After back pain,  knee pain is one of the commonest complaints that medical practitioners see and can have many causes.

The knee is comprised of two joints,  a hinge joint where the tibia meets the femur (referred to as the tibiofemoral joint) and a sesamoid joint where the knee cap (patella) glides over the femur, (referred to as the patellofemoral joint).  The knee cap may be a weird looking piece of bone but it has a very important role in the function of the knee.

In a lifetime, the knee joint has to tolerate considerable stress as it carries our weight, as well as directional forces it encounters during sports and at work.

The knee joint is held together by four ligaments and the muscles of the leg. It is very often these structures which become injured during sporting activity.

Ligaments of the knee
Anterior cruciate ligament (ACL) – controls rotational movement and prevents forward movement of the tibia in relation to the femur. It is found deep at the centre of the knee joint.

Posterior cruciate ligament (PCL) – prevents the femur sliding forward of the tibia. Located deep at the centre of the knee joint, crossing the ACL

Medial collateral ligament (MCL) – prevents the tibia moving sideways to the centre.

Lateral collateral ligament (LCL) – prevents tibia moving sideways to the outside.

The Menisci (meniscal cartilage) are attached to the top of the tibia providing stability and shock absorption.

Ligaments and cartilage can be subject to tears and ruptures if enough force is applied to the joint. Many footballers, rugby players and skiiers injure these structures when the knee is twisted or forced beyond it’s normal range of movement.

Knee Pain
Pain in the knee usually falls into two categories:
Acute – Pain comes on rapidly, usually as a result of an injury.
Chronic – Pain that has been present for a number of weeks and often comes on slowly, sometimes worsening over many months.

Pain can be felt in any part of the knee but the most usual is at the front, referred to as anterior knee pain  and whilst some types of pain are easy to locate to a particular area of the knee, some conditions will cause a more generalised, diffuse pain around the joint.

Knee pain can be accompanied by swelling, bruising and tenderness.

Arthritis of the Knee
Many people are told that their knee pain is due to “wear and tear” and are informed that they have Arthritis.  However there are over 100 different types of arthritis, some of which are very rare.

The commonest wear and tear related pain in the knee is linked to Osteoarthritis, which affects the main knee joint and is caused by the articular cartilage wearing away due to age or injury.  This leaves the ends of the tibia and femur bones exposed which rub on each other when bearing weight.
Like any other part of the body, the knee joint can also be subject to diseases and inherited conditions, all of which can cause knee pain in both young and old alike.
Referred pain in the knee
We use the term referred pain when the pain in the knee is actually coming from somewhere else in the body, such as the nerves of the back or conditions like Iliotibial band syndrome.

This type of pain may also be an indicator of faulty biomechanics or gait.

Preventing knee pain

  • The Quadricep muscles (thigh), play an important role in the stability and strength of the knee.  Keeping these muscles strong is important.
  • Always use protective knee pads if your work involves a lot of kneeling.
  • Keep active – The “use it or lose it” scenario is true of all joints and muscles in our body.  Regular exercise helps strengthen bone and muscle.
  • Sports specific strengthening exercises help prepare the knee for winter sports and those such as rugby and football.
  • Avoid being overweight – In a lifetime, your knees will have to carry many tons of weight, adding to this will increase the risk of Osteoarthritis.
  • Runners should always change their running shoes about every six months, as their shock absorbing capacity declines, placing undue stress on the knee joint.

Anatomy of the knee – Take a closer look at the knee joint.

Knee pain– Take a more in depth look at the different causes of knee pain.

Exercises for the knee – A selection of basic, intermediate and advanced exercises to strengthen the knee.

Arthritic conditions of the knee – Find out more about Osteoarthritis of the knee

Knee Resurfacing & replacement – Different techniques to replace worn or damaged knee structures.

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