Knee Pain: Everything You Need to know from your Podiatrist
Causes of Knee Pain
Knee pain is a very common debilitating condition affecting people of all ages.
Commonly caused by overuse and sometimes associated with conditions including:
- Arthritis (Osteoarthritis and Rheumatoid arthritis)
- Gout.
- Patellofemoral syndrome (often referred to as “Runner’s Knee”),
- Meniscus tears
- ACL (anterior cruciate ligament) injury
- Sinding-Larsen-Johansson Disorder
- Patella Tendinitis
- Bursitis
- Osgood-Schlatter Disease (another form of knee pain that occurs only in children and adolescents)
Knee pain can also be caused by an underlying gait or biomechanical abnormality.
Symptoms
The symptoms of knee pain can vary depending on the cause.
There are also different types of stages of knee pain, including:
- Acute pain (the initial pain you get right after an injury)
- Chronic pain (pain that has been there for months to years)
- Intermittent Pain that comes and goes.
Some of the most common symptoms of knee pain include:
- Aching
- Burning
- Stiffness in the knee joint
- Another common complaint is “knee buckling”.
When you feel like your knee buckles during activity.
It is usually because the knee joint has become misaligned, which is called patellofemoral joint pain.
This happens when your kneecap has become out of place in relation to your thigh bone. When you are running, jumping or kneeling, but is most often caused by repetitive movements that place extra stress on the knee joint.
The kneecap normally moves back and forth within its track on the thigh bone, but when it becomes misaligned it can rub against the side of the bone.
The pain may also be felt when walking, especially on an incline or when making turns or pivoting. As well as when lying on the affected side, raising the affected leg, or squatting.
Other symptoms can range from a dull ache to sharp, shooting pain, and can affect the side of the knee, the back of the knee, or both.
Patello-femoral Pain syndrome (Runner's Knee)
Patellofemoral Syndrome can often be caused by overuse or a knee injury, but there are other causes of Patellofemoral Syndrome.
The symptoms of Patello-Femoral Pain Syndrome cause great discomfort and pain in the knee joint and make it difficult for you to perform your daily activities.
Sports that involve a lot of jumping, such as basketball or football, are the most common cause of Patellofemoral Syndrome.
Other causes include biomechanics due to genetics, injury, and other conditions.
Biomechanical studies describe the causes of patellofemoral pain syndrome, which are the result of abnormal joint mechanics and soft tissue abnormalities.
These include increased patella femoral kinematics such as increased Q-angles (which is the angle between the femur and the patella), flexed knees, and increased valgus angles have been associated with patellofemoral pain.
Soft tissue abnormalities such as patellar tendonitis, iliotibial band friction syndrome, and hip muscle tightness have all been linked to patellofemoral pain.
Osteoarthritis
Osteoarthritis is a common form of arthritis that causes pain and swelling in the knee.
It occurs when the cartilage that cushions the ends of the bones wears away.
The cartilage is the rubbery tissue that enables the bones to slide over each other when we move.
The most common symptoms of osteoarthritis are pain and stiffness in the joint.
Patella Tendinitis and Bursitis
Patella tendinitis and bursitis are two common causes of knee pain.
Patella tendonitis is inflammation of the tendon that connects the thigh muscle (quadriceps) to the knee joint.
Bursitis is swelling of one or more of the bursa that cushion and protect the bony structures of the knee.
Both tend to cause pain, swelling, and stiffness in the knee joint.
Sinding-Larsen-Johansson Disorder
Also known as Sinding-Larsen syndrome, Sinding-Larsen-Johansson syndrome, SJJ syndrome, or Jansen’s syndrome.
Is a rare genetic disorder that affects the cartilage and bones of the knee, causing pain and swelling in the joint.
It is an inherited condition that occurs when the affected person inherits a mutated gene from one of his parents.
The gene mutation causes the body to produce abnormal amounts of a protein called chondroitinase,
which breaks down the protective cartilage in the knee joint.
The disorder usually begins during adolescence or young adulthood.
Symptoms
The symptoms are pain and swelling in the knee, which often occurs when the joint is forced to bend or move.
Other signs and symptoms may include a decreased range of motion in the joint, joint stiffness, and redness or warmth near the knee.
The gene mutation that causes SJD is inherited in an
autosomal recessive pattern,
which means that a person needs to inherit the mutated gene from both parents in order to have the disorder.
Because the disorder is so rare, most people with the condition are not diagnosed until age 20 or later.
Other symptoms of Sinding-Larsen-Johansson Disorder include pain and stiffness in the knee,
which can make it difficult to walk and climb stairs.
The pain often feels worse at night and when someone takes a stand or a seat for a long period of time. It may feel better when the person exercises or rests the knee.
Sometimes the pain is mild and goes away on its own but in other cases,
it may continue to get worse despite the best efforts of the person to treat it.
