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TREATMENT FOR KNEE PAINS

➤ INTRODUCTION

Pain is a common knee problem that can originate in any of the bony structures compromising
the knee joint (femur, tibia, and fibula), the knee cap (patella), or the ligaments, tendons and
cartilage (meniscus) of the knee. Knee pain can be aggravated by physical activity as well as
obesity, affected by the surrounding muscles and their movements, either be triggered by other
problems such as a foot injury and/or an underlying medical conditions such as arthritis.
Temporary knee pain is different from chronic knee pain. Chronic knee pain is usually a long-
term pain, swelling or sensitivity in one or both knees. The cause of the knee pain is determined
by the symptoms a person experiences. Many people experience temporary knee pain as a
result of an injury or accident. Chronic knee pain requires treatment and is caused by the result
of several conditions. Regardless, many injuries that cause pain in the knees are not actually
injuries, but the repetitive movements that over time will cause irritation, resulting in pain and
inflammation. Therefore, knee pain is extremely common and affects people of all ages. It may
start suddenly, often after an injury or exercise. Hence, knee pain can begin as a mild
discomfort and then slowly get worse.


For any individual who suffers from knee pain, obtaining relief is very essential. Long lasting
knee pain has an impact on the daily life which makes it tough for the individuals to conduct
activities. Physical conditions, chronic conditions and/or medical conditions that often cause
knee pain includes arthritis such as osteoarthritis or rheumatoid arthritis, tendinitis, bursitis,
chondromalacia patella, gout, bone tumors, and/or baker’s cyst. Other factors include
dislocation of the kneecap, meniscus tear and/or tear in one of the four ligaments of the knee,
either the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial
collateral ligament (MCL) and/or the lateral collateral ligament (LCL). Furthermore, the factors
that cause chronic knee pain is because of injuries to the structure of the knee, sprains and
strains, overuse of the knee such as increased physical activities, infection in the knees,
improper stretching of the muscles and bad posture and form when performing physical
activities. Some children can develop inflammation of the point of bony insertion of the patellar
tendon, generally termed as Osgood-Schlatter disease).
Therefore, knee pain should be considered a serious problem to the health and the individual
should be diagnosed and treated immediately rather than subsiding the pain and in turn
deteriorating the health. Therefore, the person suffering from knee pains must first start by
seeing a regular physician or the family doctor. Depending upon the cause of the condition,
he/she will then be referred to a doctor specializing in the joint diseases, such as a
rheumatologist, joint surgery, such as an orthopedic surgeon and/or sports medical specialist.

DIAGNOSIS
Diagnosis for the cause of knee pain depends entirely on the location and severity of the knee
pain which may vary depending on the problem. Signs and symptoms that usually accompany
knee pain includes swelling and stiffness, redness and warmth to the touch, weakness and
instability, popping or crunching noises, and/or the inability to fully straighten the knee. If
someone is suffering from these symptoms, they must immediately consult a doctor. Since there
is a difference between temporary knee pain and chronic knee pain, a physician must be
consulted in both the cases, because long lasting knee pain can impact the health and
deteriorate the basic daily life. Thus, each possible cause of knee pain requires different
diagnostic tests which include lab tests, physical examination and imaging tests such as X-
Rays, CT-Scan or MRI.

 LAB TESTS – If the physician suspects an infection or inflammation, then blood tests are
required to know the type of the infection, such as Gout. Sometimes, a procedure called
arthrocentesis is performed wherein a small amount of fluid is withdrawn from the knee
joint using a sterile needle and then sent to a laboratory for evaluation. This procedure is
especially helpful if an infected knee is suspected to distinguish between different forms
of arthritis. Hence, if there is a collection of blood in the joint due to a traumatic injury,
removing the fluid might help relieve the pain.

➜ PHYSICAL EXAMINATION – A physical examination is also necessarily needed to be
conducted by the doctor. During the physical examination, the doctor will inspect the
knee for swelling, pain, tenderness, warmth and visible bruising. Then, he will check how
far the patient can move the leg in different directions. Furthermore, he will evaluate by
trying to push on or pull the joint to check the integrity of the structures in the knee.

