Knee pain is a common complaint among the general population, with prevalence across all group ages 10-15%. There are so many different causes and different diagnostic labels for knee pain complaints.
Bursitis: is an inflammation of the bursa, which acts to reduce friction between the bones of the knee and the tendons rubbing over them. The most common area of pain with bursitis is above the knee. Bursitis can develop from extended periods of kneeling. People that lay tile or carpets or do a lot of gardening are susceptible to this type of knee pain.
Patellar tendonitis: is an inflammation of the large tendon that runs down the front of the knee. People often complain of pain in the front of the knee associated with activity.
Ligament injuries: involve sprains or overstretching of the ligaments that help to support the knee joint. Anterior cruciate ligament (ACL) tears occur four times more frequently in females than in males in the same amount of sports participation.
Chondromalacia: Overuse, injury or other factors may lead to a condition known as chondromalacia patella — a general term indicating softening and irritation to the cartilage under your knee cap. Patellofemoral pain syndrome, a more accurate term for chondromalacia patella, typically affects adolescents and young adults. In many patients the pain is not the product of inflammatory chemicals but is due to abnormal postural mechanics in the dynamic phase of knee function. Ultimately this may cause the gross changes to the cartilage showing signs of softening, fissuring and fasciculation in more severe stages of chondromalacia. Knee problems in older populations are more commonly caused by arthritis.
Arthritis involves inflammation of the joint and the breakdown of cartilage. Arthritis can be caused from strains and injuries caused by repetitive motion, sports, overexertion, and falls. Cartilage normally protects the joint, allowing for smooth movement and shock absorption when pressure is placed on the joint, like when you walk or otherwise bear weight. Without the usual amount of cartilage, the bones rub together, causing pain, swelling, and stiffness.
Osteoarthritis (OA) is the most common type of knee arthritis, occurring most typically in people over 50 years of age and results from the degeneration of joint cartilage. Aging does not cause osteoarthritis, but it does alter the articular cartilage so that it is more susceptible to degeneration initiated by other factors. And it also decreases the ability of the cartilage to protect itself and to prevent progression. Its onset is generally gradual; aging brings on a breakdown in cartilage, and pain gets progressively more severe, although it can be relieved with rest. OA pain is thought to arise from the subchondral bone, periosteum, synovium, capsule and ligament resulting from abnormal mechanical stresses on the periarticular structures. The cause of symptoms from degeneartive conditions is multifactorial involving mechanical, inflammatory, ischemic and other factors.
Proper assessment utilizing Mechanical Diagnosis and Therapy (MDT) allows to categorize patients’ conditions by the mechanical syndromes. With the knowledge of connective tissue responses to injury and stress deprivation, the appropriate management strategies can be established to facilitate the optimum recovery. It allows to direct the treatment towards the most efficient and successful outcomes.
Symptoms of a mechanical knee pain:
- Dull, throbbing pain
- Sharp, catching pain
- Limited movement
- Difficulty walking up or down stairs
- Difficulty kneeling or squatting
- Pain caused by sitting with a bent knee for long periods of time
Growing research has shown that exercise and proper patient education are the essential tools in managing your arthritis.
Do you need to see a Physical Therapist for your knee pain? Take this simple test…
I have pain in my knee that prevents me from sleeping.
I have pain in my knee when I walk on uneven ground.
I need to wear a brace on my knee when I work.
My knee sometimes buckles without cause.
I have a difficult time climbing stairs because of knee pain.
My knee surgery was successful, but I still have pain with too much activity.
I can’t play sports anymore because of knee pain.
I feel grinding in my knee when I climb stairs.
Arthritis runs in my family, so my knee pain is something I have to live with.
Results:
1 to 3 Yes: You’re doing fine. Exercising may help keep your knee in check.
4 to 6 Yes: Physical Therapy is an option for you.
7 to 9 Yes: See a doctor to get a better diagnosis. PT is definitely an option.
Physical Therapy is the treatment of choice whether surgery is needed or not. The correct, individualized exercises should be administered prior to surgery— sometimes instead of surgery—and are always essential after surgery to ensure a full recovery.
Ela Mroz, PT, DIP MDT
Spinae Vitae Physical Therapy
Clinic Certified in MDT
847.251.9790
