Pain in the kneecap

Knee pain and kneecap pain can be painful. Knee pain can be caused by muscle dysfunction / myalgia, inflammation, sciatica / nerve irritation in the back or seat, runner's knee, jumper's knee, meniscus injuries and the like.

– Common causes

Some of the most common causes are overload, trauma, wear and tear, muscular failure loads (especially the hip, thigh and calf muscles) and mechanical dysfunction in nearby joints (eg hip or pelvis). Myalgias in the thigh and hip can also refer pain to the patella at so-called active myalgias (overactive muscles). Another common diagnosis is patellofemoral syndrome. Knee pain is a condition that affects a larger proportion of the population at some point in their lives - both old and young. Those most often affected are those who have increased the amount of exercise without adequate training for the hips, glutes and nearby muscles. "Too much in too short a time" is a common denominator for many knee injury.

The Pain Clinics: Our Interdisciplinary and Modern Clinics

Our clinic departments at Vondtklinikkene (click here for a complete overview of our clinics) has a distinctively high level of professional expertise in the investigation, treatment and rehabilitation of knee diagnoses. Contact us if you want the help of therapists with expertise in knee pain.

Where's the kneecap?

The kneecap is called patella in English. You will find the kneecap in front of the knee joint where it works both stabilizing and protective.

Relief and load management for pain in the kneecap

Pain in the kneecap should always be taken seriously. It is a clear sign that your knee needs more relief. One knee compression support can help you provide improved stability and circulation in and around your kneecap. This increased blood circulation can also help to reduce swelling and fluid accumulation in the knee joint.

Tips: Knee compression support (The link opens in a new window)

Click on the image or link to read more about the knee compression support and how it can help your knee.

Knee anatomy (from front, left, and back, right)

Textures around the kneecap:

In the picture, we note in particular the rectus femoris, a part of the quadriceps, which goes over to the quadriceps tendon that attaches directly to the patella from the thigh. On the underside of the patella, we find the patella ligament that attaches directly to the tibia. We also see the extensive musculature that surrounds the knee and patella.

As we note from the pictures above, the body's anatomy is both complex and fantastic. This, in turn, means that we must focus holistically on why the pain occurred, only then can effective treatment be provided. It is also important to remember that it never does 'just muscular', there will always be a joint component, an error in movement pattern and behavior that also forms part of the problem. They only work together as a unit.

Anatomy of the patella

The patella is a thick, triangular bone that articulates with the femur. Its main task is to protect the knee joint.

This is what the kneecap looks like. Can you imagine how the tendons attach to the upper and lower sides of the kneecap?

Possible causes / diagnoses of knee pain are:

Osteoarthritis (the pain depends on which joints are affected)

pelvic locker (pelvic locking with associated myalgia can cause referenced pain to pelvis, hip and further to the knee)

Inflammation of the kneecap

Soft tissue damage

Bursitis / mucosal inflammation in the knee bowl (known as prepatellar bursitis)

Diabetic neuropathy (diabetes can cause nerve pain that can refer to pain in the middle of the knee and around it)

Gluteal myalgia (active pain from this muscle can go all the way to the kneecap)

Hamstrings myalgia / muscle damage (can cause pain to the back of the kneecap)

Iliosacral joint locking (combined with active myalgia can cause pain down to the kneecap)

Sciatica / sciatica (Depending on how the nerve is affected, it may cause referenced pain against the seat, leg, thigh, knee, leg and foot)

Jumpers knee / jumping knee

Lateral meniscus injury (can cause pain on the outside of the kneecap)

ligaments Injury

Joint locker / dysfunction in the pelvis, tailbone, sacrum, hip or lower back

Lumbar prolapse (nerve irritation / disc injury in the L3, L4 or L5 nerve root can cause referred pain all the way to the knee bowl)

Medial meniscus injury (can cause pain inside the knee)

Neuropathy (nerve damage may occur locally or further away)

Osgood-Schlatter syndrome (pain on the front and bottom of the knee bowl)

Patellofemoral Syndrome

Piriformis syndrome (may give rise to false sciatica)

Runners knee / running knee

Tendonitis in the kneecap

tendon Dysfunction

Tendon injury in the knee bowl

Spinal stenosis (tight spinal cord conditions can cause irritation down to the kneecap)

tendinitis

Tendinosis

Rare causes of knee pain:

bone cancer or any other cancer

Infection (often with high CRP and fever)

