Knee Pain

Case courtesy of Andrew Murphy, Radiopaedia.org. From the case rID: 48336

The knee is one of the strongest joints in the body and has the ability to withstand a great deal of twisting and turning under load.

You may have had discomfort that has gradually developed over time or that has come on quite suddenly. There may have been a traumatic incident such as a fall or a change in exercise levels or daily activity that could have triggered it.

Our specialist physiotherapists diagnose, treat and rehabilitate knee injuries daily, ranging from discomfort involving the PFJ, [knee cap] the structures on the inside or outside of the knee [ligaments] or even structures within the knee such as the meniscus [cartilage] or cruciate ligaments.

 

  • Front of the joint

    The kneecap, the soft fat pad either side and the thick central tendon are the commonest issues here.

    Knee cap pain can be a catching sharp pain from the knee cap not running/tracking correctly in the groove of the femur, although arthritic change can give a more dull ache.

    The fat pad can be very sensitive and is usually part of the knee cap mal-tracking process.

    The thick central tendon gives an ongoing dull ache and is tender to press, especially on the inner point of attachment to the knee cap. However, the insertion into the tibia/shin bone has some problems, particularly in growing children. Occasionally the insertion of the quads into the kneecap can be a problem.

    All of these are treated by physiotherapy in a combination of mobilisation and exercise and sometimes modalities such as shockwave.

     

  • Inner edge of joint

    Issues here are mostly ligament and cartilage although several tendons run around the inside of the joint which can cause problems. This is called Pes Anserinus but details are under the medical tendon issues page below.

    Get it looked at!

  • Outer edge of joint

    The most common is the runner’s knee where the Iliotibial band (ITB) rubs over the femur. However, there is a big ligament and the tibiofibular joint and the lateral meniscus. The meniscus usually feels deeper in the joint than the ligament and the ITB. All of these are things we deal with daily.

  • Within the joint

    Issues within the joint are either those that build up slowly and are usually wear and tear to the joint surface and the meniscus, or traumatic injury such as ligament damage.

    Please don’t just think it is ‘old age’ and there is nothing that can be done about arthritic change. We can help with mobilisation, strengthening and treatment modalities. Don’t just put up with it!

    The rehabilitation of traumatic knee injury is something we specialise in, driven from our involvement in elite sports for many years. We have rehabilitated some of the biggest names in international sport and would be delighted to help get you back to fitness. We treat everyone the same!

  • Back of the joint

    There are lots of structures here from hamstring and calf tendons to nerves, blood vessels and lymph systems. There are small muscles like Popliteus and Plantaris and deep ligaments.

    Issues are often to do with the calf muscles and hamstring tendons but things like Baker’s Cysts can be problematic when there are other issues in the knee joint.

    Get it seen!