The human knee is a hinge joint that connects the shin (tibia) to the thigh bone (femur), with the kneecap (patella) at the front of the joint. The knee contains four ligaments and two shock absorbers known as menisci. Knee pain can be caused by many factors including strain, injury, and repetitive stress, though occasionally no specific cause can be found.
The human knee is a hinge joint that connects the shin (tibia) to the thigh bone (femur), with the kneecap (patella) at the front of the joint. The knee contains four ligaments and two shock absorbers known as menisci. Knee pain can be caused by many factors including strain, injury, and repetitive stress, though occasionally no specific cause can be found.
Knee pain can cause functional problems including difficulty standing, walking, and climbing stairs. Fortunately, physical therapy can help. Here is what to expect.
Types of Knee Pain
Although knee pain may have many different causes and different structures can be involved, all knee pain can be typed. Knowing what type you have can assist us with proper diagnosis and treatment.
Acute knee pain is generally very painful. It occurs immediately after injury or trauma to the knee and generally lasts for about a week. Rest is critical during this time to allow your knee to heal.
Subacute knee pain starts around seven days after the initial incident and lasts for up to six weeks. During this phase, it is important to gently and carefully use the knee to regain mobility and functionality.
If knee pain lasts for more than six weeks, it is considered chronic. It might happen after a trauma or injury, it could be the result of a medical condition such as arthritis, or it could have no discernible cause at all. Chronic knee pain requires careful evaluation to determine the best treatment approach.
Diagnosing the Involved Structures
Exactly where you knee pain is located can help us diagnose which structures are involved.
Pain at the front of the knee generally indicates trouble with either the kneecap or its connecting tendon. A common diagnosis is patellofemoral stress syndrome (PFSS). You will likely have trouble with anything that requires extreme knee movements such as kneeling, jumping, or climbing stairs.
Pain on the inside of the knee typically involves the medial meniscus and/or the medial collateral ligament. These structures are often injured by twisting the body weight over the knee with the foot planted on the ground. Wear and tear, as well as arthritis, can cause chronic pain in this region.
Pain on the outside of the knee could involve a ligament injury or a tendon strain. Or, if your pain has a burning quality, it might be due to the iliotibial band (ITB). This thick piece of tissue, which runs from the front of the knee to the outside of the hip, can slip out of place or become inflamed.
Pain at the back of the knee normally involves the hamstring. If you have pain when fully bending your knee, though, you might have a Baker’s cyst, in which the knee joint swells into the space behind it.
Treating Acute Knee Pain
Acute knee pain that is not severe and is not associated with a break does not necessarily need either medical treatment or physical therapy immediately. Try the RICE principle: Rest, Ice, Compression, and Elevation. Stay off your feet for a few days while you ice and elevate your knee, wrapping a brace around it if desired. After a week, start using your leg, but avoid extended walking or intense workouts until it heals.
If you pain lasts for three weeks or more despite using RICE, see your doctor or physical therapist right away. Of course, if you have severe pain or there is any possibility of a broken bone, seek emergency help immediately.
What to Expect from Physical Therapy
At your first visit, we will conduct a thorough evaluation. We will ask you detailed questions about your knee pain, including what aggravates it or relieves it. We will also ask about any past medical history that could be related to your current pain. We will then perform a clinical assessment of your knee, which could include the following:
Gait assessment: This is simply a close look at how you walk. Small changes in the way your knee moves during walking could tell us what the issue is.
Range of motion: This is your ability to bend and straighten your knee. We may take measurements rather than relying solely on what we see.
Manual examination: Your physical therapist might place his or her hands on your knee to check for trigger points and structural abnormalities.
Strength testing: If we suspect that your muscles are contributing to your knee pain, we might test their strength.
Swelling measurements: If you have visible swelling in your knee, we will likely measure exactly how much is present.
Depending on what we find, we may also perform a few other tests. At the conclusion of this appointment, we will provide a diagnosis and develop your treatment plan. Each treatment plan is custom crafted, so it is difficult to predict exactly what yours will be. In general, though, your therapy will consist of in-office and at-home exercises designed to strengthen your knee and improve its mobility, perhaps in tandem with manual therapy and/or such treatments as heat or ice.
Ready to Get Started?
If you are ready to start your physical therapy journey with a team you can trust, contact Raritan Physical Therapy at (732) 662-4400 to schedule your appointment.