Knee Pain



Knee pain

You’re suffering from knee pain ? You’re not alone! Knee pains are frequent and disabling. Because of its position between the foot and the hip, the knee is a joint strongly solicited. It ensures at the same time the stability with regards to the ground and the balance of your own body. Boris Dolto said: "the knee is a joint enslaved to its two masters, the foot and the hip”. Pain in the knee can be the result of excessive solicitations from the elements that guarantee your stability and mobility. People practicing an intense physical activity (sport, professional activity, daily life) are particularly affected by knee pain . However, causes are multiple.

 

Pain in the knee: the different types of pain

Pains can be of traumatic, mechanical or inflammatory nature and can affect various anatomical structures. These structures are making up the knee joint and ensure movement and stability. They can be bone, ligament , tendinous or soft tissues related. This is why, during a clinical examination, a research for the origin will be made to reveal damage in the structure(1).

 

How to diagnose the different types of knee pains?

The clinical examination has several steps:

  • Questions about your history and the time passed since the beginning of the pain (anamnesis);
  • Examination with charge (standing) and without (laying down) to notice signs that can cause the pain;
  • Some manipulation and palpations will eliminate differential diagnoses.

In case of doubt about the diagnosis, a complementary examination will be prescribed such as:

  • An X-ray photography for rigid structures (bones);
  • A MRI (Magnetic Resonance Imaging) for soft tissues (cartilage , ligaments, menisci, muscles or tendons);
  • An arthroscopy to see inside the joint ;
  • A blood test;
  • A knee joint puncture to collect synovial fluid .
     

Symptoms of knee pain

The signs of knee pain vary according the condition. They are the ones that generally alert you! Among these signs, the more frequent are:

  • A discomfort or pain before, during or after your various activities;
  • A swelling of the painful area;
  • Pain at rest;
  • A stiffness of your knee;
  • Pain when flexing and/or stretching your knee;
  • Difficulty of weight bearing;
  • A joint locking;
  • Feeling of instability.
     

Knee: painful areas

Knee pain can involve a much larger painful area. 

Pain in the front of the knee, most frequent ones, will result in a diffuse discomfort when flexing. For example, when you’re suffering from a patellar syndrome  or patellar tendinitis . On the contrary, a meniscus pain will result in a precise sensitive area (like a point) facing the joint  line of the affected meniscus .

Pain behind the knee can be caused by a tendinitis (tendon pain caused by a strain) of one the muscles making up the hamstrings (muscles behind the thigh). A Baker’s cyst (popliteal cyst) can also cause this pain.

Pain on the inside of the knee can be caused by a sprain of the medial collateral ligament or by a goosefoot tendinitis .

The most known cause for a lateral pain is the iliotibial band syndrome (ITBS). An injury of the lateral collateral ligament can also be responsible for this type of knee pain .

Mainly occurring after a trauma or a fall (while skiing or playing football for example), the pain of an injury of the cruciate ligaments will be felt inside the knee.

Knee pains named above are just examples and are not constituting an exhaustive list. A health professional will effectively diagnose the condition you’re suffering from.

 

The different causes 

The development of the clinical picture (the clinically observable signs and conditions) also change according to the age. In that sense, conditions can be caused(2) by:

  • growth (e.g.: Osgood–Schlatter disease, OSD);
  • overtraining (e.g.: patellar tendinitis );
  • overwork (e.g.: inflammation of a synovial bursa , common condition by tile setters);
  • ageing (e.g.: gonarthrosis)

As seen previously, the origins of knee pain can be traumatic, mechanical or inflammatory.
 

  • A traumatic origin

Knee pain can be caused by a fracture of one of the parts of the knee joint . Among the parts that can be fractured in the joint , we have: the femoral condyles , the tibial plateau or even the patella (kneecap ). A sprain of the collateral ligaments or of the cruciate ligaments after a trauma forcing the joint beyond its functional range of motion can also provoke a sharp pain in the knee.

Lastly, meniscus lesions (fissure or tear) cause pain in the joint .
 

  • A mechanical origin

Knee arthrosis is one of the most common knee pain . This wear and tear of the cartilage can find its origin in a deformity of the knees or even in an overuse of the joint (due to a job or a sport for example). The ageing of tissues can also be responsible.

A bad posture or a foot deformity on the ground can also be the cause of a mechanical dysfunction of the knee.

The degeneration of the menisci is also one of the causes of osteoarthritis .

Tendinopathies arising after excessing work of the tendon also cause knee pain . The most known are the patellar tendinitis (jumper’s knee), the goosefoot tendinitis and the iliotibial band syndrome (ITBS).

In young people, the Osgood-Schlatter disease and the jumper’s knee are conditions related to the growth and include knee pain .

A Baker’s cyst (popliteal cyst) is created by a synovial effusion (liquid from knee joint ) that is leaking in the back of the knee and that causes a painful swelling behind the knee. 

N.B.: Knee pains can also be caused by a suffering hip.
 

  • An inflammatory origin

The bursitis , this inflammation of a bursae of synovial fluid located under the patellar tendon , for example, can also produce a pain in the knee.

Arthritis is also known to cause this knee pain . Moreover, this inflammation of the joint is often associated with other joint disease such as rheumatoid arthritis .

 

Kneepain: the EPITACT® solutions

That’s why, in order to answer to many conditions; pains and knee problems, EPITACT® has developed a range of knee braces.

The PHYSIOstrap™ SPORT* knee support is the first innovation of the 'PHYSIOstrap™' range. With its tendon made of EPITHELIUMFLEX®, it has been conceived for the patella to stay well-centered while letting freedom of movements. Meant for the patellar instability, the patellar syndrome and the patellar tendinitis , this knee brace goes unnoticed.

The patented silicone tendon has been adapted for the PHYSIOstrap MEDICAL* knee brace and aims to soothe arthritic knees. Unlike the previous one, this one can be worn for all your daily activities.

Concentrated technologies, ultra-light and discrete, these braces are meant to improve your comfort. Thanks to the EPITACT® knee braces* you can consider practicing your favorite sport and hope regaining all your daily activities.

 

 *These products are a class I medical devices that bear the CE marking under this regulation. Carefully read the instructions before use. Manufacturer: Millet Innovation. 09/2020

 

For more details about this general and simplified approach, here are further sources:

(1) Kermode, T, J Cornuz, P Zufferey, et O Pasche. 2014. « Gonalgies : que faire en médecine de premier recours ? » Revue Médicale Suisse, 7

(2) Chatrenet, Y. 2013. « Évaluations clinique et fonctionnelle du genou ». EMC - Kinésithérapie - Médecine physique - Réadaptation 9 (1): 1‑17.

NB : Boris DOLTO is considered as the father of modern physiotherapy.

 

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