Knee Pain: Practical Options to Manage and Prevent Knee Pain

[DrMarcPT]

Hey all, I wanted to post an article I wrote with general information on knee pain. I believe this article addresses questions that many of my patients have asked and it may help you too.

As a disclaimer, the information in this article is not medical information. It should be used for general educational purposes only.

Obviously, the right course of action depends on your specific knee injury which needs to be evaluated by a professional, but I believe that education goes a long way.

Enjoy:

What Can I Do for My Knee Pain?

It’s a sunny day and you are out hiking with your friends, your foot gets stuck in a hole, and you hear a “pop” in your knee. Immediately, you feel a warm sensation and sharp pain come over your knee. You try to walk it off, but the pain is too intense. Your friends volunteer to fireman carry you back to your car so you can rest and gather enough strength to drive home. You get home and put ice on your knee for 15 minutes because you remember the RICE (Rest, Ice, Compression, Elevation) protocol from an old high school injury 10 years ago. The next day, the knee looks swollen and it hurts when you walk, squat, and try to run.

What Do You Do?

a. Go to the doctor
b. Wear a knee brace
c. Get worried and anxious
d. Rest it
e. It depends


Before I give you the answer, I’ll discuss a few topics related to knee pain.

Signs of a Meniscus Tear

Joint Line Tenderness - There is a clinical test known as “joint line tenderness”. As the name suggests, the test is positive when you have pain as you touch the knee joint. The knee joint is formed by the tibia and femur joining together.
Pain with Weight Bearing – You may have pain with putting body weight onto your knee such as walking, squatting, or trying to run.
Catching, Clicking, or Locking – As you walk or stand, you may experience a catching, clicking, or locking sensation in your knee.

Signs You May Have Patellofemoral Pain
(Also known as Runner's Knee)

Pain at the Front of the Knee – The location of your pain feels like it is underneath the knee cap.
Pain with Squatting, Stairs, or Prolonged Sitting – You feel pain when there is increased pressure under knee cap such as squatting, walking up or down stairs, or prolonged sitting.

Signs You May Have a Ligament Tear

Knees Feels Unstable – You may feel major instability in your knee. The knee may “give out” or buckle.
Any of the other signs described above (Yes, a ligament tear could be similar to having a meniscus tear or patellofemoral pain. It will be very difficult to accurately differentiate which injury you have. In fact, it’s possible to have all of those injuries).

Should I Self-Diagnose My Injury?

I’m not advocating that you provide a diagnosis to your knee but knowing the signs of common knee injuries will help you make better decisions.

As you can see from the signs described above, it can be a challenge to differentiate if you have a meniscus injury or ligament injury. In fact, it’s difficult for your doctor or physical therapist to know because the accuracy of the existing clinical tests is relatively poor.

However, the next time you go see your doctor, he/she will be impressed with your knowledge and you will most likely be able to give them a clear picture of your symptoms, so they can diagnose you more accurately.

An honest and accurate description of your symptoms is the best information you can give your doctor.

What Should You Do for Your Knee Pain?

We’ll get back to our question from earlier.

What Do You Do?

a. Go to the doctor
b. Wear a knee brace
c. Get worried and anxious
d. Rest it
e. Move it
f. It depends (Correct Answer)

I’m a physical therapist and like answer F, “It depends.” Before you roll your eyes at my choice, I will explain each of these answers in more detail to provide you with practical tips.

The default answer to individual questions regarding knee pain or other injuries is usually “It depends.”

There are two main reason why “It depends” is a common response from your doctor or physical therapist:

Case-By-Case Basis – Each individual will have a different presentation. One person may have a meniscus tear and another person may have patellofemoral pain. Their presentations may look very similar; however, there may be slight differences. The true answer to the question, “What do I do?” will be highly specific to each individual.
Accuracy of Clinical Tests – As I mentioned before, the clinical tests for the knee are not very accurate. This does not mean the test are worthless, but we need to look at the big picture. A more accurate diagnosis can be made when looking at the big picture such as the cause of the injury, the description of the pain, how the symptoms respond to movements, etc. There are many factors that help determine what is wrong with your knee and how to find the right treatment for your knee pain.

Now, let’s discuss the other options…

Go to Your Doctor

There are cases when you should go see your doctor.

If you are unable to put any weight onto your knee, it’s a good idea to visit Urgent Care or schedule a visit with your primary care doctor to get your knee checked out. If you hear a loud “pop”, you may want to see your doctor or go to Urgent Care. If your knee pain persists, then you may want to see your doctor. In some states, you can go see a physical therapist without a referral from your doctor. This might save you time instead of waiting for a referral to see a physical therapist.

Wear a Knee Brace

There are cases when a knee brace can help.

A knee brace can provide immediate relief to your knee pain. The knee brace is unlikely to fix your knee pain, but it can reduce pain for some people. The brace may provide stability to your knee depending on the type of brace you use. Stabilizing the knee will be important for ligament injuries.

Get Worried and Anxious

There are cases when worry and anxiety can make your pain worse.

Pain is affected by emotional states. In a state of worry and anxiety, pain levels can increase and make you more sensitive to pain.
It is important to stay calm and make good decisions instead of getting stressed out. If you are really worried about your knee pain, then schedule a visit with your doctor and get it checked out.

Rest It

There are cases when knee pain will go away on its own.

If you rest the knee, your knee can begin the healing process. In many cases, the knee can fully recover if you rest it. Most of the time, the knee will heal faster by doing the right exercises. The right exercise will promote blood flow, restore normal range of motion, and increase strength of the knee.

Move It

In most cases, you want to move your knee. There are few cases in which you do not want to move your knee. If you don’t move your knee, the knee will get stiff. Even if you plan to get surgery, you still want to move your knee prior to surgery to avoid stiffness.

As stated earlier, performing the right movements can help your knee heal faster. Strengthening the right muscles can take pressure off the knee and alleviate pain. Correcting poor control of your movements can help your knee.

Conclusion

In summary, you may want to initially rest your knee then start moving it. In cases of severe knee pain, you should see your doctor. In almost every case of knee pain, you should be moving your knee by performing the right strengthening exercises and correcting problems in your movements.

A physical therapist can help you with these specific exercises to get out of knee pain without surgery or injections.

To avoid knee pain in the future, you should learn how to squat, lunge, and control your knee position with activities. Poor habits with squatting, lunging, running, and daily movements can lead to knee pain and arthritis.

There is a high cost to getting knee surgeries and injections and I would recommend that you use those options as a last resort. Even if you get surgery or an injection, you’ll still have to do physical therapy for months afterwards.

Take the Next Step: Invest in Your Body

Be proactive by taking care of your knees so you can avoid future injuries. Investing in the long-term health of your body will help you stay fit and active for many years.

I’ve designed a comprehensive 2-month online program to optimize movements in the body to avoid injuries and improve performance. The exercises are based on the most effective techniques used by physical therapists to restore functional movement.

I’ve seen many lives changed by implementing the exercises used in this program.

Contact me if you are interested otherwise I'm happy to respond to comments in this forum.