The Ultimate Guide to Knee Pain
Ultra Sports Clinic practitioners and knee specialists work closely with those that suffer from recent or longstanding knee injuries and understand the complexity of the knee joint.
The knee is a hinge joint and comprises of three main bones, the femur, tibia and patella. These are held tightly together with several ligaments. The surrounding musculature, tendons, and vascular and nervous structures also play their part to create and redistribute the load and keep the tissue healthy. Some injuries are minor and will heal well independently, but many require assistance and attention from physiotherapists.
Don’t hesitate from speaking to a physiotherapist, osteopath or chiropractor to help treat your knee pain, especially before doing any strenuous physical activities.
Types of knee pain
Knee pain can be physically restricting, making walking and weight-bearing difficult. Other symptoms that indicate an injury include stiffness, swelling, weakness, feeling unstable, or popping or crunching noises. Straightening and bending the knee may become impossible, and limping or a locked knee can greatly affect your quality of life if not treated. by a specialist or chiropractor for knee pain.
While there are various ranges and sources of these symptoms, there are two main categories of knee pain: acute knee pain and chronic knee pain.
Acute knee pain
Acute knee pain often arises from an immediate injury or infection. Acute relates to the recent introduction of pain, not the sharpness or severity of it and usually has a noticeable mechanism ie. falling, twisting etc. Acute sporting injuries usually require a large enough force to tear, break or damage tissue.
These may include:
Tears in the meniscus, the fibrocartilage found between the femur and tibia bones
Dislocated knee or knee cap (patella)
Ligament tears, including ACL (Anterior Cruciate Ligament), MCL (Medical Collateral Ligament), PCL (Posterior Cruciate Ligament) LCL (Lateral Collateral Ligament)
Chronic knee pain
Chronic knee pain can similarly be experienced after injuries or infection, but another common cause of knee pain is general wear-and-tear or inflammation from arthritis. This pain is associated with a slow degradation of the cartilage in the knee, taking away any cushion between the bones. Chronic knee pain may emerge from posture, obesity, or repetitive strain in sports such as running or cycling.
Some common examples of injuries with chronic knee pain are:
Patellofemoral Pain Syndrome - Sometimes called “runners knee” as it is often caused by overuse through sports.
Iliotibial Band Syndrome
Tendinopathy - inflamed tendons
Fat pad impingement
Common knee injuries
Knee pain from cycling
Cycling can cause repetitive strain in the knee. When cycling, the body will generate power to move the leg, and this force needs to go up/down your torso, leg, foot and into the bike to cause the pedal to move. This force needs to be uptaken/generated by certain parts of the body to allow a pain-free and efficient revolution. Poor technique, flawed bike set-up, injury, weakness or tightness can cause this force to build up in certain areas, causing stain and/or injury.
A flawed bike set-up will load the knee incorrectly and cause injury and pain, no matter if you cycle leisurely or as an elite cyclist.
Some of the typical knee injuries caused by cycling can include:
Rectus femoris (quadriceps) tightness. Rectur femoris is one of the four muscles that form your quadriceps and a hip flexor, so it generates a lot of power when cycling. Tightness in this muscle can restrict a smooth gliding of the knee cap, making it painful as you drive the pedal around. This cycling knee injury can be caused by sitting in the saddle with a closed hip. To treat it, you can use a foam roller and stretch at home. However, it may be necessary to see a knee specialist at a physio clinic in order to ensure proper recovery for good performance in the future.
ITB tightness - The iliotibial band stretches from the side of the hip area to just below the outside of the knee. A burning pain in the knees felt on the outside, IBT tightness can easily occur from the tightening of this band. ITB injuries can arise from an incorrect bike fit or weakness in certain gluteal muscles. The best way to combat this knee pain is to make sure your bike set is up correctly. The body changes shape and strength abilities over time, so it's important to check your bike regularly. Exercising and strength-building your gluteal muscles will also help. Doing exercises such as single-leg glute bridges can build up your muscles and make them less susceptible to injury.
