Knee Pain
Please note the conditions below are only possible causes of your pain and many other structures can be the source of your symptoms. Therefore a thorough evaluation by a physiotherapist is necessary to make an accurate diagnosis and treat not only the symptoms but also the origin of the pain.
Patellofemoral pain syndrome
Patellofemoral pain syndrome is an umbrella term to describe pain in and around the patella. There are many structures in the patella femoral joint that are susceptible to overload. There are numerous factors that can be contributing or be the cause of the pain, for example, increased femoral internal rotation, increased knee valgus, pronated foot, lateral displacement of the tibia, poor core strength, poor FITT principles or even a change in footwear. Therefore with most injuries, not only should the pain be addressed but the predisposing factors as well.
Signs and symptoms:
The onset of pain is usually insidious but it may also occur after an acute traumatic accident like falling on the knee. Patellofemoral pain may also follow on a previous knee injury for example a previous ligament or menisci injury on the affected knee or even after knee surgery. The pain is usually described as a diffuse ache that is aggravated by activity such as running or ascending/descending stairs. Pain can also worsen after a prolonged period of sitting.
Treatment:
Joint mobilisation techniques of the joint involved will have a neurophysiological effect and will help with decrease in pain and stiffness and will restore joint kinematics.
Soft tissue treatment and dry needling of the affected muscles to decrease muscle spasm and stiffness.
Neural mobilisation of the nerve involved is used to restore neural mobility.
Taping is used to either improve joint stability or to decrease the load from the affected muscle.
Rehabilitation: To restore normal control, strength, coordination and balance in the trunk, hips and knees. Retraining of the VMO muscle with the EMG machine to restore normal patella slide on the knee.
Patellar tendinopathy
The patellar tendon is the tendon that attaches to the inferior pole of the patella and the tibia. Tendinopathy is a term used to describe damage to the tendon itself. The tendon has poor blood flow and once injured takes a prolonged time to heal.
Signs and symptoms:
Injury to the patella tendon usually occurs in activities involving jumping or changing direction like volleyball, netball, climbing stairs etc. Pain is usually present inferior to the patella. Pain and stiffness is present in the morning, decreases with activity and aggravates again after strenuous activity.
Treatment:
Joint mobilisation techniques of the joint involved will have a neurophysiological effect and will help with decrease in pain and stiffness and will restore joint kinematics.
Soft tissue treatment and dry needling of the affected muscles to decrease muscle spasm and stiffness.
Neural mobilisation of the nerve involved is used to restore neural mobility.
Taping is used to either improve joint stability or to decrease the load from the affected muscle.
Rehabilitation: To restore normal control, strength, coordination and balance in the trunk, hips and knees. Retraining of the VMO muscle with the EMG machine to restore a normal patella slide on the knee.
Lateral knee pain- iliotibial band friction syndrome (ITBFS)
The ITB It is a common problem especially among distance runners and cyclist. Training errors and biomechanical abnormalities can predispose ITBFS. The ITB is a thickening of fascia that envelops the whole thigh originating from the tensor fascia lata muscle in the hip and inserting on the lateral part of the knee. Pain at the insertion may be caused due to increased compressive loads placed on the ITB and surrounding structures.
Signs and symptoms:
Pain in the lateral knee usually occurs after activities like downhill running or running on uneven surfaces. The pain usually develops at the same distance/time during activity, for example, when you run a 5km, the pain starts every time at the 3km mark. Longer training sessions or running downhill also aggravates the pain. Once the pain is elicited with activity it aggravates and does not decrease as activity prolongs.
Treatment:
Joint mobilisation techniques of the joint involved will have a neurophysiological effect and will help with decrease in pain and stiffness and will restore joint kinematics.
Soft tissue treatment and dry needling of the affected muscles is used to decrease muscle spasm and stiffness.
Neural mobilisation of the nerve involved is used to restore neural mobility.
Taping is used to either improve joint stability or to decrease the load from the affected muscle.
Rehabilitation: To restore normal control, strength, coordination and balance in the affected structures.
Restore normal biomechanics.
