Knee joint
Our knee joints are made of four bones connecting – the femur (thigh bone), the tibia and fibula (the two bones of the calves) and the patella (the kneecap). The knee is divided into four compartments: medial and lateral tibiofemoral compartments, the patellofemoral compartment and the superior tibiofibular joint. Each of these compartments’ components can suffer from repetitive strain injury or disease.
What are the common injuries that cause knee pain?
Some of the injuries that causes pain in our knees include the following:
- Sprain (Ligament sprain)
- Medial collateral ligament
- Lateral collateral ligament
- Anterior cruciate ligament
- Posterior cruciate ligament
- Tear of meniscus
- Medial meniscus
- Lateral meniscus
- Strain (Muscle strain)
- Quadriceps muscles
- Hamstring muscles
- Popliteal muscle
- Patellar tendon
- Hamstring tendon
- Popliteal tendon
Some of the diseases of cause of knee pain include:
- Knee osteoarthritis
- Chondromalacia patella
- Baker's cyst
- Meniscal cyst
- Discoid meniscus
- Osgood-Schlatter disease
- Larsen-Johansson disease
- Knee rheumatoid arthritis
- Osteochondritis dissecans disease
- Synovial chondromatosis disease
- Tumors
- Ankylosing spondylitis
- Reiter's syndrome
- Tuberculosis arthritis
- Septic arthritis (Pyogenic arthritis)
- Osteomyelitis
- Hemophilic arthritis
- Gout (Gouty arthritis)
- Bursitis of the knee
- Prepatellar bursitis - Housemaid's knee (most common)
- Infrapatellar bursitis - Clergyman's knee (Superficial infrapatellar bursitis and Deep infrapatellar bursitis)
- Semimembranosus bursitis
- Tendinitis
- Patellar tendinitis (Jumper's knee)
- Hamstring tendinitis
- Popliteal tendinitis
- Synovitis of the knee
- Genu varum
- Genu valgum
- Genu recurvatum (Knee hyperextension)
- Knee flexion deformity
- Bipartite patella
- Patellofemoral pain syndrome (Runner's knee)
- Plica syndrome
- Iliotibial band syndrome
- Femoral fracture
- Tibial fracture
- Patella fracture
- Patella dislocation
- Knee joint dislocation (Tibiofemoral joint dislocation)
Referred pain is pain perceived at a location other than the site of the painful stimulus. An example is where if a patient has a heart attack but feels the pain in his neck, shoulders and back instead of his heart. Likewise, there can be pain that is referred to the knee that is related from another part of the body – the pain can come from one’s ankle, foot, hip joints or even lumbar spine (lower back).
Cold-induced Pain In Knees
A study in China concluded that knee pain is significantly more prevalent in people working in cold stores than in those in normal, non-cold temperature.
Another study concluded that 17% of adolescents with anterior knee pain (a common condition though mildly self-limiting) reported that their pain is associated with cold temperatures and cold weather. In the same study, the main activities that are associated with pain are sporting, stair climbing, walking and sitting. Some people also reported pain in their knees when it’s colder…and they also wear extra tights and warm pants in winter.
Cold-induce pain in the knee can also be caused by tenosynovitis of knee tendon, where exposure to cold can be either a causative or contributing factor. To add to this, there is also a known hereditary disease, which is the FCAS which is the familial cold autoinflammatory syndrome which often demonstrates pain in the knee. Cold weather may also aggravate pain in the knee which already has osteoarthritis, rheumatoid arthritis and fibromyalgia.
Pain due to immobility/lack of movements
People who are more sedentary or involved in lesser physical activity and work environment is yet another reason for developing pain in the knees. What happens is that decreased activity and movement weakens one’s knee muscles, and the lax muscles are unable to support the knee structure, causing increased bone-to-bone impact. Blood vessels may be compressed as well, causing painful conditions in the knee. As we grow older, the movement of the knee joint causes higher friction with nearby tissues and cartilages.
As age progresses the movement of the knee joint involves higher friction with adjacent tissue and cartilages.
Other causes of pain in the knees
- Ligamentous laxity
- Fat pad impingement
- Knee effusion
- Deep vein thrombosis
- Peripheral vascular disease
It’s important that an accurate diagnosis is made for all knee-related pain and injuries, and physiotherapy and deep tissue release therapy to start as soon as possible. Treatment techniques may include specific strengthening to correct muscle imbalance, soft tissue massage, joint mobilization and ultrasound therapy. Other electrotherapy procedures such as heat therapy may also be used to accelerate healing and provide pain relief.
Ms Louise Yow, Hon. in Physiotherapy
Urbanrehab Pte Ltd
22 Malacca Street, Royal Brother Building,
#03-03 (RB Capital Building), Singapore 048980
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