Pain in the knee
Having a pain in the knee and nearby structures can be extremely troublesome. Knee pain can be caused by several different factors, but some of the most common are overload, trauma (e.g. ACL injury), wear, muscular failure loads and mechanical dysfunction. Pain in the knee or knees is a nuisance affecting a large proportion of the population.
Some of the most common causes of such ailments are sudden overload, repeated overload, age-related osteoarthritis or trauma. Often it is a combination of causes that cause pain to the knee, so it is important to treat the problem in a holistic way, taking into account all factors.
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.
Scroll below for to see more good exercise videos with exerciser that can help against your knee pain.
VIDEO: Exercises for Knee Pain (Patellofemoral Pain Syndrome)
Below you will find a training video specially developed for knee pain and knee problems. The exercise program focuses specifically on hips, thighs and knees to strengthen these structures and relieve both the knee muscles, tendons and the meniscus.
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VIDEO: 10 Strength Exercises Against Painful Hips
It is quickly forgotten that stronger hip muscles can directly relieve the knees. This is because the hips have strong shock absorbing properties and thus can prevent knee overload. We recommend that everyone who is bothered with knee problems try these exercises.
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Also read: 6 Strength Exercises for Sore Knee
Relief and load management for knee pain
Pain in the knees is a clear sign that they need a breather and some relief. En knee compression support can contribute in several positive ways - but the most important comes in the form of more stability, improved shock absorption and more blood circulation towards the painful area. The increased circulation can also help to reduce swelling and fluid accumulation in the knee and 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.
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).
6. Prevention and healing: Compression noise like that like this can increase blood circulation to the affected area, thereby speeding up the natural healing of injured or worn muscles and tendons.
Recommended products for pain relief for knee pain
Biofreeze (Cold / cryotherapy)
Some possible causes of knee pain are:
Bad gait
stance
Overuse / overload
Weak ankles
Previous knee injury
Trauma
Some possible diagnoses for knee pain are:
Arthritis (Light gout)
Osteoarthritis (Joint wear)
Bacterial infection of the knee
Baker's cyst (can be seen as a swelling on the back of the knee)
Bursitis / mucosal inflammation
Fracture of the kneecap
Charcot's disease
Chondromalacia patellae (causes pain in and around the kneecap)
Cyst in the knee
Femoral condyle rupture
Dislocated / twisted knee
Wrinkled / twisted kneecap
Anterior cruciate ligament (ACL) Damage / Tear / Rupture
arthritis
Hoffa's disease
Hoppers / jumpers knee / patellar tendinopathy (causes pain on the underside of the kneecap at the front of the knee)
Howship-Romberg Syndrome
Infrapatellar bursitis (knee mucosal inflammation)
Sciatica
Johansson-Sinding-Larsen syndrome
Knee fracture
Knee infection
Parcel Damage
Meniscus Injury (meniscus rupture - may occur in the medial meniscus or lateral meniscus)
Osgood-Schlatter's Disease (affecting most teenagers)
Osteochondritis dissecans (free bone)
Paget's disease
Patellofemoral pain syndrome
Pes anserine bursitis (mucosal inflammation on inside knee)
Prepatellar bursitis (knee bowl mucosal inflammation)
Referred pain from the hip (hip dysfunction can cause knee pain)
Referred pain from lumbar prolapse (lumbar prolapse may cause referred nerve pain to the knee)
Smoked posterior cruciate ligament
Smoked anterior cruciate ligament (ACL)
Smoked lateral ligament
Smoked medial ligament
Tendonitis in the knee (knee tendonitis)
Septic arthritis
Still's disease
Synovitis (Arthritis)
Tendinosis of the knee
Tendinitis in the knee
Tendinitis in the kneecap
Classification of knee pain
Pain in the knee can be divided into acute, subacute and chronic pain. Acute knee pain means that the person has had a knee injury for less than three weeks, subacute is the period from three weeks to three months and the pain lasting over three months is classified as chronic. Pain in the knee can be caused by tendon injuries, meniscus injuries, muscular tension, joint dysfunction and / or irritation of nearby nerves. A chiropractor or other expert in muscle, skeletal and nerve disorders can diagnose your ailment and give you a thorough explanation of what can be done in terms of treatment and what you can do on your own. Be careful not to get hurt in the knee for a long time, rather contact a chiropractor and diagnose the cause of the pain.
