Why Does My Knee Hurt?

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By: Ehren Allen, DPT, COMT

Why Does My Knee Hurt for No Reason?

Knee pain can occur for many reasons.  The knee is a complicated joint and has many structures which can cause pain.  This makes diagnosing knee pain can be challenging.  The knee absorbs significant amounts of force with daily activity.  Over time, these forces can begin to wear out the cartilage at the ends of the bones at the knee.

Knee PainImage of Knee Osteoarthritis

Cartilage is a flexible but durable tissue that allows a joint to move.  It protects the ends of bones as they come together with other bones in a joint.  The cartilage allows for smooth movement and gliding in the knee.  When cartilage begins to break down, it can lead to abnormal movement patterns in a joint.  This can accelerate the break down of cartilage. 

 
The anatomy of the knee joint includes 3 compartments which allow movement and have cartilage which can break down.  When cartilage breaks down and becomes inflamed (osteoarthritis), the knee can become painful.

The knee also has 4 major ligaments which hold the joint together.  Damage or sprain to any of these ligaments can lead to pain in the knee. 

 
There are also multiple muscles that cross the knee joints.  These include the hamstrings, quadriceps, adductors and IT band.  Irritation or inflammation in a one of these tendons or muscles could cause knee pain as well.  This may also be known as tendonitis of the knee.

If you would like to learn more about the knee, go to this KNEE VIDEO.

What is the Most Common Cause of Knee Pain?

The quick answer is people with knee pain report pain in the knee cap area.  The knee cap or patella is a small bone that floats in a grove at the end of the thigh bone.  The large muscles in the front of the thigh attach to the patella.  There is a large thick tendon at the lower part of the knee cap that attaches to the front of the shin bone (tibia).  When these muscle contract, they pull the knee cap upward in the groove and extend the lower leg to straighten the knee.  

If the patella rubs more on one side of the groove, pain can develop.  Repeated kneeling or squatting can increase the compressive forces between the knee cap and the groove as well.  This can lead to excessive wear and tear and arthritis.  

How Do I Know if my Knee Pain is Serious?

If pain in the knee limits daily activity or work activity then it may be serious. Buckling or persistent pain and swelling are a sign that you should seek a medical evaluation.  More serious conditions may also have deformity or abnormal or asymmetrical walking pattern.  If your knee pain lasts for a significant length of time, you should seek an evaluation from an Orthopaedic Physician. 

What Causes Pain on the Inside of Your knee?

Pain inside the knee may be due to arthritis or even a tear in a meniscus.  The knee has 2 menisci, lateral and medial.  They are semi-circular cartilage that help to increase stability and cushion the joint with compressive forces.  A tear in a meniscus can cause pain, swelling, instability, and limited ROM.

How Do I Get My Knee to Stop Hurting?

Knee pain can have many causes.  With mild pain, a 2 or 3 period of rest a ice may be helpful.  For more severe pain and swelling, It may be necessary to see a physician or a physical therapist.  Determining the cause can be vital to choosing the treatment.  Sometimes, an assessment of the mechanics of the legs can be helpful to determine whether there is a movement issue that is causing the knee pain.  Strength and stretching exercises may be prescribed to help improve with function of the knee.  

Flexibility or hamstring stretch for knee painHamstring Stretch for Knee Pain

If this approach does not help, further diagnostic testing maybe needed.  A physician may order an X-ray or MRI to check for tissue injuries.  I some cases, surgery is needed to repair or remove damaged tissue.  I extreme cases or arthritis, a joint replacement surgery may be needed.  This may incorporate traditional procedures or Mako-robotic assisted knee replacement.

Watch This Video of Why Knee Pain Can’t Wait

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