Treatment
The most effective treatment for SJD is physical therapy,
which helps the person strengthen the muscles around the knee and learn how to move the joint without causing pain or stiffness.
Custom Orthotics
In some cases, orthotics (special shoes or inserts designed to help the knee joint) are prescribed
to help the person move more easily and reduce pain and swelling.
It may be necessary to wear a knee brace to help support the joint and reduce pain when it is bent or moved.
The brace can be removed when the person is no longer experiencing pain or swelling in the knee,
and the person may need to wear a brace for only part of the day or for a limited time.
Osgood-Schlatter Disease
Osgood-Schlatter Disease is the most common cause of knee pain in young boys.
It is a condition in which the growth plate in the shin bone or tibia becomes injured.
The growth plate is the area in which new bone is formed. When this process is interrupted, tiny bones in the growth plate become visible on the surface of the shin bone or tibia.
These bones rub against one another causing inflammation, swelling and pain. This condition is mostly seen in adolescent boys between the ages of 10 and 15.
Symptoms
The symptoms of Osgood-Schlatter Disease usually resolve themselves with time. However, if the pain and inflammation become severe and interfere with the activities of daily living, treatment may be necessary.
Treatment
The treatment of Osgood-Schlatter can be divided into conservative and surgical treatment.
Although the majority of cases are treated conservatively by releasing the tightness in the muscles in the quadriceps and hamstring.
Prescribing anti-inflammatory medications like ibuprofen.
Knee braces, physical therapy or exercises and wearing of custom orthotics can also be used.
Surgical options include arthroscopic release of the tightness in the muscles in the quadriceps and hamstring and excision of the small bony growths in the tibial growth plate.
The decision as to which treatment is best for a particular case is made by a Podiatrist based on the severity of symptoms and response to treatment.
How your foot position affects your knee
Understanding foot biomechanics is the first step in developing orthotics that will correct the alignment issues that may be causing your pain and discomfort in and around the knee.
Inside the knee joint, there are two pads of cartilaginous tissue, the meniscus and the articular cartilage.
The meniscus is a flexible collagenous tissue that is found on the inside and outside of the knee.
The articular cartilage is a hard, rubbery tissue that lines the inside of the knee joint.
The meniscus acts as a shock absorber, helping to reduce the impact when you move your knee.
The articular cartilage serves as a surface for the femur to slide on when your knee joints are bent.
Both the meniscus and the articular cartilage are important for normal knee function.
By understanding the biomechanics of your foot you can begin to understand the relationship between your foot and the knee.
The foot is designed to function in a straight line when walking and running.
When your foot is moving in a straight line, meaning your big toe is pointed straight ahead of you. It allows muscles in your calf and thigh are working in optimal alignment and distribute your body weight evenly.
But, when your foot is turned out or turned in, the muscles in your calf and thigh are working at their minimum capacity. Often overcompensating in areas that should not be placed under such pressures.
The placement of your feet will directly affect your knee joint and its ability to move straight when you stand up, walk or run.
This is where orthotics come in.
Custom orthotics can correct the biomechanical issues in your feet that are causing your knee to move out of its normal straight line, causing pain and discomfort.
This in turn will help to keep your knee joint healthy and pain-free.
How orthotics help Knee Pain
Orthotics for knee pain can assist in the restoration of normal biomechanics and function of the knee.
Studies suggest about 70% of the population have pronated feet, which means their arches are collapsed and their feet turn in when standing or walking.
Having flat (pronated) feet places extra stress on the knees, which is why having your feet correctly aligned is so important.
Pronated feet also create additional friction across the arches, which causes additional stress on the arches and knees.
Having your feet corrected through orthotics can help to bring your feet back into proper alignment and reduce the amount of extra stress placed on the knees.
Custom orthotics are specially designed insoles that provide extra support and help to improve the alignment of the knee joint. Orthotics can be used alone or in combination with other treatments.
They are used to treat the symptoms of Patello-femoral pain syndrome by helping restore normal biomechanics and function of the knee.
The symptoms of Patello-Femoral Pain Syndrome cause great discomfort and pain in the knee joint and make it difficult for you to perform your daily activities.
The use of orthotics for knee pain can help you to alleviate these symptoms. They help to correct the abnormal foot biomechanics and bring the foot into a more normal position.
This helps to put the knee in a position where it does not rub against the thigh bone or the femur.
The reason why orthotics can help is that they provide support for the knee and help reduce the load on the knee joint.
They also reduce the friction between the knee cap and the thigh bone or the femur, which reduces the pain and discomfort.
Contact A Podiatrist about your Knee Pain.
At Unisoles believe that the biomechanics of our feet and ankles are of utmost importance when it comes to knee pain.
Our Biomechanics Specialists can help you understand your foot’s biomechanics and how to correct or improve them.
This involves addressing the following issues: stance, pronation, supination, and rotation.
To Speak to our Unisoles Podiatrists click here
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