Knee Pain

The WellHub Team

The knee joint is the largest joint in the body.  It has to be strong, provide support to the whole body and be flexible to allow us to bend down to the ground. 

 

Anatomy of the Knee

It is comprised of the femur (thigh bone) and the tibia in your lower leg which forms the hinge joint.  The patella (knee cap) sits on the front of the knee in a groove and is held in place by a large tendon running down the front of your thigh called the quadriceps tendon.  The bones are held together by the joint capsule and four large ligaments which run both inside and outside of the knee joint.  Within the joint there is a layer of cartilage which acts as a shock absorber helping to cushion the bones against impact.  Within the joint there is synovial fluid which is produced by the Synovium membrame.  This helps to lubrictae the joint and nourish the cartilage.  Providing further support and control to the knee joint are the muscles of the thigh, quadriceps (at the front) and hamstrings (at the back).

Knee pain is very common and can be due to a number of different causes.

 

Common Causes of knee pain  and how to help them can be found below:

 

Simple sprain: this will occurs when you do more activity than you are used. 

After a few days rest you want to gradually start moving your knee again and gradually increase the amount of weight you can put down through it. 

 

Patellofemoral joint pain or Anterior knee pain:  is common and research is unclear as to why it happens.  The pain is usually a result of irritation of the patellofemoral joint at the front of your knee.  The pain maybe due to a combination of factors including weakness of the muscles of the knee and hip and a result of doing 'too much, too soon'.  For example starting to run for the first time or increasing your training or activity quickly.

 

Symptoms of Anterior Knee Pain

  • Pain at the front of your knee around your kneecap.
  • Pain aggravated by walking/running, doing the stairs, bending and kneeling.
  • You may have crepitis (clicking sensation) behind the knee cap.  This doesn't ususally cause any pain.

 

How to manage and treat Anterior Knee Pain

  • Modify your activity - you may need to reduce your exercise or the activity that aggravates your pain temporarily to allow your symptoms to settle down.
  • Monitor your pain levels during and after activity.  If your pain increases by a large amount and stays for more than 24 hours you have probably done too much.  Therefore do less next time and then gradually increase what you are doing.
  • Pain relief may help to ease your symptoms.  Speak to your GP or Pharmacist for advice on what would be suitable.
  • Strengthening the muscles of around the hip and knee is one of the most important things to do.  It may take 12 weeks of doing the exercises regularly before you notice an improvement in your symptoms.
  • Stretching the muscles out at the front and back of the thigh can help to reduce pressure on the patellofemoral joint.

 

Osteoarthritis (OA): OA can affect any joint in the body and it is when there are changes to the surface of the joint which means it doesnt move as smoothly. 

 

Symptoms of OA Knee:

  • Pain can be all around the knee or at the front or sides of the knees. 
  • Pain may be worse on particular movements such as going up or down stairs  and eases with rest
  • Stiffness in the morning or after siting for a period of time.
  • Your knees may look swollen. 
  • May be creaky and crunches.
  • It can also cause a painful swelling at the back of the knee called a Baker's cyst. 

 

How to treat/manage knee OA:

There is no cure for OA but there are a number of self-help measures whihc play an important part in reducing the pain and stiffness.

 

  • Exercise - it is important to keep the knee moving and the muscles strong to help protect the joint.  The best approach is little and often and find something that you enjoy and are liekly to stick at.  A Physiotherapist can help guide you on an appropriate exercise programme. 
  • Pain relief can help with the pain if it is particularly bad or if it is preventing you from exercising.  Speak to your GP or Pharmacist for guidance on what would be appropriate.
  • Weight loss will certainly help to reduce the strain on your knees.  Recent research has shown that for every 1kg of weight loss the load on the knee was reduced by 2.2kg.  So even small changes can make a difference.
  • Reduce the strain on your knees by pacing activities throughout the day and break harder jobs into smaller chunks.
  • Avoid wearing high heels as this will alter the angle and pressure at your knee and hip.
  • Heat can help ease pain and stiffness particularly if you have done too much.  Alternatively an ice pack can help as well.

 

If your knee pain fails to improve and continues to affect yuor daily function please seek advice form your GP or Registered Physiotherapist.

 

Please seek urgent medical attention if you have any of the following symptoms.

  • Unable to weight bear or have severe pain on weight bearing.
  • If your knee locks
  • If your knee keeps giving way
  • If your thigh, knee/leg is hot, red or swollen
  • Pain, swelling, numb or tingling of the lower leg beneath your affected knee.

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