Principle Physiotherapy

Knee pain can be very debilitating and cause much distress. It can affect so many of the normal day to day activities that you would naturally take for granted. Getting in and out of bed, standing up, sitting down, walking, stairs and much more could be painful and more difficult. 

 

There are many causes of knee pain and the positive thing is that they are rarely serious. This does not take away from the negative impact it has on your life. 

 

To understand why we get knee pain we have to understand what structures might be damaged. Firstly, the bones that make up the knee include; the femur (upper leg bone), the tibia (lower leg bone) and the patella (knee cap). These bones can be fractured (broken bone) from the impact of falling on your knee or something hitting you. They can also be damaged through overuse which can lead to a stress fracture or if you live with osteoporosis (weak bones). In all circumstances you should go to A&E if you suspect a fracture.

 

The cartilage is another structure found in the knee and this specialised structure covers the ends of the bones, where one bone meets another. The role of the cartilage is the allow for smooth movement between two bones as well as shock absorption. It can be injured during a twisting injury when walking, running or playing sport. The cartilage is also a key structure that degenerates in a condition called osteoarthritis. 

 

The meniscus is a unique cartilage found only in the knee. There are two in each knee and they look like a pair of horns. They increase the depth of the joint and increase shock absorption. They provide stability to the joint and disperse weight across it. They can also be injured during twisting actions of the knee resulting in a tear. These injuries often respond well to Physiotherapy, however some more severe tears require surgery. The meniscus can also be prone to degeneration resulting in a tear that develops over time rather than after an acute injury. 

 

Next we have ligaments, these fantastic inventions that prevent the knee moving in abnormal directions, such as, twisting, bending sideways or hyperextending. The most famous is called the anterior cruciate ligament (ACL) as many footballers and rugby players injure this ligament. Others include the posterior cruciate ligament, medical collateral ligament and the lateral collateral ligament. There are many more but you don’t need to know them all. Ligaments are injured when the joint is forced into an abnormal position beyond the ligaments ability to resist that force. Depending on the severity of the injury you can often recover with Physiotherapy alone. Some will require surgery before commencing Physiotherapy. 

 

You can also strain muscles and tendons; including the hamstrings, quadriceps and the calf muscles. These often get strained when you have pushed yourself harder than your muscles/tendons can tolerate at which point a small to large tear is formed in the tissue. These often heal well with treatment and as long as you follow a regimented exercise programme you should avoid reoccurrence. 

 

Now that we have discussed many of the structures that can be injured in your knee, I would like to bring your attention to the fact that pain can be present without damage. That’s right, you might be experiencing pain around your knee cap and none of the structures above have been damaged. Hard to believe but there is a common condition called runner’s knee, which plagues many people and not just runners. It is caused by the knee being over worked, over a period of time and then whenever the knee is loaded pain is experienced. 

 

Just like many of the conditions above a course of physio for runners knee is very effective. If you have a knee injury and would like a diagnosis, head to a physio who is knee specialist. We can help diagnose and treat your injury and get you back to all the things you love to do. 

 

Many thanks for reading my blog. 

 

All the best

 

Dave Adkins 

Knee specialist

Chartered Physiotherapist