➜ IMAGING TESTS – In some cases, the doctor might suggest imaging tests such as X-
Ray, CT-Scan, Ultrasound and/or MRI depending upon the lab tests, physical
examination and the condition of the patient.

 X-RAY – Primarily, the doctor may first suggest and recommend having an X-
Ray done, which can help in the detection of bone fractures and the degenerative
joint diseases. In case, if an X-Ray cannot identify the cause, then the doctor
might suggest other imaging tests to check in depth the condition of the patient.

 Computerized Tomography (CT) Scan – CT scanners combine X-Rays taken
from many different angles to create cross-sectional images of the inside of the
body. CT scans help to diagnose bone problems and subtle fractures. A special
type of CT scan can accurately identify gout even when the joints are not
inflamed.

➜ ULTRASOUND – Ultrasound uses the technology of sound waves which produce
real-time images of the soft tissue structures within and around the knee. The
doctor may then move the knees into different positions during the ultrasound

procedure to check for specific problems.

MAGNETIC RESONANCE IMAGING (MRI) – An MRI uses radio waves and a
powerful magnet to create the 3D images of the inside of the knee. This is
particularly useful in revealing injuries to the soft tissues such as ligaments,
tendons, cartilage and the muscles.

TREATMENTS FOR KNEE PAIN

Since knee pain can be caused by various factors, treatment procedures will vary depending
upon the condition and the cause of the knee pain. Long lasting knee pain can have an impact
on the daily life of an individual. Regardless of the cause of knee pain, it should be treated.
Thus, different treatment procedures include some home remedies and medications if the knee
pain is temporary. If someone is suffering from chronic knee pain, then the doctor prescribes
medications, therapy and/or surgery, depending upon the condition of the health of the patient.

 MEDICATIONS – Knee pain relief is very essential and it requires pills or prescribed
medicines and/ or pain relief creams and ointments for the treatment. The creams and
ointments, containing numbing agent, such as lidocaine or capsaicin (the substance that
makes chili peppers hot) are applied topically on the area to relax the muscles and other
support structures like the tendons and ligaments. Sometimes, these creams and
ointments do not work well to relief the bone pain. Thus, elastic bandages wraps might
help take some pressure off the knee joint. Also, there are braces which are helpful to
keep the knee from moving in the event that the doctor instructs to keep the knee
immobilized. Some medicines include taking aspirin, Tylenol together with ibuprofen
might help to relieve some pain and pressure from the knee. Regardless, if these are not
efficient for the pain and do not provide ample relief, then in such instances, the doctor
may recommend stronger pain killers and/or other medications like antibiotics, steroids,
non-steroidal anti-inflammatory drugs and other prescribed drugs that address the pain
and also the prime source of the problem.

 KNEE INJECTIONS – Sometimes, an orthopedic surgeon might suggest injecting
medications directly into the knee joint which may be helpful in some situations. For
example, injecting a corticosteroid drug into the knee joint will help in the reducing of the
symptoms of arthritis related knee pain and provide some relief that may last for a few
months. Furthermore, hyaluronic acid, which is a thick fluid, similar to the fluid that
naturally lubricates the joints, hyaluronic acid can be injected into the knee to improve
mobility and ease the knee pain. Some studies have shown mixed results about the
effectiveness of this treatment, that by taking one to a series of shots which may last as
long as six months.

 PLATELET-RICH PLASMA (PRP) THERAPY – Platelet-Rich plasma therapy uses the
injections of a concentration of a patient’s own platelets, which contains a concentration
of many different growth factors accelerating the help of the injured tendons, ligaments,
muscles and the joints. It helps to encourage healing and reduces inflammation. A small
sample of blood is taken from the patient being treated and it is put into a centrifuge or
other specialized device that spins at high speed separating the platelets from other
blood components. The concentration of platelets is then injected into the area that
needs to be treated. Platelet-rich plasma therapy is a simple, low cost, and minimally
invasive intervention and some recent studies have shown that PRP therapy is feasible
to deliver in the treatment of osteoarthritis pain of the knee joint.

