Knee pain is a common symptom which can affect people of all ages from adolescence to older adults. Knee pain can be the result of an injury - trauma- or medical conditions such as osteoarthritis in adults or Osgood-Schlatter disease in teenagers .
So let’s have a look at the structure of the knee, the most common symptoms and causes for knee pain.
Structure of the knee
The knee joint is a fairly simple structure made of bones, cartilages and ligaments. There are 3 bones making the knee joint: the thigh bone (femur), the shinbone (tibia), and the kneecap (patella). The 2 condyles -bony projections- of the femur are covered with articular cartilage and contact with the articular surface of the tibia which is called the tibial plateau.
There are two articulations which form the knee: The hinge joint between the tibia and the femur (tibiofemoral articulation) and the between the kneecap and the femur (patellofemoral articulation ).
The lateral (outer) and medial (inner) meniscii are made of fibrous cartilage and form the connection between the thigh bone and the shin bone. They also provide better force distribution in the knee. The inner meniscus is fused with the inner ligament.
There are four ligaments which provide support and allow controlled motion of the knee joints. The medial collateral ligament (MCL) and the lateral collateral ligament (LCL) are located on the sides of the knee joint and provide side to side support to the joint. The anterior cruciate (ACL) and the posterior cruciate (PCL) ligaments are located inside the knee joint and limit movement of the tibia relative to the femur.
The most common symptoms for knee pain.
The knee being a weight bearing joint, there are a lot of forces going through the joint itself and the surrounding structures. Symptoms can vary greatly from patient to patient depending on the mechanism of injury (acute trauma like sports injury, repetitive trauma like running or absence of trauma).
Pain is the most common symptom and can be a general ache around the knee or a really specific sharp localized pain. Stiffness is also a common symptom reported by patients. Sometimes patients report a locking sensation of the knee or the patient feel the knee would give way (it rarely does though).
The most common causes for knee pain
Like the symptoms, these can vary greatly from patient to patient depending mainly on age and the presence or not of a trauma.
Osteoarthritis is a common cause for knee pain and tends to affect the older population. Usually there is no obvious trauma associated and the patient reports pain / stiffness which is usually diffuse around the knee. Osteoarthritis of the knee tend to only affect one knee joint.
Meniscus (cartilage) injury is another common cause for knee pain and is often the consequence of an acute (ski accident for example) or repetitive trauma (running for example). The knee is usually painful on weight bearing and on specific movements involving loading the meniscii.
The ligaments (ACL - PCL - MCL - LCL) can also be a common cause for knee pain and almost always are the consequence of an acute trauma where the knee joint has moved beyond its ability. Ligament injury of the knee is commonly seen on football or rugby pitches as well as in skiing accidents.
Finally, the Ilio-Tibial Band (ITB) which runs from the outer side of the hip to the outer side of the knee is another potential cause for knee pain. Although the ITB is not part of the knee, its involvement in standing, walking and running means that patients can experience pain in the knee.
Can an Osteopath help?
Although the knee is a fairly simple joint, the symptoms and causes for knee pain can be multiple. An osteopath can help by taking a detailed case history - especially of the machanism of the injury - and performing a proper physical examination of the knee. These are essential to establish an accurate working diagnosis and define the best treatment plan for the patient.
So, if you suffer from knee pain or have any knee related symptoms and would like some help, feel free to get in touch. We will be happy to discuss it with you.