Knee Pain

Knee pain may be caused by a traumatic or overuse injury. People may report feeling an ache or other discomfort.

Sports injuries to the knee are very common and can range from mild to severe. The complex motions that athletes perform involving the knee joint - repeated twisting or pivoting, frequent stopping and starting, or swift directional changes - can cause damage to both cartilage and ligaments.

Ligament Injuries

The knee is made up of four major ligaments: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL).

Anterior Cruciate Ligament (ACL)

The anterior cruciate ligament (ACL) is located inside the front of the knee. It’s responsible for stabilizing the knee joint from front to back. ACL injury frequently occurs in athletes that stop and start suddenly or change direction in mid-motion.

Posterior Cruciate Ligament (PCL)

The posterior cruciate ligament (PCL) is located inside the back of the knee and stabilizes the joint, keeping the tibia from moving too far backwards. Damage to the PCL requires extreme force, such as a direct hit to the knee. A PCL injury is generally not as severe as an ACL injury, and often will heal on its own.

Medial Collateral Ligament (MCL)

The medial collateral ligament (MCL) is located along the inside of the knee, connecting the femur and tibia bones of the leg to stabilize and limit sideways movement at the joint. The MCL is one of the most common ligament injuries and occurs when the knee joint takes a direct hit from the outside of the knee.

Lateral Collateral Ligament (LCL)

The lateral collateral ligament (LCL) is located along the outside of the knee, connecting the femur and fibula (lower leg bone on the outside of the leg) to limit and stabilize sideways movement of the knee joint. An LCL injury usually happens along with another injury in the knee, and in sports with a direct hit or during movement with a sudden change of direction.

These ligaments can be sprained during activities.

Symptoms

A tear of any of these ligaments may be accompanied by a “pop,” knee swelling, pain when bearing weight, and a “giving way” sensation when walking.

Treatment

A full tear or partial tear of these ligaments is reason to seek medical attention for further evaluation. Surgical intervention may be needed when these ligaments fully tear.

Meniscal Tear

The meniscus is a thick layer of cartilage that acts as a shock-absorber between the femur and tibia bones in the knee. It protects the harder layer of cartilage that lines the ends of the bones. In severe injuries such as a direct hit to the knee, or excessive twisting, the meniscus can tear and cause severe pain and swelling.

Knee pain or tenderness may be caused by a sudden, traumatic injury, overuse, or an underlying condition like arthritis. Knee pain can range anywhere from dull and achy to sharp and stabbing, depending on the cause.

Tendonitis

Tendonitis is inflammation of the tendons, usually from overuse. Tendons are the soft tissues attaching muscle to bone. In the knee, the patellar tendon is an extension of the quadriceps muscle group, and it connects the kneecap (patella) to the shin bone (tibia).

People who have patellar tendonitis often report pain and/or tenderness in the front of the knee, sometimes accompanied by swelling, just below the kneecap.

What Can You Do if You Have Knee Pain?

• Ice the knee for 15-20 minutes every few hours when the injury first happens.
• Take anti-inflammatory medications such as naproxen and ibuprofen.
• Rest
• Proper warm up and cool down, and sometimes physical therapy can be helpful.

First aid

• Take weight off the injured limb
• Elevate the joint (above the level of the heart)
• Apply ice
• Use pain relievers such as nonsteroidal anti-inflammatory drugs (like ibuprofen and naproxen)

IT Band Syndrome

The iliotibial (IT) band is a thick, fibrous band that runs from the outside of the hip to the outside of the knee. IT band syndrome is common in distance runners. IT band syndrome can cause pain in the outside (lateral) aspects of the hip, knee, or upper leg that is sometimes accompanied by swelling.

Treatment

• RICE Method - Rest, ice, compression, elevation
• Non-steroidal anti-inflammatory drugs (like ibuprofen and naproxen)
• Physical therapy
• Foam rolling and massage
• Stretching before and after exercise and activity

Meniscus Injury

One of the most common injuries in the knee is a meniscal tear. The menisci are the two pieces of cartilage in the knee between the thighbone (femur) and the shinbone (tibia). The menisci provide cushion between the two bones. When the knee is forcibly twisted or rotated, these pieces of cartilage can tear. If a meniscal tear is suspected, it is important to see an orthopedic surgeon to determine the most appropriate treatment.

Signs and symptoms

• Pain in the knee joint – this can be on the inside or outside of the knee
• Swelling in the knee joint
• Stiffness
• A “clicking” or “popping” sensation when walking

Arthritis

Arthritis is a common cause of knee pain in people 50+ years of age, although it can affect younger people as well too. Arthritis occurs when cartilage in the knees wear down over time. People with arthritis may complain of joint stiffness, cracking, swelling, tenderness and sometimes deformities in the joint. Arthritis is diagnosed after an X-ray shows degeneration of the cartilage in the joint. Treatment can include physical therapy, weight loss, ice, heat, medication, and joint replacement.