First, a mechanical examination will be performed where the clinician looks at the knee's movement pattern or possible lack of this. Muscle strength is also examined here, as well as specific tests that give the clinician an indication of what gives the person pain in the knee. In case of knee pain, an imaging examination is often necessary. A chiropractor has the right to refer such examinations in the form of X-rays, MRI, CT and ultrasound. Conservative treatment is always worth trying on such ailments, there before one will possibly consider an operation. The treatment you receive will vary, depending on what was found during the clinical examination.
MRI image of the knee (lateral angle, sagittal incision)
MR image of knee - lateral angle - Photo Wikimedia Commons
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.
MRI image of the knee (coronal incision)
MRI of the knee - coronal incision - Photo Wikimedia
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 normal anterior cruciate ligament
MRI of smoked anterior cruciate ligament:
MRI of smoked anterior cruciate ligament
Any tendon injuries or meniscus injuries can in most cases be investigated by a musculoskeletal expert (chiropractor or similar), and further confirmed by x-ray or MRI where necessary.
Knee anatomy
Clinically proven effect on the relief of knee pain in osteoarthritis and tendinopathies.
A meta-study (Jansen, 2011) showed that specific exercise in combination with manual mobilization was significantly more effective when it came to pain relief and functional improvement among adults with knee arthritis, compared to only specific exercise or no treatment. Another study, an RCT (Taunton, 2003) published in the British Medical Journal, showed that pressure wave therapy is an alternative to patella tendinopathies that provide increased function and decreased pain - this should be done in the context of eccentric strength training, which is one of the the most effective for tendinopathies. Electrotherapy is often used in combination with one or more of these treatment modalities, depending on the diagnosis.
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 and health.
Exercises, training and ergonomic considerations.
An expert in muscle and skeletal disorders can, based on your diagnosis, inform you of the ergonomic considerations you need to 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 the case of chronic ailments, 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 again. It is important that the individual exercises are adapted to you and your ailments - for example, there are specific exercises for ACL / anterior cruciate ligament injuries (read: Exercises for anterior cruciate ligament / ACL solution) versus osteoarthritis of the knee (Read: Glucosamine sulfate against osteoarthritis of the knee). In most cases, there will be a period of low-load training where you avoid running on hard surfaces and treadmills - then an elliptical machine) can be an excellent alternative.
Self-help for knee pain
Some of the products that can help with knee pain and problems are hallux valgus support og compression socks. The former works by making sure the strain from the foot is more correct - which in turn causes less strain on the knee. Compression socks work in that they increase blood circulation in the lower leg - which in turn results in faster healing and better recovery.
RELATED PRODUCT / SELF-HELP: - Hallux Valgus Support
Plagued with hallux valgus (crooked big toe)? This can lead to a failure of the foot, leg and knee. This support can help you.
RELATED PRODUCT / SELF-HELP: - Compression sock
Anyone with bone pain and problems may benefit from compression support. Compression socks can contribute to increased blood circulation and healing in those affected by reduced function of the knees, legs and feet.
Overview of exercises for knee pain
6 Effective Strength Exercises for Sore Knee
Exercises against Jumpers Knee
Read more here: - 6 strength exercises for sore knees!
Related issues:
- Self-treatment of knee pain and osteoarthritis - with electrotherapy.
- Elliptical machine / crosstrainer (low load training for chronic knee problems)
- Prevention and training of ACL / anterior cruciate ligament injuries.
- Glucosamine sulfate against osteoarthritis of the knee
Also read:
References:
- NHI - Norwegian Health Informatics.
- Taunton, G. Treatment of patellar tendinopathy with extracorporeal shock wave therapy. British Medical Journal. BCMJ, Vol. 45, December 10
- Jansen, M. Strength training alone, exercise therapy alone, and exercise therapy with passive manual mobilization each reduce pain and disability in people with knee osteoarthritis: a systematic review. Journal of Physiotherapy. Volume 57, Issue 1, March 2011, Pages 11–20.
