How do knee problems arise?
Knee pain can occur slowly but can also be present suddenly due to a fall or accident. In our practice we often see sports injuries. For example, you can twist your knee on the soccer field or through contact with your opponent contract symptoms. We then often see that the knee swells. Usually this indicates injury within the joint. Climbing stairs and doing simple things like getting up from a chair can already cause problems at that point. The following knee complaints are common in our practice. When the symptoms slowly get worse over time, we often speak of an overuse injury. In this case it is often the tendons or muscles that cause the symptoms in the knee. Osteoarthritis in the knee occurs more frequently as we age. Cartilage then becomes of lesser quality and can potentially cause pain. Osteoarthritis of the knee does not mean that there is always pain provocation. But when symptoms match the image on, for example, a X-ray then the pain may well be due to the osteoarthritis.
Anatomy of the knee
A joint is a place in the body where two parts of the bone meet. 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 that it can move smoothly. In order to steer the knee joint properly, 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 bone parts. In the knee is the anterior and posterior cruciate ligament. The anterior cruciate ligament provides passive stability. Ligaments, bones, capsules and the position of joints provide passive stability you have no control over. Active stability is controlled by muscles and tendons. Here you do have control. The active and passive stability together determine how stable a joint is.
Causes of knee problems
Knee problems can have many different causes. Some knee problems are more common than others. Below 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 that sit on the lower leg. When the knee has to make a quick and powerful twisting motion 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 is placed in a vulnerable position, the inner meniscus is much less flexible and therefore 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 more about meniscus complaints here.
Front cruciate ligament injury: An injury to your anterior cruciate ligament (ACL) is one of the most common injuries to the knee joint. Annually 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 ACL is very important for the stability of your knee during sport. When your anterior cruciate ligament is torn, we see a decrease in the stability of the lower leg in relation to the upper leg. This injury usually occurs without an opponent nearby where you need to brake explosively. Also, movements where you have to turn, cut or jump quickly put you at a higher risk of injuring your anterior cruciate ligament. To get back to your old level of sports, it's important to know what your options are. Read more about an anterior cruciate ligament injury here.
Osteoarthritis: Approximately 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 symptoms of osteoarthritis in the knee joint. The risk of osteoarthritis increases with age. Just like gray hair and wrinkles on the inside of the body, osteoarthritis is also subject to wear and tear. A natural process and nothing to worry about. However, if the symptoms correspond to the image on an X-ray or MRI, the symptoms are probably due to osteoarthritis. Read more about knee osteoarthritis here.
Muscle and tendon related complaints of the knee: At 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 usually just below the kneecap and can cause an unpleasant feeling when you tighten this muscle. We see these complaints most often in sports like volleyball and basketball where there is a lot of jumping. Hence, this complaint is also called a Jumpers knee. Symptoms of a Jumpers knee are often:
- Pain at the front of the knee
- Startup complaints
- Pain when climbing stairs
- Pressure under the kneecap causes symptoms
Continue reading here about a muscle or tendon related knee condition.
Physical therapy and knee problems.
During the examination, the possible cause of your knee problems will be examined. Especially with knee problems, it is necessary to get a good picture of the symptoms. The interview together with additional orthopaedic tests will provide a clear physiotherapeutic diagnosis. Based on this examination, a treatment plan will be drawn up. 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 symptoms! Besides specific advice, the treatment can consist of increasing the mobility by means of manual therapy, various muscle techniques and training the muscles through exercise therapy and strength training. Some knee problems require a longer rehabilitation, especially when the goal is to be able to perform your sport with full conviction again.