Influenza (can cause pain in almost the entire body including the kneecap)

Knee fracture

Common reported symptoms and pain presentations of knee pain:

Inflammation of the patella

Elimination in kneecap

Burning in kneecap

Deep pain in kneecap

Electric shock in kneecap

Hogging in kneecap

Kneeling in the kneecap

Knot i kneecap

Cramps in kneecap

Joint pain in kneecap

Locked in kneecap

Mooring i kneecap

Murmuring in kneecap

Muscle pain in kneecap

Nerve pain in the knee bowl

The name i kneecap

Tendonitis in kneecap

Shake in kneecap

Leaning in kneecap

Worn in kneecap

Stitching in kneecap

Steal in kneecap

Wounds in kneecap

Effect i kneecap

Sore in kneecap

Clinical signs of knee pain og kneecap pain

Swelling can occur around a trauma or through an infection.

- Reduced movement in the knee.

- Pain during prolonged sitting, for example during a seminar or flight.

- Pressure tenderness over the patella may indicate muscular or joint dysfunction.

How to prevent pain in the patella

- Live healthy and exercise regularly
- Seek well-being and avoid stress in everyday life - try to have a good sleep rhythm
- Training aimed at stability of the lower back, hip and pelvis
- chiropractor og manual therapists can both help you with joint and muscle ailments.

What can I do even for knee pain?

1. General exercise, specific exercise, stretching and activity are recommended, but stay within the pain limit. Two walks a day of 20-40 minutes make good for the whole body and sore muscles.

2. Trigger point / massage balls we strongly recommend - they come in different sizes so you can hit well even on all parts of the body. There is no better self help than this! We recommend the following (click the image below) - which is a complete set of 5 trigger point / massage balls in different sizes:

3. Training: Specific training with training tricks of various opponents (such as this complete set of 6 knits of different resistance) can help you train strength and function. Knit training often involves more specific training, which in turn can lead to more effective injury prevention and pain reduction.

4. Pain Relief - Cooling: Biofreeze is a natural product that can relieve pain by cooling the area gently. Cooling is especially recommended when the pain is very severe. When they have calmed down then heat treatment is recommended - it is therefore advisable to have both cooling and heating available.

5. Pain Relief - Heating: Warming up tight muscles can increase blood circulation and reduce pain. We recommend the following reusable hot / cold gasket (click here to read more about it) - which can be used both for cooling (can be frozen) and for heating (can be heated in the microwave).

Imaging diagnostic examination of kneskålen

Sometimes it may be necessary imaging (X, MR, CT or diagnostic ultrasound) to determine the exact cause of the problem. Normally one will do without taking pictures of the kneecap - but it is relevant if there is a suspicion of tendon injury, muscle damage, fracture of the kneecap, hip or lumbar prolapse. In certain cases, X-rays are also taken with the intention of checking for changes in wear and any fractures. Below you see various pictures of how the knee and kneecap looks in the different survey forms.

MR image of kneeneedle (lateral angle, sagittal section)

Explanation of MR image: Here you see an MRI image of a knee, seen from the side (laterally). Here we have femur (femur), patella (kneecap), patella tendon (patellasene), tibia (inner tibia) and meniscus (meniscus). This is a normal variant.

MR image of kneeneedle (coronal incision)

Explanation of MR image: Here we see an MRI image of the knee, in a coronal cut. In the picture we can see fibula, tibia, popliteus muscle, medial head of gastrocnemius muscle, semitendinosus tendon, gracilis tendon, sartorius tendon, medial meniscus (posterior horn), posterior cruciate ligament, medial femoral condyle, gastrocnemius tendon artery, vastus medialis muscle, popliteal vein, gastrocnemius, biceps femoris muscle, lateral femoral condyle, poplite tendon, biceps femoris tendon, lateral menis (posterior horn), fibular collateral ligament and peroneus longus muscle.

