What to do about Knee Pain?

Knee pain is incredibly common. It’s estimated that 25% of adults will experience pain in one or both knees during their lives. But children and teenagers can also suffer from knee pain. Sometimes an illness such as gout is the cause. Often, damage to the soft tissues around the joint causes pain. Many patients find it extra frustrating when they can’t identify the cause — when there was no incident or fall, just a niggling pain that keeps getting worse. Your osteopath can help identify the cause of your pain and provide treatment and advice so that you can get back to moving well.

The knee is a synovial hinge joint. Why do we call it a hinge? It’s pretty much meant to move in just two directions, like a door on a hinge, not laterally (side to side, but more on this later.) Synovial refers to the fluid that lubricates the joint.

The tibia (shinbone), femur (thighbone) and patella (kneecap) intersect at the knee.

The four ligaments: the medial collateral ligament, the lateral collateral ligament (try saying that four times quickly), the anterior cruciate ligament and the posterior cruciate ligament stabilise the joint, keeping the tibia from sliding out from under the femur. Cartilage is an important component of the knee, as it is for all synovial joints.

The ends of the Tibia and Femur are both covered in cartilage where they would otherwise rub together. Shock absorption for the knee is provided by c-shaped, tough, rubbery cartilaginous tissues known as the meniscus.

There are also many tendons in the knee. Some of the most prone to injury include the quadricep/patellar tendon, which connects the quadriceps to the patella and onto the front of the tibia. Patella tendinopathy, also sometimes known as jumper’s knee, is an overuse injury common among athletes.

And there are bursae (fluid-filled sacs) that can sometimes become inflamed. With all that complexity, with all the muscles that interact to move this joint, and the load we put on it day in and day out, is there any wonder that knee pain is so common?

The knee allows for some lateral movement. (The femur and lateral meniscus flow over the tibia during rotation.) But for stability, the cruciate ligaments (the one’s deep inside the knee) limit this lateral, rotational movement. Sudden twists and turns (as we might see in netball for example) can damage the anterior cruciate ligament and the meniscus by working them too hard, too suddenly. Indeed, ACL tears and meniscal injuries are among the most common injuries in netballers! While partial tears can heal over time, complete tears often require surgery, so attention to jumping, landing, and pivoting techniques is an essential aspect of training for sports and dance forms that involve pivoting!

We know what to do when there’s been an accident resulting in injury: RICER. (Rest, ice, compression, elevation, referral.) So, if you’ve had a fall, or landed badly and torn your ACL, you know what to do in the first instance… then you need to book in and see us! But what if you can’t identify the cause — what if the pain just slowly snuck up on you? You might be surprised to know that rest is not always advised. Joints need to move. Synovial fluid can only move around the joint if you keep moving through the joint’s full range of motion.

This does not mean you carry on with whatever activity you think caused the pain in the first place or continue to limp around when your physician has advised you not to. It means you keep moving the joint gently through its range of motion, perhaps without load at first and perhaps under the supervision of your osteopath or other health professional. Alongside this, it means you find a low-impact exercise to keep you healthy while you are healing. It means you gently and consistently strengthen and stretch the muscles supporting the knee: the quadriceps, hamstrings, calves, and tibialis. Your osteopath can advise you on the muscles most in need of strengthening to bring your body into balance and alignment.

Knee pain can be generalised or quite specific. It can be a little annoying or totally debilitating. Knee pain can have many causes. If pain is ongoing, becoming worse or preventing you from enjoying sports and hobbies, call on 07 5451 1599 to make an appointment today. The team at The Osteopath can help you get to the bottom of what’s causing your pain and lend you our expertise, devising a specific regime of rehabilitative exercises for you. Through gentle manipulation, we can bring function back, allowing the body’s natural healing processes to work effectively. Massage and dry-needling may further reduce pain and improve mobility. So what are you waiting for?

References:

The Living Health Group. Knee Pain. [Online] Available at https://www.livinghealthgroup.com.au/knee-pain/. Accessed on 30/01/23.

Mayo Clinic. (2023, January 25) Knee Pain. [Online] Available at https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849. Accessed on 30/01/2023.

Bishop, C. Avoiding Injuries in Netball. The Biomechanics Lab. [Online] Available at https://www.thebiomechanicslab.com.au/avoiding%E2%80%AFinjuries-in-netball%E2%80%AF/. Accessed on 30/01/23.

Bunt, C., Jonas, C., Do, A. & Chang, J. (2018, November 1.) Knee Pain in Adults and Adolescents: The Initial Evaluation. American Family Physician. 2018;98(9):576-585. [Online] Available at https://www.aafp.org/pubs/afp/issues/2018/1101/p576.html. Accessed on 30/01/23.