Pain from an unaligned foot position - If your foot is not positioned correctly while pedalling a bike, your shin can be forcibly rotated causing pain and dysfunction in the knee. If you feel knee pain, check your shoes. Sometimes wearing inappropriate attire can impact your knees, and investing in a pair of cycling shoes or shoes with stiff soles and orthotic inserts can make all the difference.
If you have any other concerns, read our article, does knee pain affect your cycling, and make sure sure to talk to a physiotherapist to get professional help and advice.
Pain in the knee from skiing
Most skiing injuries occur when individuals fall over. The greater the force of the fall, the greater the chance of a more severe. When skiers fall, their knee often twists, particularly if their boots don't unclip from the skis. The foot goes one way and the body goes the other way, causing a large rotational force at the knee. This can often lead to injuries.
Common knee injuries caused by skiing can include:
Bone fractures - These are particularly common due to the high-speed nature of the sport. Fractures around the knee include tibial plateau, femoral or patella. These can be painful and often people have difficulty bearing their weight with this injury.
Meniscal injuries - the meniscus is a piece of fibrocartilage between the femur and tibia, acting as a cushion to axial (up/down) and rotational forces. These can be small and not too limiting or painful, or quite large, and prevent people from bending or weight-bearing.
Ligament injuries - this is one of the most common skiing injuries. Ligaments in the knee all prevent excessive separation between the femur and tibia. So when the bones are pulled into slightly different directions, this places strain on the ligaments. Too much strain and they tear, causing pain, immediate swelling, and often difficult walking. The ACL prevents the tibia from translating forwards, while the MCL prevents the tibia and femur from separating under a valgus force (knocked knee position). The PCL prevents posterior shear of the tibia and the LCL prevents the femur and tibia separately on the outside.
You can reduce your chance of injury through a targeted strength and conditioning program starting at least 6 weeks before you ski, however, a bad fall is a bad fall, and there is still an element of risk with high impacts and sports.
Knee pain treatment
A common and well-known treatment for any knee pain follows the acronym R.I.C.E.
This stands for:
Rest- Most injuries require some element of either partial or full rest, and often this can elevate symptoms.
Ice - If your knee pain stems from any sort of inflammation of the joint, icing the affected area for up to 10 minutes at a time can reduce swelling and discomfort. Minimising severe swelling can also improve the speed you recover for longer injuries. This should relieve any pain or stiffness.
Compression - Using a compression garment will help facilitate normal circulation and drain any excessive fluid or inflammation that may build up while resting the injury.
Elevation - Elevation can likewise reduce excessive swelling and improve circulation.
Other treatments for knee pain may include over-the-counter medication or prescriptive medicine or a knee brace. For those suffering from more severe knee pain, a doctor may prescribe prescription medication, steroid injections, and surgery may need to be the answer.
When to see a physio for knee pain
It can be difficult to self-diagnose your knee pain. This is why musculoskeletal practitioners including physiotherapists, chiropractors and osteopaths, and doctors are here to help.
Seek medical advice about your knee pain if:
Your knee pain is severe enough to limit your ability to do your daily activities
You hear popping or crunching noises when you move your knee
You are unable to weight-bear
There is a visible deformity
There is sustained pain or discomfort
If you are experiencing any of these symptoms, it may be necessary to seek medical advice from your practitioner.
Can a chiropractor help with knee pain?
Chiropractors or sports chiropractors can be a great aid in treating and caring for the underlying issues of knee pain while using non-invasive methods, avoiding surgery or medication. Chiropractors can assess you and uncover any alignment issues that may be contributing to your knee pain. Treating issues such as tightness in the lower back or mobility in the hips can reduce overloading the knee and provide much needed relief in the knees.
How can a chiropractor help with knee pain?
