Working out what you have “done” is a challenging task let alone outlining the latest management plan which is evidence based and allows you to return to normal asap.
Accurate diagnosis is critical, and needs to be addressed in two distinct areas; pathology, and structure.
When a fracture and/or a sinister pathology is ruled out, then the inflammatory process needs early active management. This includes early use of medication with the approval of your local GP, “PEACE LOVE” recovery protocol and physiotherapy for the best possible results.
The structure that has been injured requires specific examination –
The way the injury occurred can give significant clues to the diagnosis –
- A gradual build-up of pain may point to patello-femoral or cartilage problems.
- An impact injury may point to collateral ligament damage.
- A non-contact injury may be cruciate ligaments or muscle/tendon damage.
- Did the person hear/feel a crunch, pop, snap, click as the injury occurred?
Palpation for tenderness, particularly over the joint line can also provide information on swelling and cartilage damage. Providing further clues in the restriction of joint movement as well as the integrity of muscles and tendons helps in piecing the puzzle together.
Tests for ligamentous integrity and cartilage damage provide a picture of possible instability.
A systematic approach to assessment of knee injuries can provide the answers you need to make an accurate diagnosis, good management, and correct referral to Physiotherapist, Sports Physician and if required, Orthopaedic Surgeon.
What Can I Do To Relieve Knee Pain?
The first line of treatment within the GLA:D program (which helps the population manage osteoarthritis) details education, exercise and lifestyle factors to be your first point of action.
Understanding what sort and severity of injury you have sustained and seeking the appropriate advice is a great place to start.
Under the guidance of your Physiotherapist you can begin safe guided exercises to improve the wound healing and fast track your recovery from your injury.
With some respect to your health profile you may be advised to address some lifestyle factors to aid in optimal health outcomes and a happy knee.
What Can Cause Knee Pain Without Injury?
Knee pain can be caused in a number of ways without direct trauma or injury. In most cases damage to the knee joint occurs slowly over time, and can be just as painful or significant as a direct injury.
Here are some main causes without injury –
Arthritis usually is caused by inflammation over the knee joint. Either osteoarthritis or rheumatoid arthritis can leave you with knee pain without direct trauma. Osteoarthritis is usually due to the structure inevitably wearing down over time, due to excessive stress to the joint and muscles and tendons not taking the load. Whilst rheumatoid arthritis is a chronic inflammatory disorder that affects more than just the knee joint. It will affect many joints, including those in the hands and feet.
A bursa is a thin, slippery, fluid-filled sac that serves as both a cushion and a lubricant between kneecap and skin. So when the tiny cushions within your knee begin rubbing against each other, causing the bursa’s normally thin lining to become thick and therefore produces excess fluid. The excess fluid collects in the bursa sac, causing it to swell, therefore called bursitis (swelling of the bursa due to overuse). If this occurs the pain can be long and dull, or be felt in fast, sharp pains.
Also commonly due to overuse and can be nicknamed jumper’s knee or previously called Tendonitis. It refers to the breakdown of collagen in a tendon. This causes burning pain in addition to reduced flexibility and range of motion. Often it occurs when you begin or do some physical activity that exerts the tendon. The knee pain is usually localized to under your patella, or knee cap.
Some others include –
- Chondromalacia patella which is damaged cartilage under the kneecap
- Gout – arthritis caused by the buildup of uric acid
- Baker’s cyst – A buildup of synovial fluid (fluid that lubricates the joint) behind the knee
As you can see many of these conditions are commonly associated with wear and tear to the knee or overuse because of the repetitive motion or stress
Is Walking Good For Knee Pain?
This really depends on the injury or what the cause of the pain is. But in most cases walking is very helpful for knee pain because walking allows the body to send more blood and nutrients to the injury site and in this case the knee.
If you can tolerate a good walking pattern I would highly recommend walking as a great exercise tool for knee pain as it not only improves blood flow but can also help with weight loss as reported in multiple studies one of them being Kleist et al, 2017. They found that a 12 week intervention resulted in significant reductions in body weight and fat mass by monitoring their diet and doing walking as their exercise. It also led to significant improvements in biomarkers for cardiovascular disease risk.
Walking also helps to mobilize your joint fluid and lubricate the joints which is essential for people with osteoarthritis.
What Is The Best Exercise For Bad Knees?
There is no one best exercise for bad knees but from seeing what works in the clinic and following the leading health practitioners the glutes play a major role in knee pain and knee rehab.
My go to exercise at the start of the knee rehab program is to begin with the lock clams 2×25 x 2 daily. All credit goes to Andrew Lock for this awesome variation! From rep one you feel the glutes firing if done properly.
So here are the easy steps for the Lock Clam –
- Lie on your side with bottom leg fully straight and the top leg is bent with it’s toes at the back of the bottom leg’s heel
- Now roll over till the knee touches the ground. So your hip is pointing to the floor. This is your starting position
- Lift the knee up and slowly lower to starting position, it is not a large range of movement
- As you are lifting the knee up try to keep the hip pointing down, after a few reps you will feel a burn around the glute/ back of hip region.
- Repeat this 25 times then swap sides. 2 sets/1-2 per day is plenty