The most common cause of knee pain
Anyone who’s sporty or active is likely to encounter knee pain at some point in their life. While traumatic injuries get the headlines, most knee pain develops gradually.
Patellofemoral Pain Syndrome – also known as Runner’s Knee – and meniscus injuries are the most common causes of knee pain, and the easiest to get through normal activities and sports.
Here’s what you need to know about the most common causes of knee pain, how to spot them and how they’re treated.
What is Patellofemoral Pain Syndrome?
Patellofemoral Pain Syndrome (PFPS) presents itself as pain behind or around the knee cap, aggravated by running, jogging, climbing stairs, squatting or kneeling.
While PFPS can be caused by a traumatic injury, in the vast majority of cases it develops gradually through overload of the knee joint.
Activities that involve repetitive, high impact movements on the knee in flexion and extension (back and forth) – such as squatting, running and cycling – increase the risk of PFPS developing.
The onset of pain can be caused by such activities, or even simple day-to-day activities like crouching down to clean a spill. As pain can present itself suddenly, PFPS may seem like a traumatic injury when the cause is in fact gradual.
How is Patellofemoral Pain Syndrome treated?
Reducing stress in the knee joint is the primary goal of treatment for PFPS. By strengthening the right muscles in the hip and around the knee, there is less load on the knee joint, which will then return the knee cap to its proper, pain-free position.
A misalignment of your knee cap can often be helped by loosening tight structures that attach to it. Massage therapy, foam rolling, and taping can make a big difference.
Symptoms are typically relieved between 6-8 weeks, with full rehabilitation dependent on the individual.
What is the meniscus, and how does it become injured?
The meniscus is a type of cartilage that cushions the knee joint. Each knee has two: the medial meniscus on the inside of the joint and the lateral meniscus on the outside.
When it becomes injured, you feel pain on the left or right side of your knee depending on which meniscus is injured. You also might have a sensation of your knee “locking up” when you’ve sat for extended periods.
Knee instability also often occurs with people who have a meniscus injury, which is one of the key differentiators from PFPS during diagnosis.
While PFPS usually develops gradually, meniscus injuries are fairly evenly split between traumatic injuries and degenerative.
Traumatic meniscus injuries are typically caused by flexion combined with twisting, usually from a fall or from an awkward twist of the leg during sports such as football, rugby or tennis.
Degenerative meniscus injuries, on the other hand, occur from the natural loss of mass in cartilage as we age, making it most common in people 40 or more years old. This can also lead to osteoarthritis in the knee joint, as the loss of cartilage leads to bones rubbing against each other.
How are meniscus injuries treated?
Treatment for meniscus injuries is largely identical to PFPS, as the objective is the same: reduce load on the knee through strengthening of surrounding muscles.
The mechanism for recovery is slightly different, as cartilage possesses natural healing mechanisms, so we are reducing stress on the cartilage to give it the opportunity to recover.
Like PFPS, symptoms should be relieved in around 6-8 weeks. If they don’t then occasionally an injection or keyhole surgery can be indicated.
Suffering knee pain?
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MSc BSc MCSP HCPC
Musculoskeletal and Sports Physiotherapist