Continuing from part 1, we look at a few more common causes of knee pain. In part 3, we’ll cover some simple self care advice for minor knee injuries, and a few things you can do to help keep your knees healthy.
Patellofemoral pain
Patellofemoral pain is pain that occurs under and around the kneecap. There may be a “grating” or “creaking” feeling when the knee moves, and it is often worse when going up or downstairs.
The patella (knee cap) is a bone that sits inside the quadriceps tendon. Normally, it glides smoothly over the front of the femur (thigh bone) as the knee bends and straightens. Anything that alters this movement can cause pain, as the surfaces start to rub against each other causing irritation. This most often happens as the result of an injury or impact to the knee joint, or because of an imbalance of tension in the muscles around the knee. Foot problems (such as “flat feet”), overuse of the knee joint, and sudden changes to the amount or intensity of your training may also be factors.
Over time, repeated irritation can cause damage to the cartilage on the back of the knee cap, making the pain much harder to resolve.
Treatments for patellofemoral pain typically start with rest and anti-inflammatory medications such as ibuprofen to reduce pain and inflammation. At the same time, specific exercises are used to strengthen and balance the muscles around the hip and knee joint. In some cases, taping or bracing can also help to reduce pain. Depending on how severe the problem is, it may take several months to improve. Surgery is rarely either necessary or useful.
Other causes
Bursitis is the inflammation of one of the small fluid filled sacs around the knee joint. This can cause a sharp stabbing pain when pressure is put on the area. The pain is normally very local; sometimes people describe it as a “feeling like I knelt on a drawing pin”. The best solution to this problem is prevention. Bursitis is often caused by repeated impact or heavy pressure to the area; wearing knee pads in training will reduce your chance of getting it. Usually, bursitis is treated with anti-inflammatories (eg ibuprofen), and by avoiding pressure or impact until the problem has resolved. There’s a previous blog on the topic here.
Infections around the knee joint can sometimes occur, especially when there are cuts or grazes around the knee. Mat burns are common culprits, as this can be an easy route for bacteria to find their way underneath the skin. Untreated, these infections can develop quickly – sometimes within hours – and find their way into the knee joint, causing swelling, pain and stiffness. If you experience these symptoms then get medical attention immediately - waiting a day for an appointment could be the difference between taking a course of antibiotics and needing surgery on your knee. To prevent infection, clean cuts and grazes thoroughly before using an antiseptic cream or gel and make sure they are covered at all times in training. See a doctor at the first sign of infection (pain, heat and redness).
