Knee Pain

Knee pain can be from an injury or from long term stress on the knee.

This stress can be caused from biomechanical dysfunctions leading to

structural irritation.

Knee osteoarthritis

is characterised by a decrease in joint height due to degeneration of the

cartilage lining of the bone surfaces and meniscus. This can be localised

to the inside, outside or throughout the joint as well as the patellofemoral

joint (kneecap joint). This reduction in joint space can lead to decreases in

range of motion and increase stress on surrounding structures

(ligaments and muscles). Treatment focuses on decreasing stress on the

surrounding structures and treatment any contributing biomechanical

dysfunctions. This may be over activity or weakness and well as alterations

throughout the lower limb to compensate for the pain. A specific program

will be prescribed to address these factors, as well as a structured return to walking

program. This part is particularly important as graded weight bearing and exercise

can help to protect the joint.

Total Knee Replacement

is becoming increasingly more available for advanced knee osteoarthritis and decreased ability to perform daily tasks. If you are waiting for a total knee replacement, Physiotherapy can help to reduce your pain, maintain movement and increase the strength in your knee. After surgery, you will beginning physiotherapy within 2 weeks. Physiotherapy aims to help reduce swelling, pain and begin moving towards a normal gait pattern. Following this the aim is to prevent adhesion of the scars from surgery to the underlying tissue and rapidly improve your range of motion. Throughout this process you will be given a range of strengthening and mobility exercises to assist with this and return you to normal daily activities with no hindrances.

Patellofemoral joint pain

is quite common in the younger population. This condition usually starts without an injury and worsens with activity. Patellofemoral pain is more common in younger girls than boys and usually relates to increased in joint mobility (hypermobility). The condition is a result of weakness and hypermobility which causes increased stress on the patella and the underlying cartilage. This pain is localised to under the patella or under the tendon. Functional testing as directed by your physiotherapist will show which muscles groups are weak, allowing an individualised program to be prescribed. This condition can be effectively managed through the exercise program, with acute symptoms being eased with taping techniques.

Patella tendonitis

is an overuse injury resulting in weakness and inflammation of the patella tendon (attaching the patella to the shin). This condition is prevalent in athletes whose chosen sport has a large amount of jumping stress on the knee. This stress can be increased by poor biomechanics or tight muscles. If treated early, this condition can be managed effectively with physiotherapy. Physiotherapy aims to decrease the stress on the tendon, correct biomechanics in the leg and begin a strengthening program specific for the patella tendon. During the early phase when the tendon is likely at its most painful, taping and bracing may also be effective in managing your symptoms.

Osgood Schlatters Disease

As children are still growing, their bones are not completely formed. Osgood Schlatter's causes pain where the patella tendon (from the quadriceps muscles) attaches to the shin bone. This results in a painful bump at the top of the shin which is a result of the growth plate being damaged from increased traction forces on it. This condition is more prevalent in growing children during there growth spurt and affects boys more than girls (Boys: ages 11-15 years – Girls: ages 8-13 years) and affects both knees in around 20-30% of cases. Physiotherapy is very effective for this condition. Treatment focuses on reducing stress on the patella tendon, reducing amount of exercise and giving specific exercises to reduce stress on the knee. Taping and bracing can also help.

Meniscus Tears

are often degenerative and occur in later years of life. However, meniscus tears can also be acute and due to a high impact or twisting injury. Meniscus tears vary from simple to complex, and mild to severe in symptoms. Meniscus injuries result in a cascade of symptoms including swelling within the knee, reduced knee range of motion and altered walking patterns. Depending on the type of tear the knee can sometimes lock into a bent range which can be painful. Degenerative tears often result in pain referral around the knee with common areas being a line through the back of the knee. Physiotherapy is the first line of treatment for meniscus tears and is quite effective. Physiotherapy begins with restricting stress on the meniscus, clearing swelling from the knee and restoring range of motion. Following this the aim is to gradually return you to loading the knee and resuming normal activities as well as correcting any factors contributing to your meniscus injury. In severe cases, such as when the knee is locked into a bent or straight position, surgery is required. Physiotherapy then plays an important roll in post-surgery rehabilitation to regain movement and strength in the knee.

Ligamentous Injuries

include the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial and lateral collateral ligaments (MCL and LCL). Damage to the ligaments of the knee are mostly due to sporting injuries, however, can occur with trips and slips, falls and from other recreational activities. These injuries vary in grading: Grade 1 meaning only a stretching of the ligament; Grade 2 meaning tearing of some fibres and stretching around this; Grade 3 meaning tearing of all the fibres with no continuity of the ligament. Physiotherapy is the gold standard for treating all the ligament injuries in the knee including ACL ruptures. Evidence has shown comparable return to sport rates and no increase in knee osteoarthritis rates following non-surgical rehabilitation of these ligament injuries. Physiotherapy begins with restricting stress on the ligaments, clearing swelling from the knee, restoring range of motion and accelerating tendon repair. Following this the aim is to gradually return you to loading the knee and resuming normal activities, whether that be sport or recreational. If you choose to have surgery to repair your completely torn ligament, Physiotherapy will assist before and after surgery to regain movement, increase strength and regain control of your knee with higher level activities such as running and sport.

Contact Free Movement Physio to book an appointment for a one on one consultation to discuss your knee concerns.