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Knee Pain

What leads to knee pain?

To understand what might be causing your knee pain, it’s helpful to get a better understanding of the anatomy of our knees.The knee is one of the largest, most complex joints in the body. It is made up of four bones: the femur, the tibia, the fibula, and the patella. The muscles that support the knee are the quadriceps in the front of the knee and the hamstrings in the back.These structures are connected through an intricate network of ligaments and cartilage. The anterior cruciate ligament (ACL) prevents the femur from moving backwards onto the tibia, and the posterior cruciate ligament (PCL) prevents the femur from sliding forwards. There are two collateral ligaments, medial and lateral, that also help to provide support.The meniscus (lateral and medial) is tissue that sits between the femur and the tibia, providing ease of movement between the two bones. There is also articular cartilage that sits behind the patella. Finally, the knee is surrounded by bursae, fluid-filled sacs that help to cushion the knee joint.

Dislocated Kneecap

A dislocated kneecap is usually an acute traumatic sports injury that occurs when your patella slides out of place. Like other dislocations, it is possible to pop the patella back into place, but other treatments may be necessary if this is not successful.

Knee bursitis

Knee bursitis occurs when the fluid-filled sacs in the knee (bursae) that cushion and protect tendons and ligaments become inflamed.


Patellofemoral pain syndrome

Pain that persists in the front of the knee may be due to patellofemoral pain syndrome. This injury is also related to overuse, but develops from improper kneecap alignment or excess weight. Knee pain due to patellofemoral pain syndrome typically affects athletes, teenagers, and manual laborers. With this syndrome, knee pain develops from deterioration in cartilage underneath the kneecap. The cartilage may wear down, soften, or become rougher. Symptoms include pain from sitting, jumping, squatting, or descending stairs. The sensation of the knee giving out and not supporting the body’s weight is also associated with patellofemoral pain syndrome.

Gout

Gout occurs when a uric acid build-up occurs in the blood, usually in and around the joints. Most common in the big toe, it can also occur in the knee.


Loose tissue or bone

During the normal course of activity, or in a knee that has a history of traumatic injury, small bits of tissue or bone can break off and lodge painfully in the joint.

Torn ACL

One of the more common sources of knee pain, especially from sports, is a torn ACL. A torn ACL occurs most frequently in sports with sudden changes in direction (i.e., soccer or tennis).The ACL runs from the back end of the femur to the front of the tibia. By preventing the shinbone from moving forward beyond the knee, the ACL provides about 90% of the knee’s stability, according to the Department of Orthopaedic Surgery at the University of California, San Francisco (UCSF). That’s why the signature popping noise that typically accompanies an ACL tear is sometimes joined by a quick hyperextension of the leg.About 200,000 people tear their ACLs each year, most of them while playing sports. The injury frequently develops during sudden stops, quick accelerations, twisting, or jumping. About half of the time, reconstructive surgery is needed for a full repair. Also about half the time, people with torn ACLs report simultaneous injuries to other structures in the knee, including the meniscus, articular cartilage, or medial collateral ligament.

IT (iliotibial) band syndrome

The iliotibial band (IT band) runs along the outer thigh and helps stabilize the knee and hip. With iliotibial band syndrome (ITBS), the fibers that make up the band overdevelop and rub against the knee or hip bone, creating friction and inflammation. This friction results in knee pain.This knee injury typically develops from overuse, and is common in runners, cyclists, and other athletes who heavily stress their knees or whose sports require repetitive flexing and extending of the leg.

 

Symptoms of ITBS include pain or swelling on the outside of the knee or hip bone. People with this injury will feel pain when bending their leg at a 45-degree angle.


Patellofemoral pain syndrome

Pain that persists in the front of the knee may be due to patellofemoral pain syndrome. This injury is also related to overuse, but develops from improper kneecap alignment or excess weight. Knee pain due to patellofemoral pain syndrome typically affects athletes, teenagers, and manual laborers. With this syndrome, knee pain develops from deterioration in cartilage underneath the kneecap. The cartilage may wear down, soften, or become rougher. Symptoms include pain from sitting, jumping, squatting, or descending stairs. The sensation of the knee giving out and not supporting the body’s weight is also associated with patellofemoral pain syndrome.

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What knee pain treatments can help me?

The most important aspect of treating knee pain is getting a proper diagnosis for the cause of your pain. An MRI looks at the soft tissues of the knee, and an X-ray is used to examine the health of the bones. Both of these tools, in conjunction with a physical examination and medical history, can help uncover the root cause of your knee pain.Once a diagnosis is reached, there are several knee pain treatment options that can help reduce your pain and inflammation and restore mobility in this hard-working joint.