What Causes Knee Pain

Knee Pain & Muscle Wasting

Muscle wasting is the most common of all factors in knee pain and plays a significant role in the majority of knee pain cases.  Our muscles weaken prematurely when we live in an urban environment; as they seldom get the type of workout they were evolved for. We did not evolve to walk on hard flat surfaces all the time. The vast majority of knee pain sufferers have muscle wasting in their VMO (quadricep muscle). Steadily strengthening the glutes and VMO over time is a vital piece of the knee pain jigsaw for most knee pain patients.

Knee Pain & Scar Tissue

Scar tissue is a far more common cause of knee pain than most people realise. Scar tissue from old injuries that weren’t properly rehabilitated is a major cause of knee pain. Scar tissue can form in relation to injury but it can also build up gradually due to alignment and gait issues.. The presence of scar tissue  can cause irritation of the soft tissues around the knee and  contribute to chronic knee pain. Happily scar tissue can be broken down in  most cases using shockwave therapy and Graston Technique.

Knee Pain & Tendinopathy

Tendinopathy is an integral part of many knee pains. Not surprising given that the patella tendon is an absolute whopper and lives most of its life under some kind of stretch or load.

The term tendinopathy reflects what we now know scientifically about tendon pain. Tendinopathy pain is caused by degeneration of tendon tissue. Happily though tendon degeneration can be reversed due to its rich blood supply. If your knee pain is being caused by tendinopathy you need to work with people who know how to treat it properly, and figure out why it happened.

Knee Pain & Gait Problems

Even the most sedentary of us take millions of steps per year on hard surfaces like concrete, tarmac & paving. The forces generated when your heel strikes concrete are more significant than you think. If your arches are very high or very low the strain of walking on hard ground in fashionable footwear is magnified many times. Not only are these kinds of foot issues a major cause of knee pain, ankle pain, foot pain and knee pain, they are also a major cause of knee pain.  At Featherston St. Pain Clinic we use cutting edge sensors and machine learning algorithms to identify gait issues that need to be worked on, just sayin!

Knee Pain & Bursitis

Bursitis is inflammation of a fluid sack that reduces friction in the body. You may have heard bursitis referred to as a ‘cause of knee pain’. It’s important to interpret this carefully given that bursitis itself is a reaction to some form of ‘underlying strain’ that is occurring in the knee. Whatever is causing that underlying strain is the true ‘cause’ of the knee pain, and it is the reason the bursa has become inflamed. We frequently see patients in our clinic who suffer from knee bursitis because of their gait;  the most classic cause of knee bursitis however is kneeling a lot.

Knee Pain & Sedentary Work

There is no escaping from the fact that we evolved to be far more active organisms than most of us now are. The amount of movement involved in child rearing, nest building, water gathering, foraging, hunting & evading vicious packs of honey baggers is what we were made for…  and now we ‘write code’. Our bodies are adapted to move. Prolonged sitting or even standing at work for more than 30 hours a week can lead to knee pain; by slowly but surely weakening the stabilising muscles, tightening the fascia and compressing the joint. 

Knee Pain & ‘Poor Technique’

Poor execution of movement in sports and exercise can place unnatural strain on joints and soft tissues and cause knee pain. Improper training methods are a major cause of pain and injury. Lifting heavy weights without good technique is the obvious one.  An extremely common cause of knee pain is distance running on hard surfaces like tarmac with poor form. Running on hard ground without correct technique & knee strength can place significant strain on the knee’s tissues. Using technology to identify movement imbalances is an excellent start point to improving technique and reducing this type of knee pain

Knee Pain & Lifestyle

There are many lifestyle choices that can harm our knees badly enough to cause pain.. A great example would be training excessively on knee’s that aren’t quite strong enough. Another example would be the patient who plays video games for 12 hours a day and doesn’t exercise, thus shortening their hamstrings severely..  Being forced into unnatural mobility scenarios by life is perfectly normal and healthy; it’s when these movements are excessively repetitive that they can become a cause of knee pain.

