MOST COMMON KNEE CONDITIONS

Knee pain and/or discomfort is a very common complaint which is seen in people with all ages, starting from teens to oldest. It could be the result of injury or medical conditions. Let’s see few of the most common causes/conditions of knee pain:

Meniscus Lesion/injury: Two menisci in the knee: Medial & Lateral work as cushion by absorbing any force coming towards knee. There can be two possible reasons for meniscal lesions either any injury/trauma or degenerative which affect the biomechanics of the knee joint and cause pain/discomfort.

Athletes are more prone to get meniscal tear by trauma and people with knee OA usually end up with degenerative meniscus tear/lesions. Research says meniscal injuries are common in men and mean age is from 28 to 40 years.

Clinical presentation:

  • Popping sound/Clicking in the knee
  • Knee locking/catching
  • Squatting/kneeling poorly tolerated
  • Intermittent residual pain
  • Pain/pressure triggers by prolonged knee bending

Baker’s cyst: It is fluid-filled swelling seen behind the knee joint in the popliteal fossa. In some cases, this cyst puts pressure on anatomical structures like the popliteal vein. The cause of Baker’s cyst can be an intra-articular problem with the knee or any inflammatory reaction from loose bodies in conditions like. OA, Ligament tear. Cyst can vary in size from a very small to large one.

Clinical presentation:

  • Swelling and a mass in popliteal fossa (Back of the knee)
  • Vague pain behind the knee
  • Restricted knee mobility
  • Tightness behind the knee
  • Stiffness in back of the knee, increased by activity.

PFPS (PatelloFemoral Pain Syndrome): Patello-Femoral Pain is common term used for anterior (front) knee pain resulting from structures under or nearby to patella (kneecap), which can be infrapatellar fat pad, subchondral bone, or synovium. This kind of pain is usually provoked by any sudden increase in load on knee joint, via overusing patellofemoral joint, increasing intensity, frequency, or duration suddenly in any activity or increasing degree of knee flexion in weight-bearing activity… For e.g., changing running surfaces from flat roads to hills or stairs.

Youths aged 12-17 and especially females are more common to get PFPS. Active or sedentary lifestyle, both kinds of people are prevalent to get this condition.

Clinical presentation:

  • Anterior knee pain
  • Occasional crepitus during knee flexion
  • Occasional episodes of giving away knee joint
  • Reduced muscle flexibility of knee and hip muscles
  •  Reduced muscles strength in hip muscles specially, Gluteus Medius & Gluteus Minimus

Osteoarthritis: OA involves the entire knee joint not only cartilages, we can see changes in all structures of the knee as condition progresses, like, Muscles, ligaments, menisci, subchondral bone, synovial membrane. OA can be either primary or secondary, primary OA doesn’t show any etiological basis (no cause to explain its occurrence). Whether secondary OA, is caused by underlying factors like, Diabetes, metabolic disorders, hypermobility syndromes or sports related injuries.

Knee OA is one of the leading causes of pain and disability in people of 50+ years old and women are more prevalent to get this.

Clinical Presentation:

  • Age>50 years
  • Knee joint stiffness which usually disappears after short period of exercise
  • Crepitus
  • Swelling at/around knee joint
  • Worsening, intermittent pain
  • Kneeling, squatting or other full knee bending activities leads to pain

ITB syndrome/ IT Band Syndrome: Iliotibial Band/IT Band is a thick band of fascia which runs along the lateral(outside) thigh from the hip bone to the knee joint. Near its insertion at the knee, this band passes through Lateral femoral condyle (Bony part of thigh bone). When the knee bends and extends in the 30 degrees range, ITB gets rubbed with Lateral femoral condyle and creates friction and results in inflammation at that specific spot. The cause of this inflammation can be muscle imbalances, poor biomechanics, congenital defects, or dysfunction in joints above & below.

Individuals from teens to 50s’ are susceptible to this syndrome, though runners (12-25%), cyclists(12.5%)  and hikers are more prone. Research says women are more prevalent than men due to their anatomical differences of hips and knees.

Clinical presentation:

  • Burning pain on outer side/Lateral Side of the knee
  • Pain during activity, which stops with termination of activity
  • If not treated, pain leads to antalgic gait(unnatural posture with walking).
  • Possible audible snapping sensation in knee

If you are struggling to manage pain from any of the above diagnosis, our Physiotherapists can help. Please book a free consultation and we can discuss your options.

 

Written by:

Anjali Patel. Registered Physiotherapist Resident. Orthopaedic Physiotherapist. Concussion Management

REFERENCES:

Orthopaedic Division Canadian Physiotherapy Association. Theory Manual

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    Our therapists are continually upgrading their skills and taking time to provide comprehensive assessment and treatment techniques that are always one on one without the use of assistants or double booking patients to make sure that you achieve your functional and sports goals as soon as possible.  

    Our therapists would be happy to help you to achieve your goals, get in touch to schedule your appointment.  Don’t let pain ruin your day!

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