SURGERY – Some knee pain will likely be permanent because the structure of the knee
is damaged. Moreover, without any surgery or another type of extensive treatment, pain,
inflammation and swelling will be there. Therefore, knee operations range from
arthroscopic knee surgery to the total knee replacement. So, if the knee injury requires
surgery, it is usually not necessary to have the operation done immediately, depending
upon the condition of the patient.

ARTHROSCOPIC KNEE SURGERY – Arthroscopic knee surgery, generally
known as knee arthroscopy is a surgical technique that can diagnose and treat
problems in the knee joint. During this procedure, the orthopedic surgeon will
make a small incision and insert a tiny camera which is called the arthroscope,
into the knee. This allows to view the inside of the knee joint on a screen. The
surgeon then investigates the problem within the knee and if necessary corrects
the issues using small instruments within the arthroscope. Knee arthroscopy
diagnoses several knee pain problems, such as torn meniscus or a misaligned
patella (kneecap). It can also repair the ligaments of the joint. There are limited
risks to this procedure and the outlook is good for most of the patients.

 PARTIAL KNEE REPLACEMENT SURGERY – Partial knee replacement, also
known as Unicompartmental Knee Arthroplasty (UKA), is a surgery to replace
only one part of a damaged knee. It can replace either the inside (medial) part,
the outside (lateral) part or the kneecap (patella) part of the knee. The partial
knee replacement surgery removes the damaged tissues and bones in the knee
joint. It is done when arthritis is present in only a part of the knee. The areas are
replaced with a man-made implant, called a prosthetic. The rest of the knee is
preserved. Partial knee replacements are most often done with smaller incisions,
hence there is less recovery time. Moreover, because of the bone, cartilage and
ligaments in the healthy parts of the knee are kept, a partial knee replacement
feels more natural and the knee usually bends much better.

 TOTAL KNEE REPLACEMENT SURGERY – Total knee replacement surgery
was first introduced in the year 1968. Knee replacement provides dramatic pain
relief for more than 90 percent of those patients who have undergone this
surgery. Most of these procedures are done to replace knees damaged by
osteoarthritis. The total knee replacement is considered one of the safest and
most effective procedures. During a total knee replacement, an orthopedic
surgeon removes some bone and cartilage from the areas of the thighbone and
shin bone, where they meet at the knee joint. The surgeon then replaces the
knee area of your thighbone with a metal implant and the knee area of your
shinbone with a prosthetic. This gives both the bones of the knee joint smooth
surfaces again so they can flex and bend more freely and painlessly. In many
cases, the surgeon also replaces the undersurface of the kneecap with a plastic
coating.

 BILATERAL KNEE REPLACEMENT – Bilateral knee replacement surgery or
also known as double knee replacement surgery, is the replacement of both of
the knees at the same. An advantage to bilateral knee replacement is that the
patient only has to go through this procedure and recovery process once if both
the knees are affected. Double knee replacement surgery may involve one
surgery or two surgeries. When both the knees are replaced at the same time,
the surgery is known as a simultaneous bilateral knee replacement. When each
knee is replaced at a different time, it is called a staged bilateral knee
replacement.

 PHYSICAL THERAPY – Physical therapy or physiotherapy is necessary to strengthen the muscles around the knees which will make it more stable.
 The doctor may recommend physiotherapy or different types of strengthening exercises
based on the specific conditions which is responsible for causing the pain. If the patient is physically
active or practice any sports, they may just need exercises to correct the movement
patterns that might affect the knees. It is known that physical therapy is an excellent form
of treatment used to reduce the pain, increase the functionality and strengthen and
prevent future injuries. Physical therapy can include active therapy such as specific
movements or exercises or passive therapy which includes electrical simulation and/or
massage. An effective way to massage the knees is to slowly move to the patella in a
circular motion. This is to be done rather slowly and gently, but firmly as it loosens the
unstable tissue within the knees and helps get rid of it. Sometimes, the pain is caused by
scar tissue in the knees. This procedure helps with the healing of the scar tissue. For
example massage using warm oregano oil can be helpful. Warm coconut or olive oil can
also be used to encourage better blood flow to the affected region and easy any type of
inflammation and pain that may be present. Furthermore, the alternative method of yoga
can also be effective for the treatment of recurrent knee pain and injuries. Doing regular
yoga routines focusing on the inhaling and exhaling helps to unwind and also treat the
knee pain which is due to mental stress. A trained physical therapist can also help
providing exercise regimes that includes a variety of closed chain exercises which helps
to strengthen the hips, legs and knees in order to treat the knee pain.

