Knee pain is a common issue that affects people of all ages. The knee is a robust, hinge-like joint in the body that bears significant stress from everyday activities. It is the largest joint in the body and comprises a series of bones, ligaments, cartilage, and tendons working in unison to perform basic movements like bending. The knee can also slightly rotate to the left and the right, allowing for greater agility and movement. This rotational component allows your favorite basketball player to pivot on the court as they line up for that perfect shot at the basketball hoop, or even something simpler like turning around in place to greet someone behind you.
But how does the knee work? What does it do in the body, and is it susceptible to injury? What does it mean if someone has knee pain? Is knee pain treatable? To answer these questions, it is important to understand the structures inside the knee and how they move and protect the joint!
Anatomy of the knee joint
Your knee joint forms where three bones meet: the femur, commonly known as the thigh bone; the tibia, more commonly called the shinbone; and the patella, also known as the kneecap.
Between the bones is a tough, rubbery, C-shaped piece of cartilage called the meniscus. The meniscus cushions and protects the bones. The meniscus acts as a shock absorber for the bones; the same way brake pads operate in a vehicle to absorb friction. This C-ring structure can be broken down into an inner and outer portion, protecting both sides of the knee joint.
Another type of cartilage lines the bones of the knee where they connect. This slippery cartilage, called articular cartilage, allows for smooth movements of the bones around the knee joint. This cartilage is just as important as the meniscus as it works to protect bone surfaces from rubbing and grating on each other. Therefore, articular cartilage prevents wearing down or degeneration of bony surfaces. When you hear the phrase “bone on bone,” this often describes the loss of articular cartilage.
Within and surrounding the knee are main ligaments that act like suspenders to a pair of overalls. These elastic suspensory ligaments connect the bones and provide additional stability and protection to the knee joint. Muscles also connect locally around the knee and from the pelvis, butt, and hip regions. Lastly, tough, rubbery cords of tissue called tendons connect the muscles to the bones.
The knee is a very complex structure in the leg due to multiple working parts. Each structure in the knee coordinates and works together to maintain the balance and speed required for daily movements such as walking, running, kneeling, bending, and more.
Is the Knee Prone to Injury?
The knee may be prone to developing problems because of its complexity and the continual wear and stress on the joint. For some forms of knee pain, the cause is wearing down soft tissues and joint structures, such as that seen with normal aging or repetitive activities and exercises. Other types of pain could be due to a sudden movement or trauma resulting in a knee injury. Even excessive looseness in the joint can increase the risk of injury to the knee.
Some injuries that occur to the knee are:
- Arthritis. The term osteoarthritis describes the degeneration of the joint cartilage, ultimately affecting the architecture of the bone. This wear-and-tear pattern is often seen in middle-aged and older people and is often described as feeling stiff. Other types of arthritis include inflammation of the joint, which could be mechanical or autoimmune in nature.
- Fracture describes a break or crack in the bones of the knee. It requires a doctor’s examination and can be painful. Fractures can be treated with a splint or cast to help protect and heal the knee.
- Tendinitis. This condition describes inflammation and injury of the tendons of the knee. Tendinitis can be caused by repetitive activity, prolonged inactivity, or sudden trauma like a blow to the knee. This injury is often treated by strengthening the knee muscles.
- Bursitis. Small, fluid-filled cushions exist around the knee joint. Bursitis occurs when one of these cushions becomes inflamed from trauma, repetitive motion, or being pressed against hard surfaces for prolonged periods.
- Torn knee cartilage can occur when the knee is forcibly twisted. This is commonly seeing among athletes but can also occur with slips and falls. Symptoms include swelling, pain, and stiffness and may be accompanied by a popping sensation.
- Dislocated kneecap. This usually occurs due to trauma or an accident but can also occur in individuals with connective tissue disorders. It is not a common injury.
- Sprained ligaments. This pulling injury can occur with forceful movement of the knee, such as during sporting events. It can occur alone or accompany other types of injuries. Sprained ligaments also happen from repetitive actions like new exercise programs, unnatural twisting motions, straining under an increased weight such as carrying heavy objects or obesity, and more.
- Muscle tears can occur with sharp blows or forceful movements of the knee that generate enough force to tear strong muscle fibers.
- Cyst formation. A Baker’s cyst is swelling in the back of the knee joint and can indicate another problem such as a meniscus tear. This pain can feel tight or pulling.
- Patellofemoral pain syndrome. This condition is common in active adolescents and young adults and is usually caused by vigorous activities such as squatting, running, or climbing stairs. A person may note a popping sound in the knee while bending the knee. This condition has pain after sitting for long periods or during frequent knee bending.
- And more
Here’s a great article from Johns Hopkins Medicine with structures of the knee and common injuries. Read on at this link: https://www.hopkinsmedicine.org/health/conditions-and-diseases/knee-pain-and-problems
Here’s another link for great knee pain facts from MedicineNet: https://www.medicinenet.com/knee_pain_facts/article.htm
What does knee pain feel like?
Knee pain is often described as dull and achy, but pain and dysfunction can be described in different ways like any other part of the body. Some examples of pain include sharp, burning, pulling, tightness, or soreness. Pain can also feel like a deep aching in the joint or right on top of the skin.
