KNEE PAIN – Physiotherapy Treatment

Posted on |

KNEE PAIN – Physiotherapy Treatment

Introduction to Knee Joint Pain :

Osteoarthritis of Knee: is degeneration or wear and tear between joint surfaces of the knee. It usually occurs in knees that have experienced trauma, infection or injury or age related changes. Osteoarthritisdevelops as the cartilage that protects the bone ends thins down and the bones will begin to rub against each other when the joint is moved.  With the worn-out cartilage, the joint space between the bones narrows. The surrounding bones react by becoming thicker and grow outward and form bone spurs. All these changes can lead to pain, swelling and discomfort in the knee on movement or rest.

Ligament Sprains or Tear: The knee has four major ligaments. The ligaments inside the knee joint are called ACL and PCL while the ligaments on either side of the knee are called MCL and LCL. These ligaments provide stability to the knee. Knee Ligament Injury can lead to pain and instability with the “giving way” feel. These can be associated with muscle weakness and lack of balance in the long run.

Meniscus Tears: A knee has two menisci. Any activity that causes forcefully twisting or rotating the knee, especially when there is full weight on it, can lead to a torn meniscus. A torn meniscus causes pain, swelling and stiffness of the knee. Torn meniscus might also lead to a block to knee movement and cause trouble while extending the knee fully.

Iliotibial Band Syndrome: Often seen in runners. Iliotibial band is a tight band of muscle and connective tissue on the outer thigh which causes stress on the knee resulting in pain on outer side of knee and typically with running and going downstairs.

Patellofemoral pain syndrome (PFPS)

Pain arises from the patella (kneecap) & excludes other soft tissue. PFPS constitutes 16 to 25 % of all injuries in runners. It can cause pain under the knee cap and swelling around the knee joint. Pain may increase after activities such as jumping, running down slopes, steps, prolonged walking or squatting.

Fractures: Occur in and around the knee joint due to direct or indirect trauma and may involve the patella, femur or tibia.

Dislocation or Shifting of Patella (Knee Cap): When the kneecap is partially or completely displaced out of its normal alignment. The most common direction for a patella to dislocate is outwardly (laterally). When this happens, the muscles and ligaments on the inside of the knee become overstretched and damaged.

Baker’s Cyst: pain at the back of the knee with a round swelling.

Chondromalacia Patella CMP: Happens when the patella glides through the groove with a lateral shift during the knee movement. This causes irritation of the cartilage between the patella and the femur and often results in pain.

Pain is mainly with stair climbing, prolonged sitting and knee bending with weight bearing exercises. Pre-disposing factors may include flat fleet, overuse, tight muscles on the outer side of the knee, injury or weak muscles on the inside of the knee (vastus medialis).

Osgood Schlatter’s Disease: is seen in adolescents who develop pain and a bump just below the knee due to constant overuse and traction on the insertion of the patellar tendon.

Why am I getting injured even though I am fit?

Sports injuries

Do you exercise regularly but find yourself sustaining injuries, aches and pains with your daily activities or sometimes even after your workout?

Injuries can push us back in our fitness journey progression. However, they can also be indicative of an existing problem or an absence in our exercise routine.

Here are some reasons why you might be getting injured even though you keep fit and exercise regularly.

1. Lack of warm up and cool down

It is not uncommon to hear recounts from patients telling me that they go for 5km runs or go to the gym after they get off from work. Diving straight in to your work outs and exercises after sitting at your desk the whole day is a precursor of an injury or strain just waiting to happen.

Sitting for long hours causes our muscles to get shortened and stiff. Warm ups help to increase the circulation to our muscles and warms it up, making them more elastic and ready for them to work more efficiently which helps to prevent injuries.

A proper warm up only takes about 10-20mins. You can start off with a slow 5-10min walk, jog or cycle, followed by a series of dynamic stretching exercises to get your joints mobile and well stretched out for the exercise ahead. Performing static stretches BEFORE your physical activity can actually cause reduction in muscle strength as your muscles are not yet warmed up to be stretched to its limits and can potentially cause injuries.

Static stretching is best for AFTER your work outs when you are COOLING DOWN. At this stage, your muscles have been contracting and are coursing with warm blood and nutrients. Static stretching helps to lengthen your muscles and restores them back to its natural length and speeds up recovery time. If this step is skipped, your muscles can remain in that shortened contracted length, resulting in tightness and pulling on other structures in your body, changing the biomechanical alignment of your body. Hence the importance of cooling down is as important and vital as warming up before your work outs for injury prevention

2. Muscle Imbalances

No one has the perfect body, but it becomes an issue and a precursor to injuries when there are distinct muscle imbalances in your body.

A left to right muscle imbalance can be easily identified. Usually our dominant hand or leg will be slightly stronger and we might be weaker and tighter on the other side. These imbalances will cause our bodies and joints to take on different stresses during exercises. This can result in one sided pains/injuries initially. If we don’t correct this imbalance, the joints in your body would continue to take on more stress and be prone to repetitive wear and tear and injury.

Other kinds of imbalances involve global muscles and stabilizers. Global muscles are larger muscle groups which produce a greater force but fatigue easily, whereas stabilizers do not produce great force but are enduring muscles. When our stabilizers are weak, our global muscles tighten up to compensate for the lack of the ability to contract over a long period of time. As mentioned earlier, tight muscles are a precursor for injuries. Therefore, with these kind of imbalances, it is important to consult a physiotherapist that can get you on the right track to strengthening your stabilizers and releasing those tight global muscles.

3. Poor Form

Poor form can be a result of muscle imbalancespoor body awareness, or the lack of knowledge on the exercise you are doing. Performing the exercises with a poor form will most definitely lead up to an injury. Talking more on biomechanical alignments, our weight distributes and our joints are built to take on weights. However, when you perform exercises in a poor form it leads to a change in your biomechanical alignment and force distribution in your body. This causes increased stress and strain on different joints and muscles groups which will result in sprains, tears and degeneration over a period of time.

Thus, it is important to get yourself educated with the knowledge on performing your exercises correctly. Be it walking, running, squats or lifting weights, a physiotherapist can advise and equip you with knowledge and the technical skills you need to prevent such injuries when you exercise.

Now that you know what are the common causes that leads up to an injury even though you exercise regularly, be sure to make these corrections as soon as you can and seek help to prevent yourself from getting hurt!

Rane Ng


Physio Asia Therapy Centre