NON-TRADITIONAL TREATMENTS, HOME REMEDIES AND PREVENTIVE AND KNEE PAIN AT NIGHT

MEASURES

Non-traditional knee pain treatments like natural supplements, acupuncture and homeopathic
treatments are beneficial because they are geared towards treating the cause of the pain.
Natural supplements such as Glucosamine and Chondroitin helps to rebuild the cartilage. Some
homeopathic medicines such as Arnica and Bryonic are homeopathic medicines that resolve
joint inflammation and pain. A non-traditional approach is beneficial is that it decreases the side
effects and tackles the root of the cause of pain. Research suggests that acupuncture and
Traditional Chinese Medicine (TCM) have a slightly different approach to diagnosing and
treating different kinds of knee pains. Ultimately, acupuncture involves the placement of hair-thin
needles into the skin at specific places in the body and is known to be very effective in treating
all types of knee pains and can help the recurrence of this debilitating condition. Ayurveda is
also one of the non-traditional treatments, which includes use of Ashwagandha and/or Withania
somnifera, as natural pain relievers and has been helpful in knee pains commonly caused due
to arthritis.

In treating many types of knee pains, home remedies can be useful in treating temporary knee
pains. Some measures for self-care, such as resting and taking a break from normal activities
which will help reduce repetitive strain on the knees and will give time to heal and help prevent
further damage. In treating many types of knee pains, inflammation is the first thing that must be
brought under control. When there is an injury, substances that cause inflammation invade the
knees, causing further injury, which leads to further inflammation, leading to the continuation of
the knee pain. Some common techniques is to use ice. Ice reduces both pain and inflammation.
Also, an ice pack wrapped in a thin towel can also be used. It is generally safe and effective, but
it must not be used for longer than 20 minutes because there is the risk of damage to the nerves
and the skin. In fact, applying a heat pack or hot-water bottle can provide temporary pain relief.
Also, a compressive bandage can be used which is light-weight, breathable and self-adhesive,
but tight enough to support the knee without interfering with the blood circulation. This helps the
prevention of fluid buildup in the damaged tissues and maintains knee alignment and stability.
Furthermore, keeping the legs in an elevated position, such as using a pillow underneath your
leg while sitting or sleeping, might help reduce some swelling. Herbs are also very effective to
reduce arthritis knee pain and inflammation, and one advantage of using them is that they are
free from side effects. Some herbs are effective when taken orally and some can be used
topically. For example, cayenne cream is very popular herbal remedy for arthritis pain relief, and
can be applied topically on the knee, reducing the signals of pain passing to the brain which
makes the patient feel reduced or no pain for some time. Another herb is ginger which can be
used orally or externally for knee pain relief, since it has rich anti-oxidant properties and
promotes blood flow in to the affected part. Some other popular herbs used for arthritis knee
pain are the nettle leaves. In old times, the sting of nettle thorn was directly given on the knee
for immediate relief from pain and inflammation. Sometimes, warm mustard oil is spread over a
madar leaf and tied to knee which is known to relieve the pain and inflammation caused due to
arthritis.

