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Knee Injuries Physiotherapy: Symptoms & Treatment

Knee injuries are a common complaint in the field of physiotherapy, and they can result from a range of factors including sports injuries, falls, and overuse. Effective treatment and rehabilitation typically involve a combination of exercise therapy, manual therapy, and patient education to help individuals regain strength, mobility, and function in their knees.

As with all injuries, this information is simply a guide, and it is always best to check in with a Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.

One of the most common areas of the body that we assess at Inertia Physio+ is the knee. Injuries to the knee can result from acute trauma or from chronic repetitive strain or because of deficiencies in movement patterns, balance and muscle control. Seeking treatment for your knee pain as early as possible is advised to avoid developing undesirable compensation strategies that make your rehabilitation process longer and more challenging. Ignoring an injury can also result in other musculoskeletal dysfunctions throughout the body.

The knee is composed of three joints:

Superior tibiofibular joint – This joint is on the outside of the shin just below the knee connecting the two lower shin bones to one another.

Patellofemoral joint – This joint is the connection between the kneecap and thigh bone.

Tibiofemoral joint – This joint is the connection between the thigh bone and the shin bone.

The knee joint also has meniscal structures (cartilage) that sit between the tibiofemoral joint. Sudden movement, poor mechanics, repetitive strain from poor movement, and even the general wear and tear that comes with age can cause injury to the meniscus. The knee also has several ligaments, muscles, tendons and bursae. Injury to any of these structures can knee pain.

Common Knee Injuries

Meniscus Tears

A meniscus injury can be caused by a sudden trauma from a twisting force or can be degenerative, developing slowly over time. Signs and symptoms of a meniscus injury are a popping/clicking within the knee and/or pain when pivoting, twisting or walking on uneven surfaces. There may be some swelling and an inability to fully straighten or bend your knee.  Most meniscal injuries will respond better to conservative management rather than surgery. If you believe you may have injured your meniscus, being assessed by a Physiotherapist to determine the best course of treatment is usually a good place to start.  Your Physiotherapist can refer you on for further testing if warranted.

Knee Bursitis

Bursae are small fluid filled sacs that prevent friction where muscles and tendons slide over bone and tissues. With excessive pressure on the knee or overuse, one or more bursa can become irritated and injured. There are 11 bursae in each knee. Bursitis in the knee is most often found in the supra patellar area (above the kneecap) and the Pes anserine area (below and towards the inside of the knee). While this condition can be quite painful, it can be effectively managed with the help of your Physiotherapist or Athletic Therapist.  Please see Bursitis for further information.

Knee Ligament Sprains

A sprain in your knee can disrupt normal movement and stability of the knee. With a sprain, one or more ligaments are over-stretched when the knee is bent past its natural limits. This usually happens suddenly from a trauma or it can happen gradually when there are muscle imbalances and bone alignment issues.

The four main ligaments of the knee are the Anterior Cruciate Ligament (ACL), Posterior Cruciate Ligament (PCL), Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL). The collateral ligaments are at the sides of the knee and the cruciate ligaments cross through the centre of the knee. The need for surgery will depend on which ligament is involved and the extent of the tearing.

If you think you may have sprained your knee, it is important to seek treatment. Your Physiotherapist or Athletic Therapist can assess the injury and work with you on a successful treatment plan. Please see Ligament Sprains and/or ACL Sprains section for more information.

Muscle Strains or Tendinopathy

Several muscles cross around the front, back and sides of the knee. These muscles can become strained and inflamed when excessive demand is placed on one or more of them. As with many knee injuries, muscle strains can result from a sudden trauma or the injury can come about over time from repetitive loading and/or dysfunctional movement patterns.

The tendon (part of the muscle that attaches to bone) can also be injured in a similar way, either by a powerful muscle contraction putting a forceful pull through the tendon or repetitive loading of the muscle-tendon unit.

In Tendonitis or Chronic Muscle Strains, when the tissues go through repetitive cycles of injury, healing, and then further injury or if the breakdown is happening faster than the healing, the tendon can become damaged. Your Physiotherapist or Athletic Therapist can identify the root problem of your injury and provide you with the right treatment and a stretching and strengthening program so that you can heal properly and prevent reinjury. Please see sections on Muscle Strains and Tendonitis for further information.

