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Physical therapy for knee complaints.

During the examination, the possible cause of your knee problems will be examined. Especially with knee problems, it is necessary to get a clear picture of the symptoms. The questioning along with additional orthopedic testing provides a clear physical therapy diagnosis. Based on this examination, a treatment plan is developed. We find it very important that you understand how possible the complaints arise and what you can take into account to recover as quickly as possible from your complaints! In addition to specific advice, treatment may include increasing mobility through manual therapy, various muscle techniques and training the muscles through exercise therapy and strength training. With some knee problems a longer rehabilitation is necessary, especially when the goal is to be able to perform your sport with full conviction again.

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How do knee problems occur?

Knee pain can develop slowly or be present suddenly due to a fall or accident. In our practice, we often see sports injuries. For example, you may twist your knee on the soccer field or suffer symptoms through contact with your opponent. We often see then that the knee gives swelling. Usually this indicates injury within the joint. Climbing stairs and simple things like getting up from a chair can cause problems at that point. We see the following knee complaints a lot in our practice. When the symptoms slowly worsen over time we often speak of an overuse injury. In this case it is often the tendons or muscles that cause the complaints in the knee. Osteoarthritis in the knee is more common as we age. Cartilage then becomes of lesser quality and can potentially cause pain. Osteoarthritis in the knee does not mean that there is always pain provocation. But when symptoms match image on, for example, a X-ray then the pain may well be due to osteoarthritis.

Anatomy of the knee

A joint is a place in the body where two pieces of bone come together. In the knee, this is the femur (upper leg) and the tibia (lower leg). Between these bone parts is cartilage which has a very smooth surface so it can move smoothly. To properly control the knee joint, there are different types of ligaments in and around the knee. On the inside and outside are the collateral ligaments. Between the femur and tibia is the inner and outer meniscus which acts as a shock absorber between these two parts of the bone. In the knee there is the anterior and posterior cruciate ligament. The anterior cruciate ligament provides passive stability. Tires, bones, capsules and the position of joints provide passive stability you have no control over. Active stability is controlled by muscles and tendons. So you do have control over this. Active and passive stability together determine how stable a joint is.

Causes of knee pain

Knee pain can have many different causes. Certain knee complaints are more common than others. Here are some common knee complaints.

Meniscus complaints: The knee has a medial (inner) meniscus and a lateral (outer) meniscus. The meniscus looks like two half-shaped moons sitting on the lower leg. When the knee has to make a quick and forceful rotational movement during sports, a meniscus injury can occur. Because inner meniscus is attached to the capsule of the knee, it gets damaged much faster. When the knee moves into a vulnerable position, the inner meniscus is much less flexible and, as a result, much greater forces are released on the inner meniscus. In addition to this acute form of meniscus injury, the injury can also develop gradually. Minor damage can also cause long-term symptoms. Read here further on meniscus complaints.

Front cruciate ligament injury: An injury to your anterior cruciate ligament(VKB) is one of the most common injuries to the knee joint. Every year more than 860,000 knee injuries occur during sports in the Netherlands. A large proportion of these involve an injury to the anterior cruciate ligament. The VKB is very important for the stability of your knee during sports. When your anterior cruciate ligament is torn, we see a decrease in the stability of the lower leg compared to the upper leg. This injury usually occurs without an opponent nearby where you have to brake explosively. You are also at a higher risk of injuring your anterior cruciate ligament in movements where you have to turn, cut or jump quickly. To get back to your old level of sports, it's important to know what your options are. Read here on about an anterior cruciate ligament injury.

Osteoarthritis: about 600,000 Dutch people have osteoarthritis of the knee. It is more common in women than in men. Each year, about 21,000 men and 33,000 women develop complaints of osteoarthritis in the knee joint. The risk of osteoarthritis increases with age. Just like gray hair and wrinkles in the body on the inside, it is also subject to wear and tear. A natural process and nothing to worry about. However, if the symptoms match the image on an X-ray or MRI, then the symptoms are probably due to osteoarthritis. Read here more about knee osteoarthritis.

Muscle- and tendon-related complaints of the knee: On the front of the knee runs the tendon of the quadriceps. Among other things, this muscle stretches the knee and keeps the kneecap in place. When overloaded, this tendon can become irritated. The symptoms are then usually located just below the kneecap and can cause an unpleasant feeling when you tighten this muscle. We see these complaints most often in sports such as volleyball and basketball where there is a lot of jumping. Hence, this complaint is also called a Jumpers knee. Symptoms of a Sweaters knee are often:

Pain at the front of the knee
Startup complaints
Pain when climbing stairs
Pressure under the kneecap causes symptoms

Common Knee Problems

Patella Femoral Pain Syndrome

The Patella Femoral Pain Syndrome involves complaints at the front of the knee, often caused by overuse and is most common in young women. The pain, which worsens with activities such as climbing stairs or sitting for long periods of time, is attributed to the imbalance between load and load capacity of the knee. Treatment focuses on restoring this balance, often through exercise therapy and adjustments in daily activities.

