Questions

KNEE PAIN

Pain is a common knee problem that can originate in any of the bony structures compromising the knee joint (femur, tibia, and fibula) the kneecap (patella), or the ligaments, tendons, and cartilage (meniscus) of the knee. Knee pain can be aggravated by physical activity, as well as obesity, affected by the surrounding muscles and their movements, and be triggered by other problems (such as a foot injury). Medical conditions — including arthritis, gout and infections — also can cause knee pain. Knee pain can affect people of all ages, and home remedies can be helpful unless it becomes severe.

Causes of knee pain include

Being active is one of the best things you can do for your joints and the rest of your body. There are a variety of causes of inner knee pain. Many of them can be linked to an injury. Some of the most common incidents that cause knee injury and pain include falls, sports injuries, or increased activity Medical conditions including arthritis, gout and infections — also can cause knee pain. Adults particularly those older than 60, are most likely to experience knee pain. However, inner knee pain can also occur in children and adolescents. According to the research done in by medical experts the most common causes of inner knee pain in children are:

·        Chondromalacia Patella

·        Knee Bursitis

·        Ligament injuries

·        Meniscal tears

·        Rheumatoid Arthritis

·        Gout

·        Septic Arthritis

·        Bakers Cyst

·        Fractures

·        Tendonitis

·        Osteochondritis dessicans (OCD

·        Jumpers knee

·        IT band syndrome

·        Osgood-schlatter’s disease

Larsen Johansson Syndrome

Risk factors

The knee connects the thigh bone (femur) with the shin bone (tibia) and consists of many parts including the knee joint, knee cap (patella), ligaments, tissues and more. It’s a very complex part of the body and, due to its location and job, is prone to injury. Anything that increases the already-present possibility of injury is considered a risk factor. Some risk factors for knee pain are listed below:

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.

Lack of muscle flexibility or strength. A lack of strength and flexibility can increase the risk of knee injuries. Strong muscles help to stabilize and protect your joints, and muscle flexibility can help you achieve full range of motion.

Certain sports or occupations. 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. Jobs that require repetitive stress on the knees such as construction or farming also can increase your risk.

Previous injury. Having a previous knee injury makes it more likely that you'll injure your knee again.

Preventive Measures for avoiding knee pain

You can help yourself avoid knee pain by improving your physical condition. The best way to prevent the onset of the condition is by addressing the risk factors. Although it's not always possible to prevent knee pain, the following suggestions may help forestall injuries and joint deterioration. So, consider the following tips to prevent the onset of back pain:

Keep extra pounds off. Maintain a healthy weight; it's one of the best things you can do for your knees. Every extra pound puts additional strain on your joints, increasing the risk of injuries and osteoarthritis.

Be in shape to play your sport. To prepare your muscles for the demands of sports participation, take time for conditioning. Work with a coach or trainer to ensure that your technique and movement are the best they can be.

Practice perfectly. Make sure the technique and movement patterns you use in your sports or activity are the best they can be. Lessons from a professional can be very helpful.

Get strong, stay flexible. Because weak muscles are a leading cause of knee injuries, you'll benefit from building up your quadriceps and hamstrings, which support your knees. Balance and stability training helps the muscles around your knees work together more effectively. And because tight muscles also can contribute to injury, stretching is important. Try to include flexibility exercises in your workouts.

Be smart about exercise. If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the way you exercise. Consider switching to swimming, water aerobics or other low-impact activities — at least for a few days a week. Sometimes simply limiting high-impact activities will provide relief.

When to seek medical help?

If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of knee pain must be directed at the specific cause of your problem. See the Doctor If You Have:

·        An inability to walk comfortably on the affected side

·        An injury that causes deformity around the joint

·        Knee pain that occurs at night or while resting

·        Knee pain that persists beyond a few days

·        Locking (inability to bend) in the knee

·        Swelling of the joint or the calf area

·        Signs of an infection, including fever, redness, or warmth

Treatment Overview

During the physical exam, your doctor is likely to inspect your knee for swelling, pain, tenderness, warmth and visible bruising and check to see how far you can move your lower leg in different directions, push on or pull the joint to evaluate the integrity of the structures in your knee

In some cases, your doctor might suggest some Imaging tests such as:

·        X-ray.

·        Computerized tomography (CT) scans.

·        Ultrasound.

·        Magnetic resonance imaging (MRI).

·        Lab tests

If your doctor suspects an infection or inflammation, you're likely to have blood tests and sometimes a procedure called arthrocentesis, in which a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.

 Treatment

Treatments will vary, depending upon what exactly is causing your knee pain. Your doctor may prescribe medications to help relieve pain and to treat underlying conditions, such as rheumatoid arthritis or gout.

Physical Therapy

Strengthening the muscles around your knee will make it more stable. Your doctor may recommend physical therapy or different types of strengthening exercises based on the specific condition that is causing your pain.If you are physically active or practice a sport, you may need exercises to correct movement patterns that may be affecting your knees and to establish good technique during your sport or activity. Exercises to improve your flexibility and balance also are important.

Injections

In some cases, your doctor may suggest injecting medications or other substances directly into your joint. Examples include:

·        Corticosteroids

·        Hyaluronic acid.

·        Platelet-rich plasma (PRP).

Surgery

If you have an injury that may require surgery, it's usually not necessary to have the operation immediately.  If you choose to have surgery, your options may include:

·        Arthroscopic surgery.

·        Partial knee replacement surgery.

·        Total knee replacement.

Common physiotherapy treatments for Knee Pain

After a focused examination has been completed, your physical therapist can work with you to initiate the correct treatment. It is very important for you to be active and engaged in the program. Often, exercises to help strengthen and improve the mobility of the knee will be prescribed. You may be required to perform exercises at home as well as part of a home exercise program. Exercise should be your main tool for treating your knee pain. Exercises to help your knee pain may include:

·        Quad sets and straight leg raises

·        Short arc quads

·        Exercises to strengthen your hips (Your hip muscles help control the position of your knees weakness here may cause knee pain.)

·        Lower extremity stretches

·        Balance exercises

Your PT will tell you how often to perform your exercises at home, and he or she should monitor your progress when you visit the PT clinic. He or she may also perform other treatments while you are in the PT clinic. These may include:

·        Ultrasound

·        Transcutaneous Electric stimulation

·        Kinesiology taping

·        Application of heat or ice

    Soft tissue massages or knee joint mobilization.

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