The knee is a highly mobile joint.
The joint surfaces between the thigh bone (femur) and the leg bone (tibia) are quite shallow and the contact between the two bones is increased by the presence of a thick cartilage (menisci) located along the margins of the lower leg bone. This design causes the joint to be heavily reliant on muscle support to allow for smooth and pain free movement.
Pain in the knee
Pain in the knee can be caused by any of the structures surrounding the joint. There can be changes to the joint surface caused by wear and tear (osteoarthritis) or due to injury (traumatic arthritis). You can stress the ligaments causing a sprain or tear i.e. torn anterior cruciate ligament. You may tear the edge of one of the menisci causing the knee to intermittently lock or give way. You can strain the muscles and tendons causing tendonitis i.e. Jumper’s knee or your pain may be caused by enlargement of the fluid filled sacs located around the knee resulting in a bursitis or a Baker’s cyst.
Knee cap (patella) and the tib-fib joint
The knee anatomy is further complicated by the presence of two other joint surfaces – the knee cap (patella) and a small joint located at the outer aspect of the knee – the tib-fib joint. The patella causes a condition called Patello-femoral syndrome. This is a rubbing on the surface adjacent to the femur that is frequently caused by alterations in muscle strength and length. Although the tib-fib joint is a smaller, non-weight bearing joint, changes to these surfaces can sometimes be the source of those difficult to diagnose symptoms. This joint is particularly problematic after ankle injuries as the lower fibular ligaments are frequently sprained and this can cause a change in movement at the upper end of the bone.
At The Orthopaedic Therapy Clinic your therapist will partner with you to determine the best course of treatment for your injury. When you are having symptoms the most important first step is to understand what you have. Your therapist will provide a thorough assessment to determine whether your symptoms are caused by the joint, ligament, muscles, bursa or are referred from other structures such as the low back.
Once the injury is diagnosed the next step is to determine where you are in the recovery sequence.
Treatment is predominately determined by your stage of healing as more acute injuries usually require a plan to reduce pain and inflammation. Some knees will benefit with bracing and when required we will help you to determine the best type of support to protect the injury as you recover. As you continue to heal the focus of your therapy shifts to the restoration of flexibility, rebuilding strength and re-establishing normal movement patterns. The final stage is to determine a strategy to help you return to full activity, sport and long-term prevention.
Our therapists have extensive experience in the care of both the acute and chronic knee conditions. We work with clients after ligament injuries, fractures and dislocations. We treat osteoarthritis and meniscal tears. We provide therapy both in non-operative and post-operative knee conditions.
Contact us at 416 925 4687 or physio@orthophysio.com
