Knee pain and injuries: what are the causes and treatments?

The knee joint is a primary weight bearing joint capable of supporting loads of two to five times a person's body weight. Doing such hard work means injuries and other issues can occur with our knees.

The knee joint

The knee joint is made up of two main bones: the thigh bone called the femur, and the shin bone called the tibia. The kneecap, or patella,completes this joint,. Some other structures include the cartilage and meniscus which are found between the bones of the knee joint and help to provide cushion and support.

There are also four main ligaments, which provide structure and strength to the joint. The Anterior Cruciate Ligament (or ACL) is perhaps most well-known of these ligaments, as it is commonly involved in sporting injuries of the knee.

Chronic knee pain

The term ‘chronic’ means something has occurred gradually and lasted a long time. One of the most common causes of such pain in the knee is osteoarthritis.

Osteoarthritis is a condition that affects the cartilage of the bone surfaces, leading to symptoms such as stiffness, swelling and pain. These symptoms are commonly felt after periods of inactivity such as long car rides or waking up after sleep.

In some cases, where the Osteoarthritis is severe, joint replacement surgery may be required and can have excellent outcomes. However, current best available evidence recommends several other treatment options which should take priority in the early stages.

These options include a supervised exercise program, education about the condition, and weight management if applicable. These types of management plans aim to build up the strength and control of your legs, encourage correct movement through your joints which is vital for optimal joint health, and create a plan for your recovery.

Other types of knee pain can come on more gradually can include tendinopathies, which describe a repetitive loading of a tendon – the tissue which connects a muscle to the bone. This can occur with a sudden change or increase in activity, equipment, or technique; and can cause pain and swelling in the area of injury.

Pain around the knee can also be due to muscle weakness, poor technique during sport of activity, or overloading. This can also cause pain and irritation, most noticeable when you’re trying to perform the task that’s causing the issue, however it can also limit other normal day-to-day tasks such as walking.

Acute knee pain

In medicine, ‘acute’ refers to a sudden onset, severe pain or injury. Acute injuries of the knee usually occur with sudden twisting or changing of direction, such as when playing sports like football, basketball or netball. It is common to experience pain at the area of injury, with potential swelling and bruising to follow over the coming 12-24 hours.

Mild pain which resolves after 1-3 days with a complete return to normal function would be considered no cause for concern. However, if you have significant swelling and bruising, and pain which lasts longer than a few days, you should see your doctor.

Treating acute knee pain

If you have suffered sudden onset of knee pain, one possibility is that you have strained or overstretched one of these ligaments, or perhaps the meniscus within the joint.

In instances such as these, it’s recommended that you use the R.I.C.E.R method:

• REST the joint, limiting movement
• Apply ICE for 15 minutes every 2 hours to reduce swelling
• Apply gentle COMPRESSION, such as a compression bandage
• ELEVATE the area above heart level, to reduce the amount of pain and swelling
• And REFER, by going to see your GP or physiotherapist for guidance and management

If your GP or physiotherapist thinks it is necessary, they will refer you to a specialist doctor. This might be for other assessments, such as MRIs or x-rays. These are only used if a fracture is suspected, if the extent of your injury is unclear, or if further information is required in order to manage your rehabilitation. Another reason may be for a surgical opinion, if that is needed.

For example, there may be medications which are able to help reduce your pain and symptoms, help you move more freely, and allow you to undertake your rehabilitation in order to achieve your goals.

A physiotherapist will also help you to manage your healing and symptoms, gradually building up your strength and control, and developing your function so you can get back to the activities you enjoy as soon as possible.

Your GP will recommend treatment suited to the extent of the injury. If you have any questions or concerns, you should always ask your healthcare provider.

At Ramsay Health Care, we work with multidisciplinary teams made up of orthopaedic surgeons, medical staff, specialist nurses, physiotherapists and exercise physiologists. For more information, contact us or search for a specialist.