Furthermore, just by making some changes in the lifestyle, can help reduce the knee pain.
Some self-care measures can be taken to prevent the knee pain such as warming up before an
exercise, like to stretch the quadriceps and hamstrings before and after the exercise. Losing
weight can also be a factor to help prevent knee pain. Since rough roads or pocked walkways
may be hazardous to the knee’s health, it is advisable to stick to smooth and paved surfaces
like a track or walking arena. Also, support can be taken using shoe inserts which help treat foot
or gait problems that may be contributing to the knee pains. Also, while walking down hills,
instead of running down an incline which puts extra force on the knees, walking is better.
Moreover, it is advisable to replace the running shoes frequently so that they have proper
support and cushioning. If someone is suffering from knee pains, but need to exercise to
improve the condition, it is better to try low-impact exercises. For example, instead of running or
playing sports such as tennis, it is better to try swimming or bicycling and/or mix of low-impact
exercises with high-impact exercises which will help in reducing the impact on the knees.
Furthermore, modifying the diet can help in the prevention of knee pain because obesity is one
of the reasons that can cause knee problems. Therefore, a well-balanced meal plan is
necessary. So, addition of fruits and vegetables is essential because they include
phytochemicals, a material which is known to diminish swelling. Also, including Omega-3s in the
diet which is easily found in fish, nuts etc. can help, as well as calcium and minerals for
improving the health of the bones should be added in the diet.
Thus, by making simple changes in our way of living, we can improve our health and prevent
some pressure of our knees, which in turn will help in reducing and/ or preventing the knee
pains. Furthermore, before starting any type of treatment regimen, the cause of affliction should
be known, which will be determined by a healthcare professional. Based on that, best treatment
measure can be approached, which could either be the traditional or the non-traditional
treatments, depending upon the cause of knee pain. Treatment for the knee pain will vary from
person to person. Hence, both of these have short term and long term benefits, but the key is to
follow what is best for the knees and which can be more effective in providing pain relief.
















KNEE PAIN
CAUSES, INJURIES

➤ INTRODUCTION

The proper functioning of the knee is essential to our most basic activities. Knee pain is a
common compliant that affects people of all ages and can become chronic. Knee pain is the most
common musculoskeletal complaint, since knees are tremendously prone to injuries and getting
damaged. This is because they have complex structures, which are made up of bones, tendons,
ligaments and cartilage. Therefore, knee pain may be the result of an injury, such as a ruptured
ligament or torn cartilage. Some knee pain can be excruciating because it is caused by increased
tension on the knee brought by a physical activity.
The knee is a vulnerable joint that bears a great deal of stress from everyday activities, such as
lifting and kneeling, and from high impact activities, such as jogging and aerobics. The knee is
formed by three parts which include tibia (the shin bone or larger bone of the lower leg, femur
(the thighbone or upper leg bone) and patella (the knee cap). Each bone end is covered with a
layer of cartilage that absorbs shock and protects the knee. Basically, the knee is two long leg
bones held together by the muscles, ligaments, and tendons. There are two groups of muscles
involved in the knee, including the quadriceps muscles which are located on the front of the
thighs, which are known to straighten the legs, and the hamstring muscles, which are on the back
of the thighs, which bend the leg at the knee. Tendons are tough cords of tissues that connect
muscles to the bones. Ligaments are elastic bands of tissue that connect bone to bone. Some
ligaments on the knee provide stability and protection of the joints, while the other ligaments
limit forward and backward movement of the tibia (shin bone).
There are many possible causes of knee pain. Sometimes it could just be one cause and other
times it could be a combination of various conditions that lead to the knee pain. The most
common disease that affects the knee is arthritis. There are 100 or more types of arthritis that
affects the knees and other joints. There are other rheumatic diseases that can affect the knees
and cause severe knee pain, such as gout and lupus. Being overweight also puts you at greater
risk for knee problems. In fact, overusing the knee can trigger knee problems that causes pain.


knee pain
knee pain
CAUSES OF KNEE PAIN  PART 1

Since the knee joint is one of the most complex joints in the human body, it is known to play a
pivotal role in facilitating movements and supports the entire weight of the body. Hence, the risk
of knee injuries and knee joint pain is very high and can be caused by various factors. Minor
knee injuries mainly occur due to stretching and twisting or any movements that goes beyond the
knee’s endurance. Sudden movements or jerks can cause knee injuries, which can often occur
while walking on uneven paths or athletes training on rough surfaces. Some of them have been
explained in detail below.
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MEDICAL CONDITIONS

Knee pain can be caused by a previously occurred or on-going medical conditions, which include
arthritis, such as rheumatoid arthritis, osteoarthritis, lupus, gout, or diseases such as cancers that
either spread to the bones or begin in the bones. Also, infections in the bones of the knee or the
knee joint are responsible for causing knee pain. They are explained below.