MRI of normal anterior cruciate ligament:

MRI of smoked anterior cruciate ligament:

Clinically proven effect on relief of knee painneedle

A study published in 2013 (Barton et al) showed that those with weak gluteal muscles had a higher risk of developing PFPS (patellofemoral pain syndrome - in the knee). Chiropractic traction bench therapy can provide symptom relief and functional improvement in spinal stenosis (Cox et al, 2012) which can be a cause of kneecap pain. A study published in 2015 (Pavkovich et al) showed that dry needling combined with stretching and exercises had symptom-relieving and function-improving effects in patients with chronic thigh and hip pain - and as mentioned, hip pain can refer to pain in the knee. A systematic review study (meta-analysis) published in 2010 (Kalichman) established that dry needling (see video example below) can be effective in the treatment of musculoskeletal pain problems.

Conservative treatment of knee pain

home Practice is often printed and used to address improper use of musculature, with the intention of providing a long-term, long-lasting effect.

Ultrasound can be used both diagnostically and as ultrasound therapy, the latter works by providing a deep-warming effect aimed at musculoskeletal problems.

Joint Mobilization or corrective chiropractic joint treatment increases the movement of the joints, which in turn allows the muscles that attach to and near the joints to move more freely. Chiropractic joint treatment is often combined with muscle work in the treatment of knee problems.

Massage It is used to increase blood circulation in the area and thus reduce muscular tension, which in turn can cause less pain.

heat treatment used to give a deep-warming effect on the area in question, which in turn can give a pain-reducing effect - but it is generally said that heat treatment should not be applied to acute injuries, as is ice treatment, e.g. Biofreeze, to be preferred. The latter is used in acute injuries and pain to help alleviate the pain in the area.

Shockwave Therapy is effective against a variety of tendon injuries that can hit the knee.

laser treatment (also known as anti-inflammatory laser) can be used at different frequencies and thus achieve different treatment effects. It is often used to stimulate regeneration and soft tissue healing, plus it can also be used anti-inflammatory.

List of treatments (both much alternative and more conservative):

• acupressure
• Acupuncture
• aromatherapy
• behavioral therapy
• Atlas Correction
• Ayurvedic medicine
• Bioelectromagnetic therapy
• Biofreeze cold treatment
• blockade Treatment
• Soft tissue work
• Bowen Treatment
• Coxtherapy
• Electrotherapy
• Ergonomics
• Dietology
• Reflexology
• Physiotherapy
• gonstead
• Healing
• home Practice
• Homeopathy
• Hydrotherapy
• hypnotherapy
• Infrared light therapy
• insoles
• Intramuscular needle therapy
• Ice therapy
• remedy
• kinesiology
• Kinesiotape
• chiropractic
• Cognitive processing
• crystal Therapy
• contrast Treatment
• Cupping
• Cold Treatment (can provide pain relief against sore joints and muscles? Blue. Biofreeze is a popular product)
• Laser
• Joint Correction
• Joint Mobilization
• Medical treatment
• Lymphatic drainage
• Light Therapy
• magnet Treatment
• manual Therapy
• Meditation
• Muscle Relaxing Medications
• muscle Knute treatment
• Myofascial technique
• Naprapathy
• Naturopathy
• Neurological rehabilitation training
• qigong
• Osteopathy
• breathing
• reflexology
• Shockwave Therapy
• Foam roll / foam roll
• Pain medication
• Spinology
• Sports support
• Stretch bench
• Power Management
• sole Customization
• Thought Field Therapy
• TENS
• Thai Massage
• Traction
• Exercise
• Trigger point therapy
• Shockwave Therapy
• Dry needle
• stretching
• Vacuum Treatment
• heat treatment
• Hot water therapy
• Yoga
• Exercises

What does a chiropractor do?

Muscle, joint and nerve pain: These are things that a chiropractor can help prevent and treat. Chiropractic treatment is mainly about restoring movement and joint function that can be impaired by mechanical pain. This is done by so-called joint correction or manipulation techniques, as well as joint mobilization, stretching techniques, and muscular work (such as trigger point therapy and deep soft tissue work) on the involved muscles. With increased function and less pain, it may be easier for individuals to engage in physical activity, which in turn will have a positive effect on both energy, quality of life and health.

Exercises and training for knee pain

An expert in muscle and skeletal disorders can, based on your diagnosis, inform you about the ergonomic considerations you must take to prevent further damage, thus ensuring the fastest possible healing time. After the acute part of the pain is over, in most cases you will also be assigned home exercises that also help to reduce the chance of relapse. In chronic conditions it is necessary to go through the motor movements you do in everyday life, in order to weed out the cause of your pain occurring time and time again. See training suggestions further up in the article.

