If you’ve ever experienced significant or persistent knee pain, you know that it can be a major problem.

Climbing stairs or even just walking around can bring about great agony, and can often result in a decrease in function and prevent you from completing those activities of daily living that you were previously doing.

Knee pain is a common problem that can occur suddenly or gradually worsen over a period of time. It can be the result from a number of different problems that affect many of the different structures that support the knee joint.

Osteoarthritis, tendinitis, and poor joint mechanics/skeletal malalignments can all cause significant amounts of pain on the knee.

Brooke Chapman, Exact Physiology, Exercise Physiologist

Other common knee injuries that may cause pain include sprains (where the ligaments within the knee joint are overstretched), strains (where the muscles and tendons that surround the knee are overstretched), tearing of the cartilage that lines the joint/s, and even irritation of the kneecap joint.

If the knee joint is not functioning properly, then there is an increase in the amount of stress that is placed on the different structures within the joint. As a result, you may experience irritation and inflammation, causing subsequent pain and undue wear and tear on the joint.

Knee Joint

The knee joint is one of the strongest and most important joints in the human body. It allows for the lower leg to move relative to the upper leg (or thigh) whilst supporting weight of the body. Movements at the knee joint integral for many everyday activities such as walking, running, sitting and standing. The knee joint connects the thigh bone (femur) to the shin bone (tibia). The smaller bone that runs alongside the tibia, known as the fibula, and the kneecap bone (patella) are the other bones that also make up the knee joint.

There are tendons that connect the knee bones to muscles within our legs that move the knee joint. Ligaments then joint the knee bones and act to provide stability to the joint.

• Anterior Cruciate Ligament – prevents the femur from sliding backward on the tibia (or the tibia sliding forward on the femur)
• Posterior Cruciate Ligament – prevents the femur from sliding forwards on the tibia (or the tibia sliding backwards on the femur)
• Medial & Lateral Collateral Ligaments – prevent the femur from sliding side to side

Common Knee Conditions

• Chondromalacia Patella – also known as patellofemoral syndrome, is irritation of the cartilage on the underside of the knee cap (patella). This is the most common cause of knee pain in young people.
• Osteoarthritis – most common form of arthritis that most often affects the knees. Caused by aging and wear and tear on the joint cartilage.
• Knee effusion – build-up of fluid inside the knee, usually caused from inflammation.
• Meniscal tear – damage to the meniscus (cartilage that cushions the knee), often occurs with twisting the knee.
• ACL strain or tear – the ACL is largely responsible for stability of the knee. A tear often leads to the knee “giving out”. May require surgical repair.
• PCL strain or tear – can cause knee instability. Less common than ACL tears. Physical therapy usually the best option.
• Patellar subluxation – kneecap slides abnormally or dislocates along the thigh bone during activity.
• Patellar tendonitis – inflammation of the tendon connecting the kneecap to the shin bone. Mostly occurs in athletes from repeated jumping.
• Knee bursitis – Pain, swelling and warmth in any of the bursae of the knee. Often occurs from overuse or injury.
• Gout – form of arthritis caused by a buildup of uric acid crystals in the joint.

Benefits of Exercise for Knee Pain

A thoroughly developed and individualised exercise program can be of benefit for those that have knee pain. This is because it can aid in strengthening the muscles that surround the knee, consequently increasing the joint’s stability.

In addition, It can focus on addressing any particular muscle weakness, tightness or skeletal malalignments. These could be what is contributing to the pain experienced.

Both strength and flexibility exercises should be implemented into a regular exercise routine. The should focus solely on the muscles that surround the knee joint, including your hamstrings, quadriceps and calves. Strengthening exercises will focus on correcting any weakness that may contribute to the knee pain. When stretching the muscles, you should feel tension in that muscle, but not pain. If you do experience pain whilst completing the stretch, ease off until it is no longer painful. It is recommended that you stretch at least once a day and if you exercise, you should stretch before the exercise after warming-up and immediately following your exercise session.

Proof Exercise works to decrease knee pain!

A young patient of ours at Exact Physiology first approached our clinic with left patella tendonitis pain.

He was a young high school student who was an avid Basketball player. He reported experiencing pain on and off for six months prior to coming for his initial consultation with one of our Accredited Exercise Physiologists.

However the pain had become quite constant in the last few months.

Previous history of bursitis in the knee was also reported by the patient.

When asked, the patient reported his pain to be an 8-9/10 at worst and at it’s best rating a 4/10. The patient also reported severe pain when jumping during Basketball training and games and also whilst running.

This patient was seen by our Exercise Physiologist monthly for 4 sessions. The initial program incorporated basic knee strengthening exercise to help build back the foundation strength to the muscles that surround the knee joint to aid in support and mobility. With reported improvements in pain levels and decreased pain experiencing playing Basketball and running, the patient’s program was progressed each month to incorporate weighted and resisted exercises. Exercises were then progressed to more complex exercise to continue to build and maintain the strength of the muscles surrounding the joint.

The patient reported completing his exercise program daily between each consultation and found that the days he did not complete the exercises, he could feel slight bouts of pain. By his final session with the Exercise Physiologist, the pain reported no pain jumping in Basketball training and games, and no pain whilst running. He could also feel a significant improvement in the strength of his legs and commented on how much more supported his knees felt. His reported pain levels at the final assessment were at worst 1-2/10 and at best 0/10.

In Conclusion

If you are experiencing knee pain, come see one of our Accredited Exercise Physiologists at Exact Physiology where they will be able to deliver a quality musculoskeletal assessment and prescribe an individualised exercise program to aid in strengthening the knee joint and reducing the levels of pain experienced.