Knee pain, whether from acute injury, repetitive overuse or chronic condition, is one of the most regularly reported symptoms of patients in physiotherapy clinics. Knee injuries are common occurrences in sporting activities that involve rapid changes of direction, twisting, jumping and landing. Knee pain from repetitive loading is also common in amateur athletes and fitness enthusiasts eg. Cyclists and runners. Persistent knee pain can quickly begin to affect one’s athletic pursuits but can also have a great effect on work-related duties and homelife. Our team of Brisbane physios is here to help you with your knee pain.
Do you have Knee Pain?
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In many cases, pain in the knee is related to mechanics of movement of the lower limb and understanding the anatomy of the knee can help to identify the nature of movement-related discomfort. The knee joint involves interaction of the femur bone; in the thigh, the tibia and fibula; in the lower leg and finally the kneecap bone or patella. The patella is shaped like a large sesame seed and lays embedded within the tendon attaching to the quadriceps muscles. As the knee is bent and straightened, the kneecap slides within a groove shaped at the front of both the femur and tibia. In some cases, caused by poor movement mechanics or muscle weakness in the hip and thigh, during movement the patella is persuaded to slide out of its natural groove, often leading to knee pain and can be referred to as Patellofemoral Pain Syndrome.
The knee is designed to withstand great amounts of force during running, jumping and changing directions, evident in the number of large ligaments crossing through and around the joint as well as a robust meniscus. The Anterior Cruciate Ligament (ACL), the Medial Collateral Ligament (MCL) and Medial Meniscus are often referred to as the ‘Terrible Triade’ due to the higher likelihood of injuring all three in sporting activity involving high speed and change of direction. Ways to improve injury prevention involve development of lower limb mechanics and muscle strength for dynamic support of the knee. However, in instance of injury, conservative management through physiotherapy has shown to be successful without surgery in many cases. Finally, on the outer aspect of the thigh and knee lies the Iliotibial Band (ITB), a ribbon-like connective tissue used to provide tension-type support for the lateral lower limb. The outside of the knee is a common site for ITB friction-related pain, frequently seen in runners and cyclists and often called ITB Syndrome, frequently caused by poor loading mechanics in the hip or muscle weakness.
While ligaments provide static support, the musculature around the knee helps to provide dynamic support, emphasizing the importance of regular load-bearing exercise. Having adequate strength and control of the quadriceps and hamstrings is integral for proper knee function. The quadriceps (four muscles): Vastus Lateralis, Vastus Intermedius, Rectus Femoris and Vastus Medialis come across the front of the knee to the patella and to the front of the shin (tibia). In the rear lie the hamstrings, originating at the back of the hip and pelvis stretching down across the back of the knee joint. The hamstrings are comprised of two large muscles: Biceps Femoris and the combination of Semimembranosus and Semitendinosus that lay closely to each other.
Patellofemoral pain is also common in those with hypermobility due to more flexible ligaments. Working on local muscle control around the patella will be even more important if you are hypermobile.
Some common acute or traumatic knee injuries may include:
- ACL tear/rupture
- MCL tear/rupture
- LCL tear/rupture
- PCL tear/rupture
- Meniscus tear
- Patellar Dislocation
- Patellar fracture
- Patellar ligament tear
- Tibial Plateau fracture
- Fibular head fracture
- Quadriceps tendon tear
- Semimembranosus/Semitendinosus tendon tear
- Biceps Femoris tendon tear
- Proximal Gastrocnemius tendon tear
- Popliteus tear
- Retinaculum tear
Some common atraumatic (non-traumatic) causes of knee pain may include:
- Knee Osteoarthritis
- (ITBFS) Iliotibial Band Friction Syndrome
- (PFPS) Patellofemoral Pain Syndrome
- Patellar Tendinopathy
- Biceps Femoris tendinopathy
- Joint instability
- Degenerative Meniscus Lesion
- Osgood-Schlatter’s Lesion
- Pre-Patellar Bursitis
- Inferior Patellar Bursitis
- Patellar stress fracture
- Tibial Stress Fracture
- Chondromalacia Patellae
- Fat Pad Impingement
- Pes Anserinus Tendinopathy/Bursitis
- Baker’s Cyst
- Neural Mechanosensitivity
- Popliteus Tendinopathy
- Gastrocnemius Tendinopathy
What can I do about my knee pain? Tips and general Information:
- If your knee pain has recently increased, you can try using ice 10 minutes on, 10 minutes off, doing this 3-4 times per day as needed.
