Do you experience knee pain when kneeling down, walking, or climbing stairs? Do your knees feel stiff and achy? Do your “crunching” and “grinding” noises in your knees? This article will discuss the important knee structures and some related injuries.

Knee Anatomy:

The femur (thigh bone), patella (knee cap), tibia and fibula (lower leg bones) joint together to form the knee joint. Ligaments around the knee joint attach to the bones to provide stability to the knee. Muscles and tendons attach to the knee joint and help straighten and bend the joint. Three important leg muscles that attach to the knee are the quadriceps (front of the thigh), hamstrings (back of the thigh), and gastrocnemius (in the calf). The cartilage of the knee joint is called the meniscus, and acts as a shock absorber and knee stabilizer. There are also fluid-filled sacs, called bursa, that cushion the tendons and prevent them from rubbing against the bones of the knee joint.

What caused knee pain?

1. Ligament sprains are often caused by contact injury, trauma, or overuse of the knee joint. Ligament sprain injuries are categorized in seriousness ranging from mild to severe (completely tear). Many people usually know when a ligament injury has occurred and often will hear a “pop” in the knee joint at the moment of the injury. Other symptoms of ligament sprains include difficulty walking, weakness, and give way or buckling of the knee.
2. Muscle strains are often seen in people who run, kick, and jump frequently. The injury can also be caused from direct trauma to the knee joint. Just like ligament injuries, muscle strain injuries are also categorized in seriousness ranging from mild to severe (complete tear). A muscle injury at the knee may cause swelling, bruising, pain, and tightness in the muscle that can affect your ability to walk freely.
3. Tendonitis in the knee is an injury of the tendons that attach to the knee joint, and is a common sport injury. Typical symptoms include pain and swelling. A common tendonitis is patellar tendonitis, also called “Jumper’s knee”. Another common tendonitis at the knee is quadriceps tendonitis. Tendon injuries can become chronic and require more intense therapy.
4. Osteoarthritis is the most common form of arthritis. Arthritis of the knee is wear and tear of the cartilage at the joints, causing the knee to lose its strength and flexibility. Typical symptoms of knee arthritis include pain at the inside of the knee joint, achy and stiff feelings after activity, and cracking or grinding of the joint with movement and climbing stairs. Knee osteoarthritis is common in people over the age of 50 years old.
5. Bursitis of the knee is an inflammation or irritation of the bursa that lie between the bone and tendons. Typical symptoms of bursitis in the knee are swelling, pain, and decreased knee joint movement. Baker’s Cyst is a bursitis at the back of the knee and Housemaid’s knee is the common name for bursitis at the top of the knee that is often brought on by kneeling for long periods of time.

Treating knee injuries:

Before treatment and rehabilitation can begin, it is important to get an accurate diagnosis. Chiropractors specialize in diagnosing and treating injuries to muscles, ligaments, tendons, and joints.  A correct diagnosis is important to rule out more serious conditions that may be causing your pain and symptoms. The focus of the treatment is to reduce pain, improve flexibility, stability, and strength, return you to regular activities, and prevent a reoccurrence of the injury. For serious knee injuries, you may require additional tests such as x-rays, ultrasound studies, CT scans, or MRI studies, or a referral to an orthopedic surgeon.

Your treatment may include:

• Chiropractic techniques: Manual therapies are used to improve tightness of the muscles and ligaments, and restore proper movement of the knee joint. Therapeutic Laser therapy can help to reduce inflammation and pain. Massage therapy and acupuncture to your rehab program may aid in pain relief.
• Specific Rehab Program: If you are working towards returning to a sport or resuming specific tasks at work or at home, you may require an individualized program that allows you to reach your goal and prevent re-injury.
• Activity modification: You may need to avoid certain activities until your injury heals. In addition, activities such as swimming and biking may be incorporated into your rehab program.
• You may be advised to wear a knee support during healing and/or when playing specific sports. You may also be advised to use a knee cushion device if you have to kneel for long periods of time to clean, garden, or perform other tasks that require you to kneel for prolonged periods of time.

Dr. Virginia Nsitem is a chiropractor specializing in laser therapy for spine, muscle, joint, and nerve injuries, and is a Fellow of the Royal College of Chiropractic Sports Sciences in Canada. She may be reached at (905) 275-4993, or by email at totalhealth@bellnet.ca

Stop the Pain … Before the Pain Stops You!