Externally, the knee seems like a simple structure, but underneath is a complex network that brings movement to the largest and most mobile joint in the body. Since it is vital for movement, the extent of work and the pressure it receives on a daily basis can stress out the knees, making it prone to injury. As a matter of fact, knee problems are one of the leading causes of disability in Singapore.
The basic components of the knee include:
The knee is a synovial joint that connects your thigh bone (femur) to the shin bone (tibia). The fibula is a long thin bone that runs alongside the fibula from the knee to the ankle. The kneecap (patella) is a triangular bone that sits in front of the knee with the ability to move as the knee bends.
The knee has two types of cartilage, the meniscus and the articular cartilage. The meniscus is a crescent-shaped disc that acts as a shock absorber as it cushions the bone so that it doesn’t rub against each other with movement. The articular cartilage is the thick layer of shiny cartilage that sits behind the patella.
Ligaments are tough bands of fibrous tissues that act like ropes to connect the bones from other bones. It provides stability and strength to the knee joints. The knee is supported by the following ligaments:
Anterior Cruciate Ligament (ACL) – It limits the forward motion of the shin bone in relation to the thigh bone. Limits some rotation and sideways motion of the knee.
Posterior Cruciate Ligament (PCL) – Attaches your thigh bone and shin bone.
Medial Collateral Ligament (MCL) – Limits the sideways movement of your thigh bone.
Lateral Collateral Ligament (LCL) – This ligament also limits the sideways movement of your thigh bone.
Tendons are elastic tissues that are made up of collagen that connect your bones to the muscles. Just like your ligaments, they also provide joint stability.
It is a membrane that surrounds the knee joint and it’s filled with synovial fluid that nourishes and lubricates the joints.
These are fluid-filled sacs that cushion the knee joint to reduce friction between the muscles, bones, tendons, and ligaments.
The muscles that work the knee include the quadriceps, hamstrings, and calf muscles. They all work together to flex, extend, and stabilise the knee joint. These motions allow the body to perform important movements like walking, running, jumping, kicking.
Common Causes of Knee Joint Pain
There are 3 classifications for the causes behind knee pain. These are acute injuries, underlying conditions, and overuse. Here’s a quick run down the different causes that fall under the three major categories.
Acute injuries result from a sudden injury due to a single incident. This may be a twist, fall, excessive force, or a direct blow from a solid object. These types of injuries are often acquired in sports.
Also known as a blown knee, it is a serious injury that involves three parts of your knee – the anterior cruciate ligament, the medial collateral ligament, and the medial meniscus.
A popping or tearing sound at the time of injury.
Difficulty in moving the knee
An unstable knee
Bruising appears after a day or two.
Ligament damage often occurs in sports injuries.
This can severely limit your movement.
An ACL tear is one of the most common knee injuries that is caused by sudden stops or changes in direction when jumping and landing.
Common injury in football, basketball, and downhill skiing.
This is a type of knee pain that is associated with a pre-existing disease or condition. Proper diagnosis and treatment is essential to help alleviate knee pain and other accompanying symptoms that make it worse. The goal of treatment is to reduce inflammation and restore joint function.
Type of Injury
An inflammation of your knee joint that limits your range of motion.
Virtually any form of arthritis can affect the knee, this includes
McMurray Test. Also known as McMurray Circumduction Test, this is used to evaluate if individuals suffer meniscal tears.
Apley Grind Test. This is a maneuver that is done to detect meniscal tears.
Valgus Stress Test. Also referred to as medial stress test. This is used to check for any damage to the medial collateral ligament of the knee.
Lachman Test. This is used to diagnose ACL injuries.
X-ray. This is a safe and painless test using minimal radiation to capture an image of the internal structures of a patient’s knee.
Computerized Tomography (CT) Scan. This shows cross-sectional images of a specific area of your body.
Magnetic Resonance Imaging (MRI). It provides detailed images of various sections of the knee, like the bones, cartilage, tendons, ligaments, muscles, and blood vessels.
Knee Arthroscopy. It is a surgical technique that can help diagnose and treat problems in your knee joint using a special tool called an arthroscope.
Joint Aspiration. A procedure that removes fluid from the space that surrounds the joint using a needle and syringe.
How to Find Relief from Knee Pain
There are different ways to alleviate knee joint pain. It can range from non-medical remedies to medication and procedures.
Exercise.Research consistently supports that exercise is an effective means of relieving knee pain. Regular exercise strengthens the muscles around the knee, improves your posture, and helps you shed those excess pounds, all of which reduce pain.
Warm and Cold Therapy. This is an inexpensive way to relieve knee pain. Heat relaxes the muscles and joint stiffness, while a cold compress reduces inflammation and swelling. These two can be alternated to enhance pain resolution.
Diet Adjustments. There are certain diet options that can either ease knee joint pain or trigger inflammation. You can consult your doctor or a dietician for a meal plan that will also help knee problems.
Weight Reduction. Each pound of weight you lose also reduce the load on your knees. Less pressure means less wear and tear.
P.R.I.C.E. This stands for protection, rest, ice, compression, and elevation. This helps reduce pain and swelling after any soft tissue injury around the knees.
Massage. A soothing massage can help bring short-term relief from knee pain. It also improve stiffness allowing better range of motion.
Acupuncture. This traditional Chinese medicine helps reduce short-term pain and it improves knee function for the long or short term.
TENS (Transcutaneous Electrical Nerve Stimulation). This is electrical nerve stimulation for arthritic pain by sending electric current to your nerves to override pain signals. It also triggers the release of endorphins which are your body’s natural painkillers.
Knee pain sometimes goes away on its own. However, there are also cases where it can worsen to the point where spontaneous movement can be difficult. If pain is persistent, you should seek professional help as soon as possible.
A consultation will help you get the proper assessment and diagnosis so that appropriate treatment can be started. This improves your chances of improving knee pain and further deterioration.
If you are in Singapore and suffering from pounding knee pain, visit a trained and certified orthopaedic surgeon today to get the necessary treatment. You deserve to enjoy movement without cringing with each step. Book your appointment at the Dr. Andrew Dutton Clinic today.
About Dr Andrew Quoc Dutton
Dr. Dutton has been in clinical practice since 1996 after graduating from Marist College, Canberra and the University of New South Wales, Sydney, Australia. Dr. Dutton has worked at the Prince of Wales Hospital, Sydney and the St. George Hospital, Sydney before completing his orthopaedic surgery training in Singapore.