Chances are, you know someone (or are that someone) who has knee pain. During any given year, nearly 25% of adults will suffer from chronic knee pain, with 10% of those severely disabled due to their condition (1). To make matters worse, the prevalence of chronic knee pain has been on the rise over the past twenty years (2). With the numbers growing too large to ignore, it’s time to get to the root of the problem. Let’s review three common injuries leading to knee pain.
Wear and tear on the knee joint causes the cartilage (the cushion between bones) to wear down. The friction caused by lack of cushion will lead to inflammation, irriation, and yes, PAIN. Knee arthritis can be broken down into two parts: Tibia-femoral arthritis or patellar-femoral arthritis. Tibia-femoral arthritis is the wearing down of the joint line between the femur (thigh bone) and tibia (shin bone). Patellar-femoral arthritis is the break down of cartilage between the knee cap and where it meets the thigh bone.
Knee arthritis can occur for a variety of reasons. Having a family history of arthritis, being overweight, or having previous injuries place you at increased risk for arthritis. Common complaints with knee OA (both types), include stiffness, joint noise (cracking, snapping), pain with weight bearing activities (walking, squatting, stair climbing), and even joint deformity.
We have already talked about the cartilage in the knee, but let’s break it down a little further. Along with cartilage on the bone, the meniscus of the knee provides extra cushion, joint lubrication, acts as a shock absorber, and promotes knee stability. We have two menisci, the medial (C shape on the inside of the knee), and the lateral (0 Shaped, on the outside of the knee).
Tears in the meniscus can occur due to trauma (acute injury) or with wear and tear over time (degenerative changes). Acute tears are rare, occurring in less than one percent of the population (3). Degenerative tears are more common as we age, with one study indicating over 60% of individuals over 65 have some form or meniscal tear (3). Meniscus tears are difficult to heal on their own, as the meniscus is a very slow healing tissue due to poor blood supply. Common complaints with meniscus tears include catching or locking of the knee, point tenderness along the knee joint, knee instability, and difficulty with bending or pivoting.
Patella-femoral Pain Syndrome
Patella-femoral Pain Syndrome (PFPS) is characterized by pain in the front of the knee. Three common causes of this injury are muscle imbalances of the leg (weakness or tightness), malalignment of the knee cap or lower extremity, and over activity (4). The imbalances or postural defects cause the knee cap to move incorrectly, leading to pain, irritation, and even swelling in the front of the knee. This diagnosis and can effect men or women of any age, however is most common in women ages 15-30 (4). Common complaints are pain with descending stairs, running, jumping, and squatting.
Research continues to show that physical therapy should be the first treatment when it comes to ALL THREE of these impairments. Utilizing physical therapy and exercise will increase strength, flexibility, and balance to set your knees up for success. Don’t get me wrong, there are always exceptions to the rule. Some knees will require replacement (total joint replacement), or arthroscopic surgery (debridement or repair of the meniscus), or anti-inflammatory treatment.
Are you interested in learning more about these conditions and how to exercise with knee pain? Click the link below to schedule your free discovery visit with a physical therapist.