Knee Pain

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Your knees take a lot of stress from walking, squatting, and going up and down stairs. The muscles surrounding the knee do a lot of work, helping move the hip and ankle.

Overuse, traumatic injury, and/or naturally occurring changes can lead to knee problems. If you’re suffering from knee pain, contact us to learn about treatment options.

How Your Knee Works

The knee consists of four bones, the joints between them, the ligaments that keep things stable, and the muscles that generate strength and motion.

The thigh bone (femur) stacks on top of the shin bone (tibia), creating the true knee joint. The outer lower-leg bone (fibula) bone runs parallel with the shin bone of the lower leg, forming the tibiofibular joint. The kneecap (patella) contacts the thigh bone in the front of the knee to form the patellofemoral joint.

The meniscus, a flexible rim of soft tissue, fills the space between the thigh bone and shin bone. The meniscus’ two C-shaped pieces help with stability and shock absorption.

The four main knee ligaments that help provide stability are commonly injured in sports or by trauma. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) wrap around each other deep within the knee, attaching the thigh bone to the shin bone. They helps prevent excessive pivoting of the knee and keeps the shin bone from moving forward or backward under the thigh bone.

The medial collateral ligament (MCL) and the lateral collateral ligament (LCL) help keep the knee stable side-to-side. The MCL runs vertically along the inside of the knee, while the LCL runs vertically on the outside of the knee.

Three main muscle groups surround the knee joint and help power the knee for walking. The quadriceps muscles on the front of the thigh bone cross the knee over the kneecap, attaching to the shin bone via the patellar tendon. Hamstring muscles cross the knee on the backside of the thigh. Hamstring tendons attach on the fibula and on the shin bone.

In the back of the shin bone, the calf muscles (gastrocnemius) attach to the heel and run up the back of the lower leg, connecting behind the knee on the backside of the thigh bone.

Many other muscles play a role in the knee’s function and tracking of the kneecap, including the IT band and gluteal muscles – but muscles are just part of the story. The bones, joints, ligaments, and muscles must work in unison for the knee to function properly.

Evaluating Knee Pain

Knee-pain evaluation starts with a conversation. We’ll ask you when and how your pain started, how it feels, and treatments you’ve tried. We’ll also ask about other medical conditions that may contribute to your knee pain.

We do a physical exam and test your knee’s structures, range of motion and strength, looking for specific problems. Sometimes we check hip strength and range of motion, as these can play a role in knee pain.

We might also order X-rays, to show fractures, spurs, and changes from arthritis, or MRIs, to show more bone detail and soft-tissue damage like ligament or meniscus tears.

Causes of Knee Pain

  • Arthritis
  • Fractures
  • Instability
  • Weakness
  • Inflammation
  • Less common causes: infection, tumors, or nerve problems

Treating Knee Pain

Knee-pain treatment depends on the diagnosis and severity of your symptoms.

Viscosupplementation Injections lubricate the knee, helping relieve arthritis pain.

Physical therapy focuses on getting your muscles and joints to work together properly to move your leg. Even if you’re strong and active, muscle imbalances may cause knee pain.

Medications can help with some knee conditions. Acetaminophen (Tylenol) or non-steroidal medications like ibuprofen (Advil) or naproxen (Aleve) or can relieve inflammation and control pain. For severe inflammation, a short burst of a steroid medication may be an option.
A variety of braces are available to support the knee in many ways: to help with arthritis pain (unloader braces), increase the stability of the knee (hinged braces), and keep the kneecap’s proper alignment (patellar stabilizing braces).
Cortisone injections target a specific spot in your knee using a powerful anti-inflammatory medication. Numbing medications in the injection help us know if the injected spot is the pain source.
Surgery may be an option for certain knee conditions if all other treatment options have been exhausted. Although many surgeries can be done through small incisions using a special camera to see inside the body (arthroscopy), some may still require a traditional open surgery.

More About Knee Surgery

Lifestyle modifications include: resting your knee, avoiding painful situations, riding an exercise bike with no resistance to smooth and polish the knee, and doing exercises to strengthen weak muscles.

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