Relevant exercises and advice: - 8 good tips for sciatica and seat pain

Also read: - 6 effective strength exercises for sore knees

In case of pain in the kneecap, tight muscles are often included in the diagnosis, so stretching the hamstrings, gluteal muscles and lumbar muscles can have a positive effect. It can also be beneficial to train stability in the hip, pelvis and lower back. Feel free to use these exercises for gentle (but very effective) training of deep lower back muscles.

Also read: - Is it tendonitis or tendon INJURY?

Also read: - Ischiofemoral impingement syndrome: A rare cause of chronic seat pain

References:

Barton et al (2013). Gluteal muscle activity and patellofemoral pain syndrome: a systematic review. Br J Sports Med. 2013 Mar; 47 (4): 207-14. doi: 10.1136 / bjsports-2012-090953. Epub 2012 Sep 3.

Cox et al (2012). Chiropractic management of a patient with lumbar spine pain due to synovial cyst: a case report. J Chiropr Med. 2012 Mar; 11 (1): 7–15.

Pavkovich et al (2015). EFFECTIVENESS OF DRY NEEDLING, STRETCHING, AND STRENGTHENING TO REDUCE PAIN AND IMPROVE FUNCTION IN SUBJECTS WITH CHRONIC LATERAL HIP AND THIGH PAIN: A RETROSPECTIVE CASE SERIES. Int J Sports Phys Ther. 2015 Aug; 10 (4): 540–551. 

Kalichman et al (2010). Dry Needling in the Management of Musculoskeletal Pain. J Am Board Fam MedSeptember-October 2010. (Journal of the American Board of Family Medicine)

Images: Creative Commons 2.0, Wikimedia, WikiFoundy, Ultrasoundpaedia, LiveStrong

Frequently Asked Questions Regarding Knee Pain:

Q: Cause of pain inside the kneecap?

There are several possible causes of pain inside the kneecap, including referred pain from nearby muscle dysfunction or hip. Other possible causes are jumper's knee, runner's knee, patellofemoral syndrome, patellasian injury, tendinopathy, medial meniscus irritation, referred pain from lumbar prolapse or osteoarthritis. If you elaborate on your problem in the comments section below, we can do more to help you.

Q: Cause of pain on the upper side of the patella?

There are several possible causes of pain in the upper part of the patella, but one of the most common is damage to the quadriceps muscle or quadriceps tendon; a so-called tendinopathy.

Q: Cause of pain on the underside of the patella?

There are several possible causes of pain in the underside of the patella, but one of the most common is patellofemoral syndrome or jumpers knee.

Q: Cause of pain on the outside of the patella?

There are several possible causes of pain on the outside of the patella, including referred pain from nearby myalgias or hip. Other possible causes are lateral meniscus irritation, patellofemoral syndrome, tendinopathy / tendon injury, referred pain from lumbar prolapse or wear and tear. There are also several other diagnoses that can contribute to pain on the outside of the patella.

Q: Can foam roll help me with the kneecap?

Yes, a foam roller / foam roller can help you in part, but if you have a knee problem we recommend that you contact qualified health personnel within musculoskeletal disciplines and receive a qualified treatment plan with associated specific exercises. Foam roller is often used against the outside of the thigh, against the iliotibial band and tensor fascia latae - which can take some pressure off the knee.

Q: Why do you get knee pain?
Pain is the body's way of saying that something is wrong. Thus, pain signals must be interpreted as meaning that there is a form of dysfunction in the area involved, which should be investigated and further remedied with proper treatment and exercise. Causes of knee pain can be due to sudden misload or gradual misload over time, which can lead to increased muscular tension, joint stiffness, nerve irritation and, if things have gone far enough, discogenic rash (nerve irritation / nerve pain due to disc disease in the lower back, so-called lumbar prolapse with affection against L3, L4 or L5 nerve root).

Q: Athlete asks - what should be done with a sore knee full of muscle knots?

muscle knots has most likely occurred due to muscle imbalance or incorrect load. Associated muscle tension can also occur around joint locks in nearby lumbar, hip and pelvic joints. Initially, you should get qualified treatment, and then get specific exercises and stretching so that it does not become a recurring problem later in life.

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