Sometimes dysfunction of the knee occurs without pain, too! You may have symptoms of a knee condition such as clicking, popping, locking of the knee, and feeling like the knee has decreased motion overall, with no pain whatsoever. You may feel your knee “catch” with certain movements, such as extending the knee fully while walking. There may be tingling or changes in sensation instead of direct pain over an area of the skin.
Knee pain may not involve the entire knee, either. Some individuals report having knee pain with just part or on one side of the knee. An example might be pain located just right to the kneecap, toward the outside of the knee. Knee injuries may have pain on the inside or outside of the knee, deep inside the joint, or even in the back of the knee near the crease. Some individuals may have a hard time identifying the location of the pain.
Location of pain may have a distinct role in the development and outcome of knee pain treatment. Read this research article for more information regarding the location of knee pain and clinical severity in older adults: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766069
When should I see a doctor?
Treatment of knee pain should be directed at the specific cause of your problem. A well-trained doctor will perform an examination and evaluation of your knee. Many knee diagnoses are based on medical history and physical examination alone! If the doctor needs more information, he or she may include imaging such as x-rays to visualize bones and joint spaces or an MRI to visualize soft tissues like ligaments and muscles for possible injury.
See the doctor if you have:
- Difficulty or loss of ability to walk comfortably on the affected side
- Knee pain that occurs while resting or at night
- Injury that causes knee deformity
- Swelling of the joint or the calf area
- Knee pain that persists longer than several days
- Difficulty or loss of ability to bend the knee
- Signs of infection or inflammation including fever, warmth, swelling, or erythema (redness)
- Any other unusual symptoms prompting immediate medical attention
Knee pain and knee injuries are best diagnosed with a proper evaluation and assessment. A doctor of chiropractic is a musculoskeletal specialist and the right person to assess the most common knee conditions.
A person with knee pain doesn’t have to stop their daily routine. Still, management depends on the severity of the symptoms and the ability to continue performing usual activities and movement patterns. Additionally, conservative care options will depend on the severity, duration, and frequency of your pain.
Suppose your knee pain is due to an acute injury. In that case, your condition may be co-managed by your doctor with another healthcare professional such as a primary care doctor, orthopedist, or physical therapist.
Conservative care may include specific stretches for muscles and tendons of the knee, joint mobilization, specific exercises to strengthen the surrounding muscles and tendons, hands-on soft tissue work into the muscles and fascia, changes in exercise routine or modifications at work or home, home exercise, and stretching programs, and more.
How we treat knee pain
In our Boca Raton Sports Chiropractic practice, we take a detailed history of your injury and perform a thorough examination of your knee movements, including changes in range of motion, muscle weakness, wobbling, or the way you walk (gait analysis), to determine knee function. Our goal is to not only provide you with the correct diagnosis of your injury but also determine the underlying root cause of your injury and create an individualized treatment plan specifically for you. We have many tools in our toolbox to create an effective evaluation and devise the appropriate treatment.
We may analyze your daily ergonomics and habits to determine if lifestyle or activity modifications are necessary. Your treatment plan is unique to you and your condition. Some approaches we may use to help your knee pain consists of sports rehabilitation exercises to perform at home or in the office, as well as targeted soft tissue therapies including Active Release Techniques (Muscle Work), chiropractic, Graston Technique®, and deep tissue laser therapy to help with your knee pain.
Frequently Asked Questions (FAQ)
Could my knee pain be arthritis?
Knee pain can come on gradually over time, or it might come on suddenly. Although the pattern and frequency of pain may vary, knee pain is not always arthritis.
Osteoarthritis is the most common form of knee arthritis. Although it can affect patients of any age, patients with knee osteoarthritis tend to be over the age of 50 and feel that their knee is stiff and painful at times. It may affect one knee or both.
Pain from osteoarthritis can occur in the morning, but it tends to go away with movement as you start your day. Pain from osteoarthritis might be felt all around the knee or in one specific location.
A proper examination will determine if your pain is caused by arthritis or another cause. Not all joint pain is due to arthritis!
VersusArthritis is an excellent website with more information to read about arthritic changes in the joints: https://www.versusarthritis.org/about-arthritis
My knee hurts. Is it better to rest or try to exercise?
Great question! The answer is, “It depends.”
Having sore knees is common and isn’t usually a sign of anything serious. Sometimes the pain is mild and will go away on its own or with general movement. This type of knee pain can often be treated at home and should improve after several days.
However, if the pain is moderate to severe, or prevents you from performing your usual routine, then it’s a sign that something else may be going on. A proper examination is required to obtain more information.
Knee pain that prevents you from doing your job, walking, sitting, or engaging in recreation should prompt you to seek a trained musculoskeletal specialist for an evaluation and possible management.
From there, your doctor can advise you to modify your activities to include rest, exercise, or another treatment intervention.
Are injections or surgery needed for knee pain?
Injections or surgical interventions are not recommended as first-line treatment for knee pain. This is because people often recover just as well with conservative, non-invasive methods of treatment. Exercise, rehabilitation, soft tissue, and myofascial work, taping, and other approaches for care work without the use of needles, anesthesia, or a scalpel.
Furthermore, an injection alone is unlikely to resolve the issue that caused the knee pain. Not all knee conditions benefit from injections or surgery. There may be complications from the injection or surgical intervention that result in other issues in the knee or local muscle and joint structures.
If you are dealing with knee pain and want a same-day examination and treatment for your injury, call our Boca Raton or Miami chiropractic and sports injury office at 561-997-8898 or schedule online!