. Pain can arise in front of the knee joint, within the knee joint or from the back of the knee joint. All of these suggest a different problem.
- Pain arising anterior to the knee joint
If your pain is coming from the front of your knee joint, then the problem may with the knee cap. This condition is often referred to as patellofemoral stress syndrome (PFSS). In this condition, the knee cap and the tendon between your patella and the shin bone become inflamed, thus causing pain. PFSS usually reduces activities such as kneeling, climbing up or down the stairs or running and jumping.
- Pain arising from within the knee joint
If your pain seems to be coming from inside of the knee joint, then the likely problem is an injury to the medial meniscus or medial collateral ligament. This type of injury occurs as a result of athletic activity. It happens when you your foot is planted on the ground and the body twists over the knee joint. Although the menisci are shock absorbers, the knee can still experience occasional wear and tear. Arthritis can also develop in the knee, and sometimes the knee can get damaged without any apparent reason.
- Pain arising in the back of the knee joint
Pain in the back of your knee joint is quite rare to occur. The possible causes for knee pain to arise in the back include hamstring strain or baker’s cyst. One of the hamstring tendons attaches to the bones at the back of the knee joint. So if there is a strain in the hamstring muscle, then the pain can arise from the back of the knee joint.
Baker’s cyst is an abnormal swelling in a space at the back of the knee joint. The pain is aggravated with the bending of the knee joint.
Physical therapy for your knee pain
Knee pain does not always need medication or surgery, sometimes just a bit of physical therapy and some lifestyle modifications are all you need to get rid of the pain. If you have been referred to a physical therapist for your knee pain, then the very first visit to them is extremely important to ensure that an accurate diagnosis is made. This is crucial for planning the management of your injury. During this first visit, the physical therapist may take a brief interview to collect information about the history of your problem. The therapist might want to learn what factors may relieve the pain or aggravate the pain, and about your past medical history that might have an association with the current problem.
After taking a detailed history, the physical therapist will move on to a full examination of your knee. The examination may include the following:
- Evaluation of your gait – Your physical therapist may ask you to walk a few steps and will assess if there is any affect to your gait. They are trained to notice small changes in movement during walking.
- Palpation of the knee joint – Your physical therapist will then feel the different structures of your knee joint to look for any abnormalities. While doing this, the therapist will also note if certain movements or touching a specific location causes any pain.
- Assessing the range of motion of the knee joint – The knee joint can only extend and flex your leg. Your physical therapist will assess up to what degree this function is affected. The therapist will want to see how far your knee can be straightened and bent.
- Measurements of the strength of the surrounding muscles – The knee joint has several muscular attachments around it. Therefore, assessing the strength can determine if a weakness in the muscles is causing pain in your knee joint.
- Special tests – Your physical therapist may perform special maneuvers to determine what structures may be responsible for causing the knee pain.
After examining your knee joint, your physical therapist can come to a diagnosis based on the result of the examination and history. This can help him or her work out a treatment plan for you. It is very important that you follow all directions in the scheduled plan, as the physical therapist instructs to see maximum results.
Often, they will prescribe you some strengthening exercises to improve the movement of your knee joint.