Knee pain? What are the different types of knee pain? When should I consult an osteopath for my knee?
Gonalgia or knee pain
Gonalgia refers to pain in one or both knees. The knee joint is made up of 3 bones: the femur, the tibia and the patella. Knee cartilage covers the end of each bone. The knee is stabilized by numerous ligaments, including the anterior and posterior cruciate ligaments, as well as the medial and lateral collateral ligaments. Numerous muscles are also responsible for its stability and mobility: the quadriceps and its patellar tendon, and the hamstrings, for the most important. The knee also has 2 “shock absorbers”: the internal and external menisci, 2 collagen discs between the tibia and femur. Each of these joint components can thus be a source of pain.
Initially, the osteopath will analyze the situation and carry out clinical tests, with a view to referring you to a specialist or your GP for further examination in the case of so-called organic pathologies such as a sprained or dislocated knee, for example.
Ligament injuries
A ligament injury is a distension of one of the knee’s ligaments (or sprain), or a total rupture of the ligament (or severe sprain). The anterior or posterior cruciate ligaments and collateral ligaments are the main ligaments affected in a knee sprain.
Symptoms: Acute pain depending on grade of injury, with joint instability. Potential cracking during the incident. Possible swelling of the knee.
Cause: Abrupt pivot shift when the feet are fixed to the ground, direct trauma to the knee, incorrect landing of a jump in hyperflexion or hyperextension… Very common in sports such as skiing or soccer.
Meniscus lesions
A meniscus injury is damage to the medial or lateral meniscus, or both. It can be traumatic (meniscus tear, partial meniscus dislocation) or degenerative (in the context of osteoarthritis with excess stress on the meniscus, degeneration of meniscus tissue).
Symptoms: Pain in the femoral-tibial space, often episodic and triggered by certain movements, especially pivoting with the knee bent. Swelling. Sensation of joint locking and popping. Reduced knee mobility.
Cause: Pivot shift or raising from a sitting position in traumatic meniscal injury, associated osteoarthritis or age-related degeneration in degenerative meniscal injury.
The “terrible triad” or “unhappy triad
It’s a combination of a tear in the anterior cruciate ligament, the medial meniscus and the medial collateral ligament. Relatively frequent in skiing, always in the famous pivot-shift movement.
Dislocations
Knee dislocation is the dislocation of the tibia from the femur, following a tear in at least 2 of the 4 main ligaments. It can also be a dislocation of the patella, which dislocates towards the outside of the knee, also resulting in ligament damage. In most cases, the dislocated knee will return to its normal, original position.
Symptoms: Acute pain with deformation of the knee joint and instability.
Cause: Severe trauma, such as in a car accident or in severe sports injuries. Congenital malformation in most patella dislocations.
Patellofemoral or patellofemoral syndrome
Patellar syndrome is anterior knee pain at the level of the kneecap, resulting from incorrect tracking of the patella when the knee is flexed, leading to excessive compression of the patellar facets.
Symptoms: Anterior knee pain, especially during bent-knee movements such as descending stairs, playing sports or sitting for long periods.
Cause: Mainly accident or overuse. But it can also be caused by anatomical anomalies, muscular dysfunction or poor biomechanics of the lower limbs.
Tendinopathies
Knee tendinopathies can affect various muscular tendons involved in knee mobility: patellar tendinitis (tendinitis of the patellar tendon, the end extremity of the quadriceps), crow’s-foot tendinitis (involving 3 muscles: the gracilis, the semitendinosus and the sartorius, meeting on the posteromedial side of the knee), fascia-lata tendinitis or more commonly known as “ice-wiper syndrome”.
Tendinopathy can be an inflammation of the tendon or its sheath, or a progressive deterioration of the tendon.
Symptoms: Pain in the knee that is amplified by movement, stiffness, a feeling of weakness in the tendons, possible swelling of the knee with a sensation of heat.
Cause: Excessive strain on the tendon following a sudden change in volume and/or intensity of sporting activity, or repeated daily movements.
Osteoarthritis
Osteoarthritis of the knee is a progressive degeneration of cartilage, usually occurring after the age of 50. However, it can sometimes occur earlier. Osteoarthritis can often be asymptomatic.
Symptoms: Pain with limited knee mobility, swelling.
Causes: mainly age. There may also be risk factors such as heredity or repeated microtrauma during physical or professional activity.
Good advice to avoid knee pain
- A good warm-up before sport
- Gradual, controlled physical activity: Exercise is extremely beneficial. But be careful, modulate your physical activity. Going from 2 hours a week to 10 suddenly is the best way to injure yourself. Likewise, more intensive sessions such as split training should be introduced gradually.
- Specific muscle strengthening of the various muscle groups in the lower limbs to optimize joint stability: especially before resuming episodic sporting activities such as winter sports, which are particularly hard on the knee.
- Weight control
- Stress reduction
