Many people in the United States will experience knee issues in their lifetime. In fact, researchers used The Consumer Product Safety Commission National Electronic Injury Surveillance System database and found that an estimated 6,664,324 Americans presented with knee injuries in Emergency Rooms (ERs) alone between 1999 and 2008. The factors that play into these numbers are broad, but a high level of awareness can be helpful for prevention and early intervention.
Anatomy of a knee issue
Troubling symptoms often develop from everyday wear and tear, overuse or injury, which commonly occur during sports or recreational activities, work-related tasks or home projects.
The upper and lower bones of the knee are separated by two discs (menisci). The upper leg bone (femur) and the lower leg bones (tibia and fibula) are connected by ligaments, tendons and muscles. The surface of the bones inside the knee joint is covered by articular cartilage. It absorbs shock and provides a smooth, gliding surface for joint movement.
Problems are often caused by a trauma affecting one or more of these parts of the joint. Alternatively, some people are predisposed to knee issues. Many jobs, sports and activities, getting older, or having a disease such as osteoporosis or arthritis increases an individual’s chances of having knee complications.
Traumas are the most common cause of knee problems. Sudden (acute) injuries may be the result of a direct blow to the joint. Other scenarios include abnormal twisting, bending or falling on the knee. Pain, bruising or swelling may be severe and occur within minutes of the incident. Nerves or blood vessels may be pinched or damaged, so the knee or lower leg may feel numb, weak, cold or tingly, and might appear pale or blue.
Acute injuries include:
- Sprains, strains or other injuries to the ligaments and tendons that connect and support the kneecap.
- A tear in the rubbery cushions of the knee joint (meniscus).
- A torn ligament, such as the anterior cruciate ligament (ACL) or, more commonly, the medial collateral ligament (MCL).
- Breaks (fracture) of the kneecap, lower portion of the femur, or upper part of the tibia or fibula. Knee fractures are most often caused by abnormal force in situations such as falling on the knee, a severe twisting motion, severe force that bends the knee and the knee forcefully hitting an object.
- Kneecap dislocation, which occurs more often in active teens and young adults.
- Pieces of bone or tissue (loose bodies) from a fracture or dislocation may get caught in the joint and interfere with movement.
- Knee joint dislocation is a rare, serious injury that results from great force and requires medical care right away.
Overuse injuries occur from repetitive activities or repeated or prolonged pressure. The knees can get irritated and inflamed when you climb stairs, ride a bike, jog or jump, putting stress on your joints and other tissues.
Overuse injuries include:
- Inflammation of the small sacs of fluid that cushion and lubricate the knee (bursitis).
- Inflammation of the tendons (tendinitis) or small tears in the tendons (tendinosis).
- Thickening or folding of the knee ligaments (plica syndrome).
- Pain in the front of the knee from overuse, injury, excess weight or problems in the kneecap (patellofemoral pain syndrome).
- Irritation and inflammation of the band of fibrous tissue that runs down the outside of the thigh (iliotibial band syndrome).
Conditions connected to knee issues
Problems not directly related to an injury or overuse may occur in or around the knee and be linked to medical conditions such as:
- Arthritis, especially osteoarthritis (degenerative joint disease) may cause knee pain and often occurs at the site of a previous injury.
- Osgood-Schlatter disease causes pain, swelling, and tenderness in the front of the knee below the kneecap.
- A popliteal (or Baker's) cyst triggers swelling in the back of the knee.
- Infection in the skin (cellulitis), joint (infectious arthritis), bone (osteomyelitis) or bursa (septic bursitis), which can result in pain and decreased knee movement.
- A problem elsewhere in the body like a pinched nerve or a problem in the hip.
- Osteochondritis dissecans can cause pain and decreased movement when a piece of bone or cartilage (or both) inside the knee joint loses blood supply and dies.
Caring for knees
If an individual is experiencing discomfort, there are some things they can try at home to gain relief, such as:
- Pain relief medicines. If their doctor provided a prescription for pain, they should take it as prescribed. If a person is not taking a prescription pain medicine, they can ask their doctor if an over-the-counter medicine is appropriate. In all cases, it is important to read and follow all instructions on the label.
- Rest and protect the knees. Pause any activity that may cause pain.
- Put ice or a cold pack on the knee for 10 to 20 minutes at a time, being careful to put a thin cloth between the ice and the skin.
- Prop up the sore knee on a pillow while icing it or anytime the individual sits or lies down for at least three days following the onset of pain. They should try to keep it above the level of their heart. This will help reduce swelling.
- If there is no swelling, applying moist heat, a heating pad or a warm cloth can be helpful.
- If their doctor recommends an elastic bandage, sleeve or other type of support for the knee, the patient should wear it as directed.
- Follow doctor's instructions about how much weight to put on the leg. If recommended a cane, crutches or walker should be used as instructed.
- Follow doctor's instructions about activity during the healing process and increase activity as advised.
- Stay at a healthy weight. Extra weight can strain the joints, especially the knees and hips, and make the pain worse. Losing a few pounds may help.
The treatment plan for any knee problem is going to depend greatly on:
- The location and type of injury, and how bad it is.
- The patient’s age, health condition and activity level (taking into account work, sports, and hobbies).
Parkview Ortho Express offers quick, convenient care from orthopedic experts at two locations in northeast Indiana. Learn more about these services so you can get on the road to recovery.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.