Knee Pain

The knee joint is a hinge joint with strong ligaments between the thigh and shin bones. Smooth cartilage covers the end of bones to reduce friction. There are also two extra pieces of thick cartilage called menisci which act as shock absorbers.

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The knee ligaments and capsule (the bag that surrounds the joint), prevent the bones moving in the wrong direction or dislocating. The thigh muscles (quadriceps) also help to hold the knee joint in place and produce movement.

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Problems with knee joints are common. See below for information on conditions / self help. 

 

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Common causes of knee pain

Osteoarthritis

Osteoarthritis (OA) is a common knee condition. The cartilage which protects the surface of your joints get worn/ damaged which causes friction and prevents the joint from moving smoothly. The joint can become swollen and inflammed, the joint can change shape and the muscles can feel weaker. Click here to visit Harrogate's webpage for Osteoarthritis of the knee for more information. Alternatively, check out the Escape Pain information for Osteoarthritis here



Patellofemoral pain (Anterior knee pain)

The Patellofemoral joint (PFJ) is the joint between the knee cap and the thigh bone. Problems with the PFJ can lead to pain anywhere around the knee.

Symptoms can include swelling, pain, and crunching/cracking sounds.

The following can cause Patellofemoral pain:

  1. Too much loading too quickly eg. Hill walking on holidays, or taking up new sports. Repetitve bending and kneeling can make it worse.
  2. Anything that can affect the knee cap sliding correctly e.g flat feet, knocked knees etc
  3. Injury e.g falls

Things you can do to improve your patellofemoral pain:

  1. Exercise helps to keep the muscles strong so they will support the joint and help improve your symptoms. Click the link below
  2. Stretching the muscles will also help. Keep thigh, calf and hamstrings muscles as flexible as possible (see below)
  3. Avoid sustained activity/positions e.g sitting for long periods/ doing repetative exercises as these can provoke the pain.
Stretching the Hamstrings. Hold the stretch for 10-12 seconds and then release. You should feel a pull to the back of your leg when you stretch. Stop if the stretch is painful. Stretching the Quadriceps. Hold the stretch for 10-12 seconds and then release. You should feel a pull to the front of your leg when you stretch. Stop if the stretch is painful. Stretching the calf muscles. Hold the stretch for 10-12 seconds and then release. You should feel a pull to the back of your lower leg when you stretch. Stop if the stretch is painful.



Ligament / Cartilage Injuries

Your knee ligaments give the bones of the knee stability by helping to keep them together. There are two main sets if ligaments in your knee. The collaterals, which run down the sides of your knee and the cruciate ligaments, that are inside the knee.

Collateral ligaments:

The medial collateral ligament is on the inside of your knee. It can be damaged if your knee is twisted or pushed outwards too far.

The lateral collateral ligament can be damaged if your knee is forced inwards too much.

Cruciate ligaments:

Your anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) help to keep your knee stable by preventing excessive forwards and backwards movements.

ACL and PCL tears are usually as a result of a jumping or twisitng injury or falling on a bent knee e.g a fall in skiing

Symptoms of knee ligament injuries include:

  • Swelling aroud the knee

  • Pain

  • Instability (feeling of knee giving way)

How to manage Collateral ligament injuries:

  • Protection: During the first few days after an injury, you should rest the injured joint. After 72 hours, gentle movement can be started. If walking is difficult or painful, a stick or crutch may help.

  • Although it might be painful, it is important to maintain movement in your knee to avoid stiffness. Complete non-weightbearing rest is rarely useful.

  • Ice: Applying ice with gentle compression using a bandage may help with pain relief and reducing swelling around your knee. Click here to download an information sheet

  • Elevation: Placing the knee higher than your hip whilst lying or sitting will help the swelling reduce.

  • Use of over the counter pain relief if necessary to enable to keep mobile. (Speak to your local Pharmacist if you are unsure about what you can take)

  • Exercise can help. Click here to download an exercise sheet.

If your knee does start to improve within 2-3 weeks or you are concerned then seek further advice from a health professional. In some cases, following an indepth examination, further investigation maybe necessary to decide on the best treatment plan.



Dislocation / Instability

We're still working on this section. Please bear with us.



Osgood-Schlatter's disease (Children)

Osgood-Schlatter disease is a common cause of pain in front of the knee. It is more common in boys and occurs around early adolsence or around a growth spurt. One or both knees may be affected. The condition often occurs in children who are highly active, particularly in sports involving running and jumping. In Osgood-Schlatter disease, repeated running and jumping leads to a repetitive strain on the thigh muscle attaches which to the shin bone just below the knee cap. This causes a painful lump. Pain is usually worse during or just after activity and tends to improve with rest. With a bit of rest and stretching, things should start to settle down. Try the stretching exercises in the leaflet below.



Meniscal Injuries

There are two menisci in each knee. They are shock absorbing cartliages and sit between your shin and thigh bone. One on the inside and one on the outside of your knee. Injury to your menicus can occur when you twist your knee when you have weight on it.

If you have injured your meniscus, you may experience the following:

  • Pain around the knee

  • Swelling

  • Clicking

  • Lack of knee movement

  • Locking (the joint becomes stuck in one position)

  • Giving way

In most cases, meniscal tears can be managed without surgery.

Things you can do to help yourself:

  • Protection: During the first few days after an injury, you should rest the injured joint. After 72 hours, gentle movement can be started. If walking is difficult or painful, a stick or crutch may help.

  • Although it might be painful, it is important to maintain movement in your knee to avoid stiffness. Complete non-weightbearing rest is rarely useful.

  • Ice: Applying ice with gentle compression using a bandage may help with pain relief and reducing swelling around your knee. Click here to download an information sheet

  • Elevation: Placing the knee higher than your hip whilst lying or sitting will help the swelling reduce.

  • Use of over the counter pain relief if necessary to enable to keep mobile. (Speak to your local Pharmacist if you are unsure about what you can take)

  • Exercise can help. Click the link below to download an exercise sheet.

If your knee does not settle within 4-5 weeks or you are concerned then seek further advice from a health professional. In some cases, following an indepth examination, further investigation maybe necessary to decide on the best treatment plan.



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Harrogate & District NHS Foundation Trust, Lancaster Park Road, Harrogate, HG1 7 SX

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