Knee Pain


Image of a knee

Knee Pain Overview

By: Ehren Allen, PT, COMT

Knee pain is common in people of all ages and the Jacksonville Orthopaedic Institute can certainly help diagnose your knee pain and provide several treatment options. JOI and JOI Rehab have developed a conservative approach to treat knee pain. However, if you need surgery, JOI has the most experienced team of orthopedic surgeons to get you back on the road to a full recovery.  

Here are some of the cause of knee pain: 

  • Sports-Related Injuries
    • such as a torn ligaments
    • quad/hamstrings strains and overuse injuries
  • Medical Conditions
    • such as Arthritis or Osteoarthritis & Rheumatoid Arthritis
  • Trauma
    • such as fractures from a car accident or falls at home

Any of these issues can lead to instability in the knee joint. This may increase knee pain and swelling and possibly lead to buckling or the knee giving way. The treatment plan for the knee depends on the severity of the pain. Physical therapy can certainly help with minor knee pain. For more severe pain, your physician will help determine whether surgery is needed or more extensive rehab.  

If you want to learn more about side knee pain or general knee pain symptoms, go to: https://www.joionline.net/library/show/knee_pain_symptoms/

Knee Injuries

  • Knee Sprains: ACL, MCL, LCL, PCL and Meniscus Tears.  These are injuries to the ligaments of the knee.  They vary in the degree and severity of the sprain from grade 1-3.
  • Patellar Tendonitis - also known as Jumpers' Knee, is the inflammation of the tendon that connects your kneecap to your shinbone.  It can be the infrapatellar or suprapatellar tendons which are involved. 
  • Iliotibial Band Syndrome - this is a very long band on the outside part of your knee to your hip.  Irritation of the iliotibial band. Often irritated with running activities.
  • Dislocated Kneecap - occurs when the patella slips or dislocates from the joint.  The kneecap or patella can also sublux. 
  • Knee Bursitis - Inflammation of a small fluid-filled sac (bursa) situated near your knee joint.  This condition occurs with repetitive movements or trauma to the knee. 

How do You Know if You Have Arthritis in Your Knee?


Arthritis is inflammation inside a joint which occurs from damage to the cartilage. It is often referred to as excessive “wear and tear.”  The severity of symptoms can range from mild pain from time to time, to severe joint deformity. Loss of mobility and functions such as walking can be affected as well. Patients with arthritis can experience knee pain behind the knee, or side knee pain. The knee has 3 compartments: 

  • Medial 
  • Lateral 
  • Patellofemoral 

Patellofemoral pain can lead to significant problems. It often is due to muscular imbalances of the quadriceps muscle and tights hamstrings and IT Band. Physical Therapy can certainly help with this condition.  You should avoid excessive squatting if you have this condition.  

Arthritis in any or all of these compartments can cause knee pain with daily activity. Arthritis on the back of the kneecap is a common cause of knee pain in the front of the knee (anterior knee pain).

image of knee arthritis


The most common forms of arthritis in the knee that cause knee pain are Osteoarthritis and Rheumatoid Arthritis.  Both can cause knee pain in the back of the knee, side knee pain, and in the front of the knee.  Both can lead to severe joint pain and loss of function.  Osteoarthritis is the most common and is diagnosed by X-ray. It may come from excessive abnormal wear and tear of the knee joint due to muscle imbalance or over use in compromising positions. Rheumatoid arthritis is an auto-immune disorder that is diagnosed most commonly through blood work. Gout is a very common type of arthritis. The difference between the two is that gout is a build up of uric acid crystals in the joint, whereas pseudogout is a build up of calcium-containing crystals in the joint fluid. 

Why Do I Have Pain on the Side of my Knee? 


Side knee pain can come from several issues including arthritis. A tear in a meniscus may cause side knee pain. The side knee pain depends on which meniscus is torn. There is a medial collateral ligament on the inside of the knee and a lateral collateral ligament on the outside of the knee. Side knee pain may also stem from a sprain of one of those ligaments. Side knee pain may also come from tendonitis in the muscles that pass by the sides of the knee. These may include the: 

  • hamstrings 
  • IT Band 
  • adductor tendons

However, knee pain on the side of your knee tends to not swell as much as a ligament injury. 

How do You Get Knee Pain to go Away?


The remedy for knee pain is a little different for everybody but most people can benefit from specific strength exercises to improve the quadriceps and gluteal muscles. When you have pain and swelling inside the knee, the brain is signaled to decrease the contracting information to the muscles around the knee to protect it. The problem is that these muscle sometimes need help to learn how to begin to work properly again. Physical therapy may be necessary to re-educate proper muscle activity help decrease the swelling in the knee.  

Wearing proper shoes can improve the function of the knee and help to decrease pain in the knee. Sorry Ladies, but high heels can increase knee pain and wear and tear on the knee. Avoiding deep squats and kneeling activity can help to decrease pain in knee.  Deep squats can cause the pressure between the knee cap and the thigh bone to increase.  This pressure can cause increased wear and tear in the knee.  

How do You Know if you Have a Torn Meniscus in Your Knee?

 
A torn meniscus is difficult to diagnose on your own.  The meniscus is a “C” shaped piece of cartilage that helps to increase the contact surface between the thigh bone (femur) and the lower leg bone (tibia) at the knee. There are 2 of them in the knee, one on each side. A tear in the meniscus can be caused by trauma or from abnormal wear and tear. A meniscus tear may cause side knee pain, swelling, and locking of the knee. If you have side knee pain, you might have a torn meniscus. There are special tests that a physician, physical therapist, or athletic trainer may perform to detect a tear in a meniscus but typically a tear is diagnosed through an MRI.  

Risk Factors

Excess weight - Being overweight can cause added stress on the knee joint. Simple activities such as walking can be affected. The added stress also puts you at increased risk for osteoporosis by wearing away joint cartilage

Certain physical activity - Sports that include increased stress on your knees such as running or basketball can increase your chance of knee injury. Physically demanding  jobs such as contracting or moving can also factor into joint cartilage wear 

Previous Injury - If you have injured your knee before you are at greater risk to re-injure your knee


When Should You See An Orthopedic Doctor

If you experience any of the following symptoms in your knee, you should consult an orthopedic physician:

  1. Clicking, locking, or popping in the knee joint.
  2. Swelling
  3. Knee pain when sitting, driving, walking, sleeping, or exercising
  4. Instability or a feeling of the knee giving way
  5. Pain or stiffness which causes a decreased ability to bend or straighten the knee

JOI Physical Therapy for Knee Pain

It is not uncommon for people of various age groups to have knee pain. There are several different ways to treat pain in the knee in physical therapy. It is important to know what the cause of your knee pain is.  Once this is determined, a therapist will develop an individualized program specific to your knee.  This would include flexibility and strengthening exercises.  

If you are interested in scheduling an appointment at JOI Rehab for physical therapy, call 904-858-7045

If you would like to learn more about knee pain, go to: https://www.joionline.net/library/show/knee_pain_symptoms/


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