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Can Osteopathy Help With Knee Pain?
30 January 2020
Most people know that osteopaths treat back pain. The truth is, osteopaths have a detailed understanding of human anatomy and physiology that goes far beyond simply looking at the spine…
For example, knee pain is one of the most common complaints that we see in our practice and it tends to affect people of all ages. Knee pain is often the result of an injury, such as a sprained/ruptured ligament/tendon or torn cartilage. Medical conditions — including arthritis, gout and infections — also can cause knee pain. Unfortunately, a total rupture or tear of one of the soft tissues within the knee will often require a surgical repair. Thankfully, the majority of patients we see complaining of knee problems can be helped very effectively by osteopathic treatment and a rehab program that we can help devise.
The signs and symptoms that patients with knee problems present to us with include:
• Swelling and stiffness
• Redness (and warmth to the touch)
• Weakness or instability
• Grinding, popping or crunching noises
• Locking : An inability to fully straighten or bend the knee
A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursae) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Some of the more common knee injuries include:
• Anterior/Posterior cruciate ligament (ACL/PCL) — two of the ligaments that connect your shinbone to your thighbone. ACL & PCL injuries are particularly common in people who play sports that require sudden changes in direction.
• Fractures. The bones of the knee, including the kneecap (patella), can be broken during any traumatic impact. People whose bones have been weakened by osteoporosis can sometimes sustain a knee fracture with very little trauma.
• Torn meniscus/cartilage. The meniscus is formed of tough, rubbery cartilage and acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.
• Knee bursitis. Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint.
• Patellar tendinitis. Tendinitis is essentially an inflammation of the tissues that join muscles to bones. Runners, skiers, cyclists, and those involved in jumping sports and activities may develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the shinbone.
Some examples of mechanical problems that can cause knee pain include:
• Loose body. Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement, in which case the effect is something like a pencil caught in a door hinge.
• Iliotibial band syndrome. This occurs when the tough band of tissue that extends from the outside of your hip to the outside of your knee (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners and cyclists are especially susceptible to iliotibial band syndrome.
• Hip or foot dysfunction. If you have a hip or foot problem, you may change the way you walk to spare these sometimes painful joints. But this altered ‘gait’ can place more stress on your knee joint.
• Types of arthritis
More than 100 different types of arthritis exist. The varieties most likely to affect the knee include:
• Osteoarthritis. Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It's a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.
• Rheumatoid arthritis. The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.
• Gout. This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.
• Pseudogout. Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
• Septic arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. Septic arthritis often occurs with a fever, and there's usually no trauma before the onset of pain. Septic arthritis can quickly cause extensive damage to the knee cartilage. If you have knee pain with any of these symptoms, see a doctor right away.
Patellofemoral pain syndrome is a general term that refers to pain arising between the kneecap (patella) and the underlying thighbone (femur). We see this a lot in our practice. It's common in athletes; in young adults, especially those who have a slight maltracking of the kneecap; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.
So how can osteopathy help?... Well, osteopaths always seek to treat the underlying cause of any problem that we see. In the case of knee pain, often we must address the acute presentation first. We can do this in a number of ways: In our clinic we use Interferential Electrotherapy to relax muscles and promote local Endorphine (anti-inflammatory) release. We use soft tissue massage to aid ‘drainage’ and encourage swelling to reduce. We can use soft tissue and joint mobilisation techniques to promote more mobility within the joints and muscles and other soft tissues. We can use hydrotherapy and ultrasound therapy to also reduce swelling and inflammation. Once the acute issues are resolving we can look at other areas of the body which may be referring pain or causing undue stress on the knee. Towards the end of our hands on course of treatment we are able to help build a rehabilitation program that our patients can follow at home. We will also advise on how to minimise or avoid the factors that we know can increase your risk of having knee problems, including:
• Excess weight. Being overweight or obese increases stress on your knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.
• Lack of muscle flexibility or strength. A lack of strength and flexibility can increase the risk of knee injuries. Strong muscles help to stabilize and protect your joints, and muscle flexibility can help you achieve full range of motion.
• Certain sports or occupations. Some sports put greater stress on your knees than do others. For example the repeated pounding your knees take when you run or jog massively increase your risk of knee injury. Jobs that require repetitive stress on the knees such as construction can increase your risk.
We try to educate and help devise strategies for avoiding common triggers for knee pain so that we are less likely to see the same patients returning with the same knee complaints. Ultimately happy patients are our best source of advertising!
If you suffer from knee pain and want to know how osteopathy could help, please call us on 02082038977