- Elevate the knee while using ice or without, if your knee is swollen.
- You may also apply some compression or support for the joint using some tubigrip or a bandage.
- Rest your knee from overloading the painful structures by avoiding aggravating activities (these may include running, cycling, stair climbing, jumping and deep squatting under heavy load).
- You can try gentle self-massage of any surrounding tender muscles, 5-10 minutes at a time as often as needed.
- Beginning a daily routine of gentle muscle strengthening exercises will aid in improving your knee health, decreasing pain and reducing the risk of reinjury.
- Occasionally a knee brace may provide the required support needed, if you’re unsure of the correct option, see your local physio for advice and recommendations.
How can a Brisbane physio help my knee pain?
PhysioTec is your choice for physiotherapy for knee pain in Brisbane. There are many potential options for management depending on your condition and your personal needs and goals. Physiotherapy for knee pain at PhysioTec may include:
- A thorough patient interview and physical assessment
- An evaluation of possible underlying causes, particularly important for long standing or recurrent conditions (Please book a 1 hour session)
- Education and personalised advice about how to best manage your knee condition and speed your recovery
- A tailored and progressive exercise program, including video-based exercises on a free App and/or colour photographs and typed text instructions
- Real time ultrasound training of the VMO or popliteus muscles of the knee
- A gym program and a progressive return to sport plan as required
- Taping or bracing as required
- Hands-on-treatment as required/preferred
FAQ
1. What is Runner’s Knee?
Runner’s Knee is a broad term used to describe anterior knee pain typically under the knee cap and is not only experienced by runners. Patellofemoral Pain Syndrome is a term that may also be used to describe a similar presentation of symptoms. Characteristically, pain is felt under the knee cap when loading the knee joint during walking, running or climbing stairs. Treatment usually involves de-loading from aggravating activities and addressing strength-related and mechanical deficits of the lower limb.
2. Why does my knee hurt when squatting?
There are multiple reasons a knee may hurt during a squat. Some common features leading to painful knees on squatting are poor mechanics of movement, decreased ankle mobility, and decreased hip mobility or strength. These can lead to poor loading angles and forces at the knee eventualising in patellar tendinopathy or patellofemoral pain syndrome.
3. Why does my knee make a clicking sound?
A few possibilities can lead to a clicking sound coming from the knee joint. Tendons and fibrous folds in the knee capsule (plica) can roll over bony structures making a snapping sound and connective tissue in joint articulations can also make clicking sounds when bending and straightening the knee. These sounds are commonplace in many joints of the body, however if the clicking is paired with pain, you may benefit from consultation with your physiotherapist.
Clinic Location
Our Brisbane Physiotherapy Clinic, services areas including: Brisbane, Tarragindi, Mount Gravatt, Holland Park, Rocklea, Yeronga, Annerley, Camp Hill, Carindale, Coorparoo, Salisbury, Sunnybank, Greenslopes, Seven Hills, Acacia Ridge, Indooroopilly, Woolloongabba, etc.
Because of our expertise in hip conditions, dance injuries and performance, and hypermobility, we also have people visiting us from all over Queensland, Australia and even international visitors. We also have a telehealth service for remote patients.
23 Weller Rd, Tarragindi QLD 4121, Australia
📞 Ph (07) 3342 4284 Fax (07) 3342 4204
reception@physiotec.com.au
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