Chiropractors will examine your medical, past and recent history and assess you physically before any diagnosis or treatment plan is made. All of the body will be examined, not just the knee.
Areas of the body, such as the pelvis, hips, lower back, ankles, and feet, have an immediate influence on the knee and could be causing it pain. Chiropractors will look to reduce joint inflammation and promote soft tissue healing through laser or ultrasound therapy. They may use manipulation or mobilisation, such as trigger point therapy, to normalise joint function. Exercise will also be utilised as a rehabilitation tactic and to prevent further injuries.
Can you go to the physio for knee pain?
Physio treatment can also combat knee pain through non-invasive means. Your physio will assess your injury, look at biomechanical or other factors that may be causing your injury/pain, create a treatment plan to improve those factors inlcuding referring you for relevant scans and rehabilitating you with targeted strengthening programs. Techniques can be hands on massage, mobilisations, dry needling, taping and more, and focus on improving tissue health while creating an environment to heal. There is also a strong focus on prevent re-occurrence and re-injury.
What is the best way to manage knee pain?
The best way to manage knee pain, especially if chronic or from trauma may be to see a physiotherapist, chiropractor or osteopath for treatment. Our practiioners at Ultra Sports Clinic will be able to create a personalised plan to assess, diagnose, treat, rehabilitate and assist you on the road to recovery.
What is the fastest way to relieve knee pain?
The fastest way to relieve knee pain is to find out what is causing the pain. Our practitioners at Ultra Sports Clinic can help you with this.
Sometimes, knee pain can be caused by increased muscle tension. Improving flexibility, reducing tightness and increasing targeted muscle strength to reduce the overload in the first place can be a helpful place to start.
Exercises for knee pain
Here are some exercises and stretches that you can do at home to prevent and relieve knee pain:
ITB roller - Roll the side of your thoigh with a form roller for two or three minutes. Make sure to roll from the hip to the knee along the ITB band, rather than the bone itself. Repeat this three to five times a day.
Glute stretch - Lie on your back with the knees bent. Place the left foot onto the right knee and grab your right thigh with both hands. Pull the thigh gently towards you and hold the position for about 20 seconds. Repeat on the other side. This can also be done when sitting, which makes it very easy to be done during the day when working.
Calf stretch - Stand facing a wall with your hands placed on the wall and one foot moved back as far as is comfortable. Make sure both feet face forward, that the heels are flat, and there is a slight bend in the front knee and back knee is straight. Lean into the stretch for 30 seconds and repeat on the other side.
Donkey kicks - Get on all fours with a neutral spine. Flex your right foot with a bent knee and push the foot towards the ceiling while squeezing the glutes, while avoiding arching your lower back. Do this exercise 15 times on each side.
Fire hydrants - Remain in the all-fours position. Move your right knee (keep it bent) to the side and squeeze your glutes. Avoid arching your lower back. Do this exercise 15 times on each side.
Glute pick-ups - Place a small weight on the floor in front of you. Balance on your left leg, bend through the knee and pick up the weight with your right hand. Stand up straight while squeezing the glutes. Then put the weight back down. Repeat 10 times on each leg.
Single leg calf raises - Stand on one leg with a wall or chair nearby for support. Lift the standing heel off the ground to stand on the balls of your feet. Slowly lower back down. Start by trailling three sets with repetitions between 8 - 12.
Low-impact exercise when injured is a great way to stay healthy, provided it does not exacerbate your injury. We recommend trialling gentle yoga, pilates, swimming, cycling or even an elliptical machine instead of running or sports.
If you are injured and are experiencing knee pain, don’t hesitate to get in touch and talk to a professional to find the best exercise plan to help you get back to doing the daily activities you love.
At Ultra Sports Clinic we offer both a sports chiropractor, osteopathy or sports physiotherapy in London that are ready to get your body back to its full potential.
Call us on 0203 893 5100 as we are happy to answer any questions. Book an appointment online today!