For more information, visit our page on Patella Femoral Pain Syndrome.

Sweaters Knee

A condition particularly common in athletes who do a lot of jumping, such as volleyball or basketball. It is characterized by pain at the front of the knee caused by irritation of the tendon that connects the kneecap to the tibia. Treatment focuses on adjusting sports load, improving flexibility of surrounding muscles, and a specific exercise program to promote tendon repair.

For more information, visit our Sweaters Knee page.

Post-traumatic osteoarthritis

This condition occurs after a serious injury, such as an anterior cruciate ligament injury, and can lead to osteoarthritis in the knee. It is more common in young people as a result of sports injuries. Post-traumatic osteoarthritis is manifested by pain, stiffness, and decreased mobility in the knee. Treatments range from physical therapy aimed at strength and mobility improvement to surgical intervention in more advanced cases.

For more information, visit Post-traumatic Osteoarthritis After a Knee Injury.

Injury to the Posterolateral Complex of the Knee

This type of injury occurs with damage to the structures on the outside and back of the knee, often caused by a fall or twisting. It leads to instability symptoms and may be accompanied by injury to other knee components such as cruciate ligaments or meniscus. Treatment depends on severity and can range from physical therapy to surgery, especially if other structures are involved.

For more information, visit Injury to the Posterolateral Complex.

Cyclops syndrome (arthrofibrosis)

This is a complication that often occurs after anterior cruciate ligament surgery, characterized by scar tissue formation that causes pain at the front of the knee and interferes with full mobility. It usually occurs between 8 and 32 weeks after surgery, with stretching of the knee being painful and sometimes accompanied by an audible "click. Treatment may require surgical removal of the scar tissue, especially if it causes significant symptoms.

For more information, visit Cyclops Syndrome.

Runner's Knee

A common condition in runners, characterized by pain on the outside of the knee. It results from irritation of the tendon, the tractus iliotibialis, which becomes overloaded during activities with an increase in intensity or frequency. Treatment includes finding a balance between load and rest, and specific exercises to repair and strengthen the tendon.

For more information, visit Runner's Knee.

Popliteus

The Popliteus plays a crucial role in the stability and function of the knee, especially in rotational movements and bending of the knee. Complaints to this muscle can range from overuse to acute trauma, with symptoms such as a feeling of swelling or pinching in the knee area and limited movement. Treatment often addresses overuse complaints, especially in runners, and includes exercises for improved control and stability.

For more information, visit The Popliteus.

Meniscus Problem

Acute meniscus problems are common in sports that require jumping and twisting movements. Symptoms such as swelling, instability, and lock symptoms can indicate meniscus injury. Treatment focuses on recovery through physical therapy, which can help improve stability and reduce pain, with or without surgical intervention depending on the severity of the injury.

For more information, visit Meniscus Problem.

Osgood-Schlatter Disease

This condition often occurs in young athletes during growth spurts, characterized by pain below the knee. It is caused by excessive traction on the attachment of the thigh muscle to the tibia, resulting in irritation and sometimes a visible bump. Treatment usually includes adjustments in activity level and targeted exercises to relieve symptoms.

For more information, visit FysioFitaal - Osgood-Schlatter.

Patellofemoral Pain Syndrome

This syndrome causes pain around the kneecap, especially during activities such as stair climbing, squatting, and squats. It is more common in young adults, especially in young women. The condition is characterized by pain, stiffness, or a feeling of instability. Treatment focuses on strengthening the quadriceps and other surrounding muscles to better support the kneecap and reduce strain.

For more information, visit FysioFitaal - Patellofemoral Pain Syndrome.

Medial Tibial Stress Syndrome (MTSS)

Medial Tibial Stress Syndrome (MTSS), also known as "shin splints," is characterized by pain along the inside of the shin bone, often experienced by runners or athletes who do a lot of jumping. It results from repetitive strain, leading to overuse of the muscles, tendons, and bone. Treatment and rehabilitation focus on reducing the pain through rest and gradual buildup of activity, strengthening exercises for the lower extremities, and adjustments in training regimens or footwear.

For more details, visit Medial Tibial Stress Syndrome.

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