One of the most common joints I treat as an Osteopath is the knee, as you can imagine the knee takes a good pounding in everyday life whether your a runner, lifter or someone who is sat at a desk all day. Our knees undergo a range of varying forces, therefore I'm sure you or a family member has stated that their knees ache or hurt at the end of the day.
Knee are one of the largest and most complicated structures in our bodies due to the varying nature of the structures which make up the knee. The knees therefore can be damaged from an acute injury or wear and tear overtime, this is wear manual therapists such as osteopaths can help, through either hands on work or rehabilitation advice.
What is knee pain?
Knee pain can be either referred pain or related to the knee joint itself. It will usually involve inflammation and swelling of the tissues around or in the knee joint. The pain can be at the front, at the back, on the sides, below the knee or the knee cap itself.
The knee is a hinge joint which means its prime movement is bending and straightening the leg, due to its structure twisting is also possible at the joint. Due to the knees complexity once the knee joint has become symptomatic you may find that even the simplest of things such as walking and sitting become painful and your daily routine becomes a struggle.
Structure of the Knee Joint
There are two parts to the knee joint: the tibiofemoral joint (thigh and shin bones) and the patellofemoral joint (knee cap).
The joint is held together and stabilised by 4 main ligaments called the anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament and lateral collateral ligament.
You then have the muscles which move the joint – primarily the quadriceps and the front and hamstrings at the back.
There are 6 fluid sacks which can be found between muscles, bones and the ligaments. These fluid sacks are known as bursa's which act as shock absorbing pads. These bursa are known as; the popleteal bursa (semimebranosis bursa), supra-patella bursa, infra-patella bursa, subcutaneous prepatalla bursa, deep infra-patella bursa and the pes-anserine bursa (subsartorial).
The muscles are attached to the bones by tendon, for example the patella tendon that attaches the quadriceps muscle to the front of the shin bone via the knee cap.
The ends of the bones are lined with articular cartilage and between the joint there are 2 extra pieces of cartilage called the menisci.
Finally there is the joint capsule which is like a bag that surrounds the joint and contains synovial fluid which nourishes and lubricates the knee.
Symptoms of Knee Pain
The location and severity of the pain can vary and will depend upon the cause of the problem. You may experience one or a combination of the following:
Swelling and stiffness
Redness and warmth to the touch
Weakness or instability
Popping or clicking/crunching noises
Inability to straighten the knee
Pain when kneeling or going down stairs
Locking – where the knee gets stuck
Pain when sitting for long periods
Pain from running
You should call your GP or seek medical advice if you can’t bear weight on your leg, see obvious deformity in your leg or knee, or have a fever in addition to redness, pain and swelling in your knee.
Causes of Knee Pain
Due to the complexity of the knee and the number of structures which make it up this means that any number of the structures can cause pain. A few of the most common causes of knee are:
Tendinitis
Bursitis
Muscle Strain
Meniscus Tear
Ligament Sprain
Synovitis
Iliotibial band syndrome
Rheumatoid Arthritis
Osteoarthritis
Trauma
Ankle or Hip problems
Sitting for Long Periods
It is common for teenagers and growing children can experience some pain in their joints due to their bones and muscles growing. This is a where the muscles and tendons are stretching and pulling on their bony attachments. Excessive activity, with little stretching and warm up is the cause of most knee pain, especially in young adults. This can lead to early wear and tear known as ‘degeneration’ or ‘arthritis’.
How Can Osteopathy Help?
As you have read the knee joint is very complex and is made up of a multitude or muscles, ligaments and tendons as well as the bursa, meniscus and bones. Osteopaths are trained over a 4 year period, with an advanced knowledge of the anatomy and physiology of the body, and are taught a variety of treatment techniques aimed at improving joint function and muscle mechanics.
Here at Health First Osteopathy we will review your symptoms and medical history and conduct a physical examination of your body – back, pelvis, knee, ankle and feet. We will then use a combination of hands–on techniques to improve joint mobility, stretch muscles, decrease inflammation, facilitate healing and re-balance the mechanics of your body. We may also give you some 'easy' but 'effective' exercise to help strengthen the knee to aid your recovery. I am also trained in Kinesiology taping which has many benefits whether it is used to help stabilise, aid strength or provide proprioceptive stimulus to aid recovery.
We are fully trained to recognise if your condition should require medical intervention, or whether further investigations are required such as MRI and in such cases we will refer you to your GP. You may also like to see your GP if you require pain or anti-inflammatory medication.
It is difficult to say how many treatments you will need and how long it will take for you to recover until we have actually examined you. Having said that if it is a minor injury in a young person this will usually resolve in a few weeks, whereas if it is a more elderly person with degenerative changes you may consider having regular maintenance treatments to keep you moving and pain free.
What Can You Do Now?
If you are reading this blog or have visited this website because you have knee pain, then don't suffer in silence. You can either ask us about your knee problem via the contact section on the website or you can call us on 07732059388.
At the assessment, we’ll take some details from you and build your case history. We’ll discuss why you’ve come to see us and where you have any aches and pains. Then we’ll examine you with the aim of giving you the appropriate treatment for your knee pain.
This will take a little while to complete, but it’s a necessary part of the ethical guidelines we work to. The guidelines are there to make sure everything is done professionally and to a high standard of patient care. I’m sure you agree that’s a good thing!
If you have any questions about what we do and how we do it, call us and we’ll be happy to help.