ARTHRITIS – Arthritis :is probably one of the most common cause of knee pain, and it is
caused by a number of factors, which include trauma, heredity, aging and even being
overweight, as it puts added stress on the joints. The most common form of knee arthritis
is osteoarthritis, which is generally termed as degenerative joint disease. In fact,
osteoarthritis is caused due to the degeneration of the cartilage that protects the knee
joint. Some of the symptoms that the patients complain usually includes pain, stiffness,
and tenderness to the touch and less range of movement. Pain may also occur when
rheumatic arthritis invades the delicate tissues around the knee joint. Another cause of
knee pain due to arthritis is the crystallization of uric acid within the joint cavity, which
usually occurs in the case of Gout. Furthermore, in auto-immune disease such as lupus,
the immune system of the body mistakenly attacks the healthy tissues, which can affect
the joints easily, causing severe knee pain. Another type of arthritis which is called the
septic arthritis is caused due to inflammation of a joint because of a bacterial or fungal
infection. It may also occur when the joint is directly infected with a microorganism from
an injury or during surgery. Joints that are commonly affected are the knees and hips.

BAKER CYST – Baker cyst is caused by a buildup of joint fluid or synovial fluid that
forms a cyst behind the knee. It is usually caused by the swelling in the knee, which
occurs due to increase in the synovial fluid, which lubricates the knee joint. When the
pressure builds up, this fluid squeezes into the back of the knee, which results into the
swelling of the knee. Baker cyst commonly occurs in patients with cartilage injuries, knee
arthritis or other knee problems that cause knee swelling and synovitis.

OSGOOD-SCHLATTER DISEASE – Osgood disease is a painful swelling of the bump
on the upper part of the shinbone, just below the knee. This bump is called the anterior
tibial tubercle. Osgood disease is caused by small injuries to the knee area from the
overuse before the knee is finished growing. The quadriceps muscle is a large, strong
muscle on the front part of the upper leg. When this muscle squeezes or contracts, it
straightens the knee. The quadriceps muscles are necessary for running, jumping and
climbing. Thus, when these muscles are used a lot, which is usually in sports activities,
this area becomes irritated or swollen and causes pain. It is common in adolescents.
Osgood disease affects more boys, when compared to girls.

BONE TUMOR – A bone tumor is an abnormal growth of cells within a particular bone.
A bone tumor may be cancerous, widely termed as malignant or non-cancerous (benign).
Usually, the cause of bone tumors is unknown. They often occur in the areas of the bone
that grow rapidly. In most cases, no specific cause is found, but usually it occurs due to
heredity genetic defects, radiation therapy or injuries. Thus, to conclude, knee pain can
also be caused due to tumors that either spread to the bones or begin in the bones.

OSTEOMYELITIS – Osteomyelitis is a bone infection. It is mainly caused by bacteria or
other germs. When a patient suffers from osteomyelitis, bacteria or other germs may
spread to a bone from infected skin, muscles or tendons next to the bone. This may occur
under a skin sore. Furthermore, the infection can start in another part of the body and
spread to the bone through the blood. This infection can also start in another part of the
body and spread to the bone through the blood. It is also known that such infection can
start after a bone surgery. This is more likely if the surgery is done after an injury or if
metal rods or plates are placed in the bone. In children, mostly the long bones of the arms
or legs are most often involved. Therefore, Osteomyelitis is one such infection in the
bones of the knee.
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INJURIES AND OVERUSE

As we all know, the knee joint has many components facilitating its movement which include
ligaments, tendons, and cartilage with knee pain affecting any of these. The convolution of the
structure of the knee joint and the verity that it is a weight-bearing joint are issues that make knee
problems common and knee one of the most injured areas.
BURSITIS KNEE – Bursitis knee or Kneecap bursitis, commonly known as bursitis is
the swelling and irritation of a bursa, which is a fluid-filled sac that acts as a cushion
between muscles, tendons and bones. Bursitis knee is often a result of overuse. It can be
caused by a change in the activity level, such as training for a marathon, or by being
overweight. Bursitis knee is also known to be caused by trauma, rheumatoid arthritis,
gout or an infection. Sometimes, even the cause is unknown. Therefore, bursitis knee is a
result of the inflammation from the repeated pressure on the knee, such as kneeling for a
long time, over use or injury.