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is characterized by pain at the front of the knee around or behind the knee cap.  It is usually caused by caused by irregular tracking of the patella (knee cap) along the grooves formed by the femur (thigh bone). The body is designed to have the projections on the back of the kneecap line up with the grooves in the femur and glide smoothly together as the muscles around the knee bring it through bending and straightening motions.  When things don’t line up or move well, a grinding or friction occurs between the two bones, resulting in inflammation and pain.

Patellofemoral syndrome can be common through the teenage years as muscle and tendon length is having trouble keeping up the rate of growth in the skeleton length. However, at any age, dysfunctional foot, knee or hip alignment, muscle imbalances and other factors can cause the patella to slide outside of the groove and tracks, resulting in this injury. Your Physiotherapist or Athletic Therapist can help you manage this injury, by first doing a thorough assessment to determine the cause of the injury.  Effectively treating the cause will be the key to fixing this injury. Determining what is causing the friction between the bones and removing it, so that the bones can glide smoothly again will prevent the inflammation and pain from occurring. Your Physiotherapist or Athletic Therapist can also guide you on the use of thermal therapy such as heat or ice, rest, pressure and elevation to treat the existing inflammation. You will also receive a customized exercise program to work on any strength or flexibility imbalances that may be contributing to your injury.

Registered Massage Therapy can also help loosen the muscles and other soft tissues surrounding the knee that may be causing a pull on the knee cap.

Degenerative Changes

Typically, middle to late-aged individuals are the ones who will experience osteoarthritis of the knee. Osteoarthritis may affect younger individuals who have experienced a traumatic knee injury or surgery. This degenerative process is a natural wearing of the joint over time. The cartilage that covers the bones of the joint wears down and thins. This can lead to more pressure to the surface of the bones. In response, the bones may thicken or form boney outgrowths, called osteophytes. These changes can lead to pain, inflammation, and stiffness in the knee joint.  

To avoid worsening your condition and to manage the symptoms, it is important that the muscles affecting the knee be kept strong and flexible. A healthy body weight and maintaining an active lifestyle are also valuable strategies. Your Physiotherapist or Athletic Therapist will work with you on a customized program to successfully manage your condition and prevent or manage flare-ups. Manual treatment will also consist of techniques aimed at increasing the mobility and space within the joint through traction of the knee and joint mobilizations as well as soft tissue release.

As with most conditions, Registered Massage Therapy can help as well by loosening the surrounding soft tissues to prevent any unnecessary stress on the joint.

Chondromalacia Patella

The amount of force and pressure absorbed through the knee joint and quadricep muscles is more than any other joint in the body. That is why the cartilage behind the patella (knee cap) is the thickest in the body. With Chondromalacia Patella, the cartilage behind the patella deteriorates or breaks down with time and excessive wearing. This condition is usually a result of poor alignment between the femur (thigh bone) and the patella (knee cap) combined with repetitive loading actions.

Correcting muscle imbalances around the hip, knee and feet can help to correct these imbalances, thus improving the alignment of the bones as well as the tracking of the patella. Your Physiotherapist or Athletic Therapist can work with you to create an individualized plan to help you with these corrections through both manual and exercise therapy.  The goal will be to stop further advancement of the condition and manage symptoms, so that you can continue to enjoy the activities you love.

Lumbar Radiculopathy as A Cause of Knee Pain

The knee pain you feel can sometimes originate from your lower back and not even from the knee itself. There are nerves that travel from your lower back down to your leg to the muscles, skin, and tissues of the lower body. When a nerve is irritated or compressed, it can refer pain down the leg along its pathways. With this condition, you might also experience stiffness and/or pain in your lower back. You might even find that when your back is in a specific posture it translates to pain in your knee or leg.

A thorough assessment from your Physiotherapist is important to determine the original source of your pain so that your treatment can be developed to address the pain as well as the source of the problem.

As with all injuries, this information is simply a guide, and it is always best to check in with a Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.

Contact Us For Help

Inertia Physio+ offers Kanata and Stittsville exceptional Physiotherapy, Athletic Therapy and Registered Massage Therapy with private treatment rooms, one on one care, a maximum of two patients per hour and treatment focused on the evidence-based practices of manual and exercise therapy. Don’t suffer any longer.  If you have pain or injury, our Kanata and Stittsville Physiotherapy, Athletic Therapy, and Registered Massage Therapy team is here to help you get back to living pain-free life and activities.  Please reach out to us at (613) 672-2200 or for an appointment today! You are also welcome to book online. We also offer direct billing on Physiotherapy and Massage Therapy services whenever your plan allows.


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