Knee Pain Physiotherapy in Bristol
The knee
The knee joint is a hinge joint, which mainly allows for bending, straightening and a small degree of rotation. The tibiofemoral joint involves the thigh bone (femur) meeting the shin bone (tibia). The patellofemoral joint is where the knee cap (patella) slides on the thigh bone (femur). These joints work together, alongside ligaments, tendons and muscles to provide a stable system to help when standing and walking.
Common conditions of the knee
Osteoarthritis of the knee
Symptoms
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Pain during or after the movement
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Stiffness felt early morning or after long rest
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Swelling on the affected joint
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Tenderness around the affected joint
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Grating, popping, cracking felt during movement
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Pain common on walking and when going up and down the stairs
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There is often a restriction in bending or straightening the knee
In osteoarthritis we see changes to the cartilage of the joint as well as other secondary changes such as inflammation. Cartilage helps our joints move freely. Changes to the cartilage can lead to pain, stiffness, and loss of movement. This can in time lead to weakness around the muscles of the joint.
Important information to know:
Being overprotective and doing less can mean that you will get weaker and stiffer and eventually have more symptoms.
It is safe to exercise, and exercise doesn’t speed up the osteoarthritic process.
Many people have signs of osteoarthritis on x–rays but no symptoms. Often, changes seen on x-rays do not always correlate to the level of pain a person will report. These changes are best thought of as normal age related changes. The pain is believed to be as a result of a flare up of your osteoarthritis. This often settles as the body repairs itself. This is the wear and repair cycle.
To see how I can help reduce your pain and stiffness, make an appointment here
Anterior Knee Pain/ Patellofemoral Joint pain
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Dull ache felt on front of knee
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Pain during kneeling or squatting
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Pain felt while walking up and down the stairs
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Cracking or popping felt under the knee cap during movement
Symptoms
What is it?
Anterior knee pain (AKP) is pain in the front of your knee which is very common. It is usually not related to any significant injury and can arise at various stages of life. It is related to various structures around your knee becoming sensitive.
What are the common symptoms?
Things that may be painful may include deep squatting, walking up or down stairs and slopes, or standing up after a prolonged sitting period. You may notice clicks within the knee, do not worry about these as they are not necessarily a sign of something being wrong.
To book for a biomechanical assessment and subsequent treatment to correct this issue, click here
Patella tendinopathy
Symptoms
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Pain felt on front of knee cap and top of shin bone
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Pain felt at the start of activity, worsens with high intensity workouts
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Tenderness felt on front of knee cap and top of shin bone
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It can become a dull ache at the front of the knee as time goes by
What is it?
Patella tendinopathy is associated with pain at the front of the knee under the knee cap. It is sometime called jumper’s knee.
A tendon is the structure that attaches muscle to bone. The patella tendon (blue arrow on picture) connects the lower end of the knee cap (patella) to your shin bone (tibial tuberosity). It helps the large powerful thigh muscles (1 quadriceps) move the lower leg.
It is often caused by an overload to the tendon due to an activity that the knee is unaccustomed to or a sudden increase in activity. There may be structural changes to the tendon over time that may contribute to the ongoing pain.
It most commonly affects people in the age group 15-30. It is more common in men than women and more common in those who play sports involving jumping. Other factors thought to contribute to developing patella tendinopathy include poor fitness levels, being overweight and repetitive heavy load or strain on the tendon.
Hoffa’s fat pad syndrome
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Pain on front of knee and bottom on knee cap
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Pain flares up with knee hyperextension, standing longer, or walking up
and down the stairs
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Swelling is common around the bottom of the knee cap
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Tenderness felt on bottom of knee cap
What is it?
The infrapatellar (Hoffa’s) fat pad is a structure found within the front of the knee. It can be a common source of anterior knee pain if it becomes irritated or overloaded.
What are the common symptoms?
It is situated deep to the patella tendon below your knee cap area and will often swell with a “horseshoe swelling” under your knee cap area if irritated. This is nothing to worry about and is a normal presentation for this to occur.
You will often feel pain over the site of this swelling, sometimes more to one side of the swelling than the other but it can be both sides equally. The irritation of this structure is often caused by a subtle change in the way we are loading our knee (altered biomechanics). Sometimes this is caused when people over-straighten their knee naturally (hyper-extend).
Lateral knee pain/ Runner’s Knee
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Pain on outside of knee most commonly due to Iliotibial band irritation.
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Pain on knee movement
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Pain settles with rest
What is it?
Lateral (outer) knee pain can be caused by several things, but the most common cause is
Iliotibial Band Syndrome, an overuse injury due to the Iliotibial band moving across the outside
of knee joint.
The iliotibial band, a thick band of fibrous tissue that runs down the outside of the leg, works in coordination with several of the thigh muscles to provide stability to the knee and to help in flexion of the knee joint (see picture above). When irritated, movement of the knee joint becomes painful and usually worsens with continued movement.
Pre-patellar bursitis
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Pain on front of knee, pain usually increases with activity
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Commonly difficult to kneel on your knee
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Tenderness felt on front of knee cap
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Swelling on front of knee cap
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Skin on front of knee becomes warm and red in bursal infection
What is it?
This is inflammation of the small sac of fluid at the front of the knee (bursa) it is often caused by repetitive or prolong period of kneeling. The bursa is present to prevent friction. If this becomes inflamed it can be painful. It can also be caused by a one off injury or by an infection.
Treatment from Physiotherapy: Knee pain
Along with advice, manipulation, strapping, muscle stimulation and home exercises, The Storm Clinic can also offer you (click on the links for more information)
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Acupuncture sessions could potentially help in reducing inflammation of soft tissue and cartilage, which may be common causes of hip pain and long-term discomfort.
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Shockwave therapy is a physical treatment that uses high-energy acoustic waves — known as shockwaves — to treat musculoskeletal pain and promote the healing of painful tissue. It works by stimulating increased blood circulation and cell growth, improving elasticity in the affected area, and ultimately reducing inflammation and pain. In some cases, it can be very effective in breaking up scar tissue or calcifications.
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Laser therapy helps to accelerate the healing process, reduce pain and reduce swelling.
To book a consultation click here