Knee Pain & Stress  

Many people attending their chosen healthcare providers office with bad knee pain have some kind of increased stress going on in the background. Occupational, financial and relationsiliotibial band (ITB) stressors are triggers for chronic knee pain in a percentage of cases. It is important to distinguish ‘trigger’ from ‘cause’ here because if you have a healthy knee it is not likely that stress will trigger bad pain. If however, you suffer from stress or unresolved trauma they can trigger latent knee issues into stubborn knee pain. Regardless of whether stress is playing a part in your knee pain it should still respond well to pain management tools and technologies.

Knee Pain & Cartilage Tears

The knee joint bears a huge amount of weight and needs thick cartilage structures to absorb shock. Due to the amount of repetitive loading these cartilage structures endure they are prone to damage. The most common cartilage structure that sustains damage in the knee is the meniscus. Meniscus tears are thankfully not too common, but they do occur. Some meniscus tears require surgical intervention but thankfully many others respond just as well to rehabilitation that involves support and strengthening of the knees supporting muscle.

Knee Pain & Osteoarthritis

In many ways osteoarthritis is just a normal part of the aging process. Everyone over the age of 60 has some osteoarthritis in their body, but interestingly only a percentage of these joints ever end up hurting. While there can be a connection between a person’s knee pain and osteoarthritis there is often none.  It is a complete myth that all arthritic knees hurt!!!  Some knee pain is caused by osteoarthritis, the vast majority of knee pains are not caused by osteoarthritis. Even when osteoarthritis is present in a joint it doesn’t necessarily mean that it will need replacing. Lots of good news about knee arthritis!!

Knee Pain & Inflammatory Arthritis

Inflammatory arthritic conditions are body-wide conditions with the capacity to cause knee pain. These types of arthritic conditions include rheumatoid arthritis, psoriatic arthritis and gout. These forms of arthritis are not common causes of knee pain but they do nonetheless show up. We still know very little about the full complexity and subtlety of many of these auto-immune type conditions, many of which may be more to do with the health of the gut than anything else. If your knee pain is being caused by an inflammatory arthritis it’s likely that you will have pain in other areas and have been feeling unwell in other ways. Blood tests and x- rays can usually identify inflammatory arthritic issues pretty quickly if they are present.

Knee Pain & Bone Disease

On occasions knee pain can be caused by disease within one or more of the ‘knee bones’. In older people with osteoporosis bone can become seriously weakened and become susceptible to fractures. Other ways a bone can become weakened by disease include cancer, kidney disease and endocrine disease; if the bone is sufficiently affected any of these can turn into knee pain. Often these types of issues will not make themselves known until they have caused a bone fracture. 

Thankfully it is not that likely that your knee pain is being caused by a disease process. If however you are sweating profusely –  getting a lot of pain at night –  losing weight without any change of diet or exercise – feeling increasingly unwell in combination with knee pain, get yourself checked out ASAP. 

Knee Pain & Major Injuries

It probably goes without saying that significant injuries to the knee and it’s associated tissues can cause bad knee pain. True injuries to the knee are not that common and usually only occur under more extreme accidents. Probably the most common are tibial plateau and fibular fractures in contact sports and vehicle accidents. If you badly injure your knee in a sporting context or in a serious accident you will almost certainly know all about it in the form of serious amounts of  pain. Hospitals do an excellent job screening for these types of injuries so very few of them slip through the net these days. 

Knee Pain & Infections

Bone infections are a less common cause of knee pain that nonetheless should be considered. Infection should be investigated if there is a ‘hot spot’ around the knee or if you have other symptoms of infection like fever. There are basically 2 kinds of bone infection. There is a slow creeping kind that can behave a lot like normal knee pain and is often misdiagnosed as a result, and there is also a far more aggressive kind of acute infection that makes people very sore and very sick very fast. There are numerous possible causes of a bone infection in the knee-  all of which warrant a serious medical investigation.

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