These are inside the joint and act as shock absorbers and means of spreading the load through the knee. The inner part of the knee is affected more often than the outer. It tends to result from twisting injury in the under 40’s and with no obvious cause/degeneration in the over 50’s. There may be swelling the day after the injury and painful clicking. The knee may give way or be locked. Approximately 25% are repairable through surgery, others are helped by doing strengthening exercises.
Anterior cruciate ligament ruptures.
Caused by twisting injury so common in footballers and more so in netball as they land on one foot then twist. There is immediate swelling in the knee and a feeling of instability more than pain. Will be unable to weight-bear. The younger or more active the person, the more likely to need surgery. As patient gets older knee gets stiffer and so gives more stability.
Patello/femoral (knee cap ) disorders. There may be pain when pressing down on the patella which is called chondromalacia patella. There may be a problem of instability or maltracking. The latter will be noticed when walking down-hill or going downstairs. It may be caused by postural abnormalities in the hip and/or knee or where the outer quadriceps muscle are much tighter than the inner one. Pain below the knee in an adolescent indicates Osgood Schlatters where tight quadriceps muscles have pulled the bone below the knee making it larger and tender. In adults it would indicate patellar tendinitis
Iliotibial Band Syndrome.
This refers to pain on the outside of the knee that may have increased over a few days. It often relates to running especially downhill running. The pain usually occurs when the heel is about to strike the floor. The iliotibial band is a flat muscle which runs from outer side of the hip/top of the leg down to the outer side of the knee.
Osteo-arthritis/rheumatoid arthritis. See previous article
Some knee pain may actually be referred pain from elsewhere such as the back or hip so it is important to get a full osteopathic assessment to establish the source of the pain.
Many of these conditions and other knee conditions can be helped with osteopathic treatment, taping, modification of sport as well as strengthening and stretching exercises.