KNEECAP DISLOCATION – Kneecap dislocation occurs when the triangle-shaped
bone which covers the knee, which is known as the patella moves or slides out of place.
The dislocation often occurs towards the outside of the leg. Kneecap or the patella often
occurs after a sudden change in the direction in which the leg is planted. This puts the
kneecap under a lot of stress. This can occur when playing certain sports, for example,
basketball is one such sports. Also, kneecap dislocation may occur as a result of direct
trauma. It is also known that when the kneecap is dislocated, it can slip sideways to the
outside of the knee.

 FRACTURE OF THE KNEECAP OR ORTHER BONES – One common category of
knee pain which results from the sudden injury can be due to a fracture of the kneecap or other adjoining bones, which can result in chronic pain. Regardless, knee pain due to
fracture, torn ligaments, cartilage and/or muscles occur mostly in athletes. It is said that
the more active you are, the more likely you are to experience knee pain from a sport-
related injury.

ILIOTIBIAL BAND SYNDROME – The Iliotibial band (ITB) is a tendon, which is a
thick elastic tissue that connects muscles to the bone, runs along the outside of the leg. It
is known to connect from the top of the pelvic bone to just below the knee. Iliotibial band
syndrome occurs when the Iliotibial band becomes swollen and irritated from rubbing
against the bone which is located on the outside of the hip or knee. Furthermore, there is
a fluid-filled sac, termed as Bursa, located between the bone and the tendon on the
outside of the leg, providing lubrication between the tendon and the bone. The rubbing of
the tendon can cause pain and swelling of the bursa or the tendon or both. The Iliotibial
band pain often affects the runners and cyclists. Therefore, bending the knees over and
over during these activities can cause irritation and swelling of the tendon, which results
in the Iliotibial band injury or Iliotibial band syndrome.

 ANTERIOR KNEE PAIN – The kneecap or patella, which is located at the front of the
knee, is known to provide leverage and power to the leg muscles. When the knee is
overstressed, an individual may feel a dull, aching pain in the front of the knee. This is
termed as anterior knee pain or Patella-femoral joint syndrome. Anterior knee discomfort
tends to occur in overweight individuals, athletes, children, young adults and senior
citizens who over-stress their knees. Anterior knee pain or Patella-femoral joint syndrome
is described as a chronic pain occurring in the front and center of the knee. While this
condition can affect boys as well, it is more prominent in young girls.

 FRONTAL KNEE PAIN – Frontal Knee Pain is chronic knee pain which is experienced
beneath the knee cap. Frontal knee pain originates due to deterioration of the cartilage,
which happens because of the inferior position in the kneecap while it glides across the
lower end in the quad cuboid bone, which is generally known as the femur. This problem
is well known to develop in individuals who participate in a number of sporting activities,
both professionally or as a recreation. In such cases, the frontal knee pain is mainly a
result of muscle imbalance.

CHONDROMALACIA PATELLA – Chondromalacia patella is a painful knee condition
mainly seen in adolescents and young teenagers, usually between the ages of 13 and 15
years. This condition is also generally known as Runner’s Knee, and is caused by an
irritation beneath the kneecap or patella. It is a chronic knee pain which includes swelling
on top of the kneecap and characterized by softening of the articular cartilage of the
kneecap. Chondromalacia occurs due to overuse of the muscles, injury to the muscles,
tendons or joints, muscle weakness or misalignment of the patella.

 ANTERIOR CRUCIATE LIGAMENT (ACL) INJURY – The ACL is one of the major
ligaments of the knee, which extends from the front of the tibia and inserts on the back of
the femur. This structure prevents excessive posterior movement of the femur on the
tibia. The ACL is often torn when an athlete changes the direction rapidly, slows down
from running, or lands wrong from a jump. The pain associated with a torn ACL is
usually moderate to severe, increasingly as the knee begins to swell. The pain mostly
increases with the bending or straightening of the knee.