- Punnett, L. et al. A Conceptual Framework for Integrating Workplace Health Promotion and Occupational Ergonomics Programs. Public Health Rep. , 2009; 124 (Suppl 1): 16–25.
Ask questions using the comment box below. We will add your question to this section if you wish.
Frequently Asked Questions:
Recommended knee support for sore knees?
We recommend the previously mentioned knee support in this article, as it combines relief with compression - which thus promotes blood circulation at the same time as it reduces overload.
What Is the Treatment for Knee Overload? Treatments? Kneøvelser?
With knee overload, it sounds as if there is talk of wear and tear in the meniscus - recent articles have shed light on the fact that knee surgery should be the last resort for such changes, and that one should put full effort into specific training and treatment, as well as support in deferred periods. Some studies also claim that Glucosamine sulfate along with chondroitin may be beneficial for knee osteoarthritis. First and foremost, it is important that you seek out a therapist who can help you treat the dysfunctions and then contribute with specific exercise training programs. Some typical weaknesses of those with knee pain are often found in the form of low muscle activity in the gluteus medius and vastus medialis oblique (VMO). These can both be trained in a relatively simple way without any means other than therabands or training knits (the same knits are also used as low intensity training for training from injuries). Ergometer cycling and an elliptical machine are also two recommended types of exercise.
Can one get psoriasis on the inside of the knee?
Yes, psoriasis can affect patches around the body - it is most common and perhaps most obvious when it affects the elbows, but can also occur on the knees. You can read more about psoriatic arthritis here .
Q: Can you have a nerve in your knee?
Answer: Nerve pain is not the most common ailment in the knees, but meniscus irritation and cruciate ligament injuries can be sharp in the presentation as well - and sometimes so much so that one thinks that it must be a nerve that is pinched or the like, even if it is not. On the other hand, you can get nerve irritation in nearby structures.
Q: Why do you get a sore knee when running downhill?
Answer: The most common diagnosis of knee pain when running downhill or simply descending stairs is what we call Runner's knee / runner's knee. The cause often stems from overpronation in the feet or overactivity in the hamstrings versus weakness in the quadriceps. For the overpronation, you should start with exercises today, read more HEREAnd since running tightens / trains hamstrings more than quadriceps, so should you stretchy hamstrings while practicing quadriceps. It is when the strength ratio between hamstrings and quadriceps becomes incorrect that we get a misalignment on the knee, which is then known to occur at larger loads such as longer runs and the like. If the problem is not dealt with it will get worse and worse, so we advise to start with exercises today, preferably under the guidance of a musculoskeletal expert. Good luck and good recovery.
- Related questions with the same answer: 'Cause I get a sore knee when I go down the stairs?', 'Why do I get sore knees downhill?', 'Sore knees downhill - diagnosis?'
Has pulsating pain in the knee. What could it be?
In addition, if there is redness, swelling, very high pressure and pulsating pain (even at night) it can be a tendonitis, mucosal inflammation or other inflammation of the knee. If you have recently overloaded or incorrectly loaded, it can also be a load injury in the knee structures, tendons or ligaments - this must be seen in its entirety clinically. In the first instance, the RICE principle is recommended - and in the event of no improvement, you should contact your GP.
Why did I hurt my back bend / back bend?
We interpret backward bending as flexion of the knee (bending of the leg). The reason for pain with this movement may be due to an injury - for example in sports or falls where the knee has been pushed backwards in an unnatural position. What is injured varies, but it can potentially cause damage to the anterior cruciate ligament, posterior cruciate ligament, medial collateral ligaments and lateral collateral ligament - this of course does not happen every time such a trauma occurs. It can also be caused by damage to muscles, such as the hamstrings (back thighs). But pain in back flexion / flexion is usually due to hamstring muscle attachment - for example a muscle strain or muscle injury. Other possible diagnoses are Baker's cyst or meniscus injury / riot.
Why did I hurt my knee during forward bending / forward bending?
