The human knee is at once both sublimely simple and highly complex. It is a hinge joint that connects the tibia, or shin, to the femur, or thigh bone. The kneecap, or patella, lies at the front of the joint. There are four ligaments and two shock absorbers (menisci).
Knee pain can be caused by injury, strain, or repetitive stress, although it occasionally occurs with no discernible reason. Knee pain can lead to functional limitations such as trouble standing up, walking, or climbing stairs.
Types of Knee Pain
Regardless of the cause of your knee pain, or exactly which structures are involved, all knee pain falls into three basic types. Understanding which type you have can help to ensure proper diagnosis and treatment.
Acute knee pain is typically the most painful. It occurs during the first week after an injury or trauma. It is important to rest the knee during this time to give it an opportunity to heal.
Sub-acute knee pain can last for up to six weeks following an injury or trauma. After the first seven days, it is time to start gently using the knee again to help regain mobility.
Chronic knee pain lasts for more than six weeks. It can occur following an injury or trauma, or can appear with no discernible cause. Either way, it must be evaluated by a healthcare provider to determine the best course of treatment.
Diagnosing the Involved Structures
Where your knee pain occurs can help to determine which parts of the knee are causing the pain, and can help to ensure that you receive just the right treatment.
If your pain is located at the front of your knee, it is generally a problem with your kneecap or the tendon that connects it to your shin. Patellofemoral stress syndrome (PFSS) is a common diagnosis. You will likely experience trouble climbing stairs, running, jumping, and kneeling.
If your pain occurs on the inside of your knee, the medial collateral ligament or medial meniscus may be involved. These injuries typically happen when the body weight twists over the knee while the foot is firmly planted. Arthritis or simple wear and tear can also cause issues in this area.
Pain on the outside of knee could be caused by many different factors, such as a ligament injury or tendon strain. Another possibility is stress on the iliotibial band (ITB). This is a thick piece of tissue that runs from the outside of the hip to the front of the knee. Sometimes this gets inflamed or out of place, rubbing across the knee. If your pain feels like a burning sensation, the ITB may be to blame.
Pain at the back of the knee is most often due to a problem with the hamstring. A rarer cause is something known as a Baker’s cyst, in which the knee joint swells into the space at the back of the knee. This typically causes pain when bending the knee past a certain point.
Treating Acute Knee Pain
If you have acute knee pain, you do not necessarily need medical treatment or physical therapy right away (assuming that nothing is obviously broken, and the pain is not severe). Instead, apply the R.I.C.E. principle: Rest, Ice, Compression, and Elevation. Stay off of the knee altogether for a few days if at all possible. After several days, begin gently using your leg, but postpone extended walking or heavy workouts for a couple of weeks.
If your pain persists for more than a week despite R.I.C.E. and activity restrictions, see a doctor or physical therapist as soon as possible. Always seek emergency assistance right away for any possibly broken bones or severe pain.
What to Expect from Physical Therapy
Your first visit will focus on diagnosis and treatment planning. We will collect details about your knee pain, what factors aggravate or alleviate the pain, and any past medical history that could be related. We will then perform a detailed clinical evaluation. Depending on what we learn from the discussion, your evaluation might include such sections as:
- Gait assessment: A gait assessment is a detailed look at how you walk. Small changes in your knee movements during walking could signal what the problem is.
- Range of motion: Your range of motion is how you can bend or straighten the knee. Your physical therapist may take range of motion measurements rather than relying solely on observation.
- Manual examination: Your physical therapist may use his or her hands to feel different parts of your knee in search of abnormalities or pain triggers.
- Strength testing: Strength testing can help to determine if the muscles in your knee are playing a role in your pain.
- Swelling measurements: If your knee is swollen, your physical therapist will likely measure the extent of the swelling.
- Diagnostic Imaging – with these advanced imaging techniques we here at MPT are able to see what’s happening inside the knee soft tissue and capsule.
Other tests might also be performed, depending on what information is still needed. At this point, your physical therapist will be ready to complete your diagnosis and begin to implement a treatment plan.
Each person’s treatment plan is unique, so it is difficult to predict what yours might involve. In general, though, you should expect to work hard. Your therapy will primarily consist of exercises to strengthen your knee and improve its mobility, and you will likely be expected to exercise at home between sessions. An open, active, and engaged attitude is the best way to ensure that you receive maximum benefits from your physical therapy.
Founded by physical therapy innovator Dr. Joseph Simon, the Manhattan Physical Therapy and Pain Center is a leader in pain relief and injury recovery conveniently located in Midtown New York City. We offer several dedicated programs for different conditions, along with the latest innovations in physical therapy for all. If you are ready for the latest treatments for your pain or injury, we invite you to call us today at (212) 213-3480 to learn how we can help.