 POSTERIOR CRUCIATE LIGAMENT (PCL) INJURY – One of the other major
ligament is called the Posterior Cruciate Ligament. PCL injuries are much less common
when compared to ACL injuries. The PCL is often injured when an athlete receives a
blow to the front of the lower leg, just below the knee or makes a simple misstep on the
playing field. The PCL prevents the tibia from sliding backwards and works with the
ACL to prevent pivoting of the knee. The PCL tear causes knee pain, decreased motion
and swelling.
 MEDIAL COLLATERAL LIGAMENT (MCL) INJURY – Another one of the ligament
is the Medial Collateral Ligament. Most injuries to the MCL are a result of a direct blow
to the outside of the knee. Athletes who play soccer or football are at an increased risk for
this type of injury. The MCL spans the distance from the top of the tibia to the end of the
femur on the inside of the knee. This structure prevents widening of the inside of the
joint. A torn MCL causes swelling over the ligament, bruising and a feeling that the knee
will give out or buckle.
 LATERAL COLLATERAL LIGAMENT (LCL) INJURY – The last one of the four
major ligaments is the Lateral Collateral Ligament. The LCL connects the end of the
femur to the top of the fibula (the smaller shin bone). It is located on the outer aspect of
the knee. The LCL helps to prevent unnecessary side-to-side movement of the knee joint.
The LCL is usually torn from the traumatic falls, motor vehicle accidents or during
sporting activities. The pain on the knee depends on the severity of the torn LCL. It
causes pain, swelling, difficulty in bending the knee and instability of the joint.

 TORN MENISCUS – The meniscus is the rubbery, tough cartilage that sits between the
femur and the tibia. This structure is known to work as an absorber. Athletes are at a high
risk for tears in this cartilage with cutting, pivoting, twisting, decelerating or being
tackled. There are two menisci of the knee and they lie between the femur and tibia, one
on the inside and one on the outside of the joint. A meniscus tear causes severe and
chronic knee pain, swelling, popping sound with the knee and the limited motion of the
joints.

 STRAINS AND SPRAINS – Sprains and/or strains occur when minor injuries to the
ligaments are caused by a sudden or unnatural twisting. Usually a sprain is an injury to
the ligaments around the joint. Since ligaments are strong, flexible fibers that hold bones
together, so when a ligament is stretched too far or it tears, the joint will become painful
and swell. Thus, sprains are caused when a joint is forced to move into an unnatural
position, such as twisting an ankle causes a sprain to the ligaments around the ankle.
Regardless, a strain is when a muscle is stretched too much and tears. It is also called as a
pulled muscle. A strain is a painful injury which is caused by either too much physical
activity or effort, poor flexibility, overusing a muscle or improperly warming up before a
physical activity.

CONCLUSION

As we all know, knee is the most essential and vulnerable part of our human body which is in use
for all our day-to-day activities, such as walking, running etc. However, as we age, our muscles
begin to deteriorate and the joint muscles in our knees are no exception. Thus, knee pains can
happen to everyone at some point in their lives. The patients that are mostly affected by knee
pain are athletes, but there are some common individuals also who are severely affected by this
condition. One of the most important and common factor that causes knee pain is the sudden and
jerky movements. Athletes are likely to have sudden movements that may contribute to
development of the pain in the knee area. Since the knee is a joint, it is very vulnerable to pain
because sudden movements may result into a severe impact that may result in severe pain.
Pain is a common knee problem that can originate in any of the bony structures compromising
the knee joint (femur, tibia, and fibula), the knee cap (patella), or the ligaments, tendons and
cartilage (meniscus) of the knee. Knee pain can be aggravated by physical activity, as well as
obesity, affected by the surrounding muscles and their movements, and be triggered by other
problems (such as foot injury). Knee pain can also be attributed to various diseases and
infections. Thus, runner’s knee is the most common term used to describe any one of several
conditions that cause pain around the kneecap, also known as the patella. These conditions
include anterior knee pain syndrome, patella-femoral misalignment,  chondromalacia patella ,
and iliotibial band syndrome. It is widespread cause of knee pain among youths. The pain is
generally spread behind the kneecap. Furthermore, a recent study reveals that women should be
extra careful about knee problems, because more number of women suffer from knee pain when
compared to men. Thus, it is very important to be cautious and extra care must be taken for the
knees as it is an important part of our human body.


TREATMENT FOR KNEE PAINS, HOME REMEDIES & PREVENTION OF KNEE PAIN AT NIGHT PART2

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