We interpret forward bending as an extension of the knee (straightening of the leg). The reason for pain with this movement may be due to an injury - for example in sports or falls where the knee has been pushed backwards in an unnatural position. What is injured varies, but it can potentially cause damage to the anterior cruciate ligament, posterior cruciate ligament, medial collateral ligaments and lateral collateral ligament - this of course does not happen every time such a trauma occurs. It can also be caused by damage to muscles, such as the quadriceps (front thighs) or hamstrings (back thighs). But pain with forward bending / extension is usually due to the quadriceps muscle attachment - for example a muscle strain or muscle injury.
Q: Knee pain and knee pain after football. Why?
Answer: Football is a physical sport that can place high demands on the knee and its supporting muscles and ligaments. In the event of sudden twists or other physical strain, damage to the knee or nearby muscles may occur. In case of persistent knee pain, you should contact a musculoskeletal expert.
Q: Knee pain and knee pain after cross-country skiing. Cause?
Answer: Cross-country skiing is a physical sport that can place high demands on the knee and its supporting muscles and ligaments. Sudden twisting or other physical strain can cause injury to the knee or nearby muscles. In case of persistent knee pain, you should contact a musculoskeletal expert.
Q: Sore knee and knee pain after cycling. Cause?
Answer: Cycling is a physical sport that can place high demands on the knee and its supporting muscles and ligaments. Sudden twisting or other physical strain can cause injury to the knee or nearby muscles. In case of persistent knee pain, you should contact a musculoskeletal expert. Cycling is normally considered one of the better sports you can do for good knee health.
The reason I hurt my knee and have to stretch and break?
It is difficult for us to say based on the little information you give us, but if you feel that the knee is generally 'too tight' and that it tightens when you stretch it, then we recommend that you have it examined for wear and tear or injuries. Regardless of the findings, it is otherwise recommended that you train the stability of the knee and the supporting muscles.
Hi I suddenly got a sore knee when I woke up. Could it be rose infection. I've been lying on the couch all day because I've been in so much pain. What can this be?
Hi Elin,
Rose infection is characterized by the fact that the infected skin is red, inflamed and sore. Do you have such a reddish, clearly inflamed skin? Have you swollen up? Does it help to freeze? How is it going today?
If you do not have such a reddish skin, then it can be biomechanically conditioned - ie linked to muscles, joints and support structures.
Hello.
I got pain in my left knee (outside) in late August. I then went to the doctor, and she said it was the ligament that was inflamed, and I was given a cream to apply for a week. The painkiller had no effect and it was still painful so I was referred for an MRI examination. I have received answers from there, and everything was as it should be.
Now I do not quite know what to do. The knee is still sore. It is a pain that comes when I touch my legs in certain positions, and they come the day after I have, for example, worn high heels.
What could this be?
Hi Jeanett,
To understand more of what can give you this pain, we need answers to some questions.
1) Did the pain start suddenly or did it come gradually?
2) What analgesic gel was prescribed?
3) What was the basis for saying that it was inflamed? Was it reddish, swelling, very pressure sore and throbbing pain (even at night)? You mention that it hurts to wear heels, so for us it sounds more biomechanical.
4) What knee movements are it that hurt or reproduce the pain?
5) Where is the pain located? Is it on the inside, outside, under the patella, inside the knee - or where is the pain?
Looking forward to hearing from you so we can help you further.
1. It came all of a sudden. It happened during a set of squats.
2. I do not remember which one it was, but it was on prescription and I was going to use it for 5 days.
3. The basis was because it hurt when she touched it, that is, compressed
4. There are many random positions that I can not reproduce that hurt. But I can reproduce it when I put my left foot on the edge of the sofa, and push my knee to the right.
5. It is on the outside of the kneecap, it is difficult to explain more concretely.
Thanks for your help
Hi again, Jeanett,
KNEE: Could it be that you increased the amount of exercise a little fast? Do you pay attention to the 'toes not above the knees' rule (the knees should not be above the toes when doing the exercise)?
RECIPE PAINED OINTMENT: Great if you can find out what it's called.
KNEE MOVEMENTS THAT HURT: Does it hurt to bend the knee? Or to stretch it out completely?
