Knee Pain and Injury

Do you want help to feel happier and healthier? Our Osteopaths have been treating knee pain and injuries for over 15 years! We have treated thousands of happy satisfied clients because we treat everyone like a VIP.

MORE ABOUT THE KNEE

The knee is quite a complex structure of the human body that takes on a significant amount of load and stress. It is for this reason that the knee is commonly a large contributor to pain and vulnerable to dysfunction in all ages and fitness levels.

Anatomy

The knee is a hinge joint that is responsible for weight bearing and is vital for movement. It is made up of:

Bone: ​This includes the femur (thigh bone), tibia (shin bone), patella (knee cap) and fibula (thin bone on the outside of the leg).

Cartilage: ​Between the femur and tibia there is cartilage called the menisci that assists with shock absorption and fluid movement of the knee.

Ligaments:​ There is the anterior and posterior cruciate ligaments (ACL and PCL) which prevent forward and backward sliding of the tibia on the femur. There is also the medial and lateral collateral ligaments (MCL and LCL) that prevent side to side sliding.

Other: ​There is a multitude of muscle tendons which cross the knee joint helping with stability and movement. In addition, your knee is home to many bursa (fluid filled sacs) which reduce friction and aid smooth movement of the knee.

COMMON KNEE INJURIES AND CONDITIONS

Ligament Sprains

These injuries are common in sports such as football, basketball and soccer where a sudden change in direction, or any motion which causes a twisting motion of the knee, occurs. This motion puts high stress through these stabilising ligaments where excessive load can result in a sprain or tear. The ACL and MCL are the most common of the four to become injured.

Possible Symptoms:
–  Pain and swelling
–  Instability and inability to weight bear
–  May hear a pop

Diagnosis:

Your osteopath will assess your knee based on how you injured your knee and your symptoms to decide on a diagnosis and management plan. Depending on the severity of pain and instability you may require further imaging to assess the degree of the injury.

–  Grade 1: Mild stretching of the ligament, knee is still stable
–  Grade 2: Moderate overstretching of the ligament, ligament is loose
–  Grade 3: Full rupture of the ligament, knee is unstable

Treatment:

Treatment will depend on the severity of the injury. Full rupture may require surgery. Non-surgical treatment includes:

–  Rest, ice, compress and elevate leg if swollen
–  Wear a brace to help protect and stabilise knee
–  Manual therapy to reduce muscle tightness and increase range of motion
–  Strength exercises to assist knee stability and reduce risk of future injury

Recovery:

–  Grade 1 Sprain: Usually within a few weeks
–  Grade 2 Sprain: May take up to 8 weeks
–  Grade 3 Tear: Non-surgical can take approximately 3-4 months, with surgery up to 12 months

Meniscus Tears

Just like ligament injuries of the knee, meniscus injuries are also common in sports such as football, basketball and soccer where a twisting motion of the knee may occur whether from landing awkwardly, changing direction or with impact to the area. It is also common for the menisci to be injured in conjunction with a ligament injury due to a shared mechanism of injury.

Possible Symptoms:

–  Pain and swelling
–  Inability to weight bear
–  May hear a pop
–  Difficulty bending or straightening the knee
–  A sensation of the knee locking, clicking or giving way

Diagnosis:

Your osteopath will assess your knee based on how you injured your knee and your symptoms to decide on a diagnosis and management plan. Depending on the severity of pain and instability you may require further imaging to assess the degree or the tear or if an ACL injury is also suspected.

Treatment:

Treatment for a meniscus tear will also depend on the severity of pain, locking and function. If the knee continues to cause pain and dysfunction following conservative treatment and management then surgery may be required. Non-surgical treatment includes:

–  Rest, ice, compress and elevate leg
–  Use of a brace to reduce stress placed on the knee in early stages
–  Manual therapy to reduce muscle tightness and increase range of motion
–  Strength exercises to assist stability in the knee and reduce risk of future injury

Patella Tendonitis / Tendinopathy

This is an overuse injury that results in the patella tendon (between the kneecap and shin bone) becoming overstretched and overloaded, causing one or more of its fibres to become irritated and potentially inflamed. It commonly occurs in people who participate in sports such as basketball, football, athletics, gymnastics and skiing as the greatest amount of load in the patella tendon is experienced with jumping, landing and repetitive squatting.

Possible Symptoms:

–  Gradual onset of pain just below the knee cap
–  Stiffness before and after activity
–  Pain worse when kneeling or squatting

Diagnosis:

Diagnosis of patella tendinopathy can be made through a clinical assessment when used in conjunction with patient reported symptoms and onset. Imaging is rarely necessary unless exclusion of an alternative injury is required. Your osteopath will test certain movements to reproduce your normal pain and match it with normal findings of this injury.

Treatment:

The goal of treatment is to reduce the current load going through the tendon by altering physical activity in the short term and to address the cause of increased load in the patella tendon (biomechanics and weaknesses). Treatments include:
–  Controlled rest
–  Stretching and manual therapy
–  Taping to offload the tendon
–  Strengthening to address any deficiencies that may overload the patella tendon
–  Advice on training load

Recovery:

In mild cases, this condition with the right management can usually resolve within 4 weeks. In more severe cases it can last up to 6 months.

Osteoarthritis and Degeneration

Osteoarthritis is the most common form of arthritis involving wear and tear of the cartilage that lines the joints. Due to the amount of load that goes through the knee joint, it is a common victim of osteoarthritis. There are factors that put you at greater risk of developing osteoarthritis and these include; previous injury, being overweight, history of repetitive use and loading of the knee.

Possible Symptoms:
–  Pain
–  Stiffness
–  Swelling
–  Reduced range of motion
–  Clicking in the joint

Diagnosis:

Diagnosis of osteoarthritis can be done by collecting a history of your pain, background, occupation and lifestyle in addition to a physical examination that will look for a pattern of decreased range of motion and pain.

If another condition or form of arthritis is suspected, other tests or imaging may be recommended to rule these out before a definitive diagnosis of OA is made.

Treatment:

While there is currently no cure for osteoarthritis, there are many ways to treat and manage symptoms to ensure a happy and healthy lifestyle going forward. Treatment options include:

–  Physical and manual therapy
–  Weight loss program (if overweight to reduce stress in joints)
–  Individualised exercise program
–  Assistive devices (braces, walking stick)

WHAT AN OSTEOPATH CAN DO FOR YOUR KNEE PAIN

Some general goals of treatment include:
–  Increase and maintain joint mobility and flexibility
–  Strengthen muscles surrounding your knee
–  Teach you how to move and use those joints correctly
–  Address any risk factors and correcting imbalances
–  Keep you positive, healthy and active

Your osteopath will do this by:
–  Using soft tissue massage and joint mobilisation techniques
–  Tailoring and coaching at home stretches and exercises
–  Managing training loads when returning to exercise/sport
–  Recommending any assistive devices that may help (brace)
–  Educating you on what the injury is and what the management plan entails.

If you experience pain or dysfunction in your knee your osteopath can assess, diagnose, treat and tailor a management program for you. By assessing the exact cause of your knee pain, a detailed and structured management plan can be put in place to give you the best chance at reaching whatever goals you may have, whether this be returning to sport and exercise, or living out your normal daily life without pain.