PAIN ON THE OUTSIDE OF THE KNEE BOWL: If the pain is on the outside of the knee, it can be a fibular joint lock (in the fibular head), ITB / tensor fascia latae myalgia or also an injury in the muscle attachment, or also meniscus irritation. A joint lock in the fibular head will also make sense mtp that it hurts after you have worn high heels.
SUGGESTION: Use foam roller on ITB / TFL, daily for 3 weeks. Stretch your hamstrings and quadriceps daily. 3 × 30 seconds. Avoid too much compression in the knee. Do not run on asphalt or the like. Also use footwear with good cushioning - do you have any good sneakers that you like to wear, for example? A shock-absorbing sole may also be required to temporarily dampen the shock load. A chiropractor can possibly help you with joint function in the tibia and possibly also the ankle / foot.
Have you tried any of these measures already?
Man 44 years with a sore knee.
Hey!
I've had problems with my left knee.
I jogged a little earlier, and eventually I got pain just below the kneecap. I stopped jogging, and now it's just a short walk once in a while. After a mountain hike this fall, I got pain in both knees. The pain was reminiscent of tendonitis (which I have had in my wrist). It disappeared in the right knee, but the left knee continued to hurt. It often felt good in the morning, but after a lot of walking during the day it only got worse and worse.
The other day I was going up the stairs at home, and when I stepped on the first step with my left foot, I got an acute pain in my knee. I could not bend my knee more than a maximum of 1/4 of what I usually can, and I was in terrible pain when I tried to bend my leg. I was in the emergency room and there is no fracture, and the doctor thought the knee felt stable. I could bend my knee again the next day, but feel that I can not strain my knee much. The pain is mostly on the outside of the knee, and it feels like I am numb or have received a blow just above the knee on the outside of the thigh.
Do you have any thoughts on what this could be? I suspect a nerve in a pinch because it hurt terribly…
Regards Mikael
Hi Mikael,
Pain in the knee can be sharp and violent - so the mind can often go towards fractures and nerve irritation, even though it is extremely rare in the knee.
If there is pain in knee flexion (bend) then it is always a matter of injury or irritation in the knee joint itself - in the same case it can be patella tendinitis (tendonitis) and / or PFPS. We suspect general overuse without adequate strength training of the hips, back and knees. Lack of stability muscles leads to the knee joint / knee structures being overloaded and thus painful - that is why it becomes more painful for you throughout the day when you have walked a part and loaded it. There was probably also fluid accumulation in the knee when it erupted so acutely - so when this gave way, the flexion movement was also improved. What you feel on the outside of the lower thigh is TFL / iliotibial band syndrome; it is often overloaded in an attempt to try and relieve the knee.
We recommend that you take up stability training, balance training, and rest a little temporarily from shock-bearing training (jogging, especially on hard surfaces). It can also be helpful to get some treatment for tight muscles in the legs and thighs - as these can both affect your knee function.
Man, 43. Managed to twist my knee when I jumped down half a meter 4 days ago. Now it gets stiff when I sit still and it hurts to go up stairs. What could be wrong? Are they something I can do?
Hi man (43),
1) Where is the pain? We need the location to be able to give you a specific diagnosis.
2) Is it swollen?
3) Did you hear a distinct "click" or sound from your knee when you twisted it?
4) Do you recognize these symptoms?
Based on what you write, you have a (most likely) temporary meniscus irritation (often occurs by twisting). The menisci are the primarily weight-bearing structures in the knee and explain why it hurts to walk in the knee.
We recommend that you use the RICE principle for 72 hours. If the pain persists after 3 days, please contact a public health-authorized clinician (doctor, chiropractor, manual therapist) to investigate the injury.
Hi! I get pain in my left knee when I go up and / or down. I know nothing if I just walk away. Withstands small hills.
Hi Maren,
This sounds like overuse without sufficient support muscles in the calf and hip. Do you train strength or do you walk most of the time? We recommend that you try these exercises. Without enough stability muscles, you will risk meniscus irritation / meniscus injury.
The strength of the support muscles must withstand the load - and it is higher uphill and downhill.
Regards.
Alexander v / Vondt.net