Knee Pain & Knee Problems
There are a lot of buzz words used in the medical field used to describe pain. My job over the next few months is to make these medical terms more understandable to ’Joe Public’.
I guess the most common buzz word for knee pain is arthritis.
How many people really have arthritis and what is it?
Put simply arthritis is damage to the joints. The most common joints to develop arthritis are the finger joints which can become damaged or twisted. Our bones are covered by a tissue called cartilage. This cartilage acts as a buffer. When it wears away we develop arthritis. When it wears away completely, we get bone rubbing on bone, which can cause excruciating pain. The problem with cartilage is that once it wears away, it doesn’t grow back.
The best course of action is obviously to prevent it wearing away in the first place. Three suggestions from Wellbeing:
1. Build up your leg muscles
2. Lose that excess weight
3. Take two supplements called Glucosamine and Chondroitin Sulfate.
These are natural substances found in and around the cells of cartilage. They are not wonder drugs and no replacement for one and two above.
How much of these supplements do you need?
Glucosamine- 1500mg daily taken as 3x 500mg
Chondroitin - 1200mg daily taken as 3x 400mg
Is there any other treatment I can get if I have knee pain but think it’s not bad enough for surgery?
A recent study in Germany has shown that acupuncture is extremely effective in reducing osteoarthritic pain in knee joints. Where there is also a reduction in mobility, a combination of acupuncture and physiotherapy/physical therapy is the way to go.
What about when it’s too late for preventative treatment?
That’s when you need to consider surgical intervention. A scan will determine what the best course of action is. The most radical surgery is obviously a knee replacement. In the past a knee replacement held for an average of ten years. A second replacement was not without difficulty therefore surgeons were reluctant to operate on patients under 65. Now however knee replacements last longer and are being carried out on younger patients.
Depending on the damage, the orthopaedic surgeon may recommend an arthroscopy instead. This is a procedure where the debris is cleared away from the joint using keyhole surgery. Patients can be back on their feet within a few days. An arthroscopy can give up to ten years ‘ relief. A second one may be possible (even a third sometimes ) but with reducing levels of success.
In certain cases an arthroscopy won’t be recommended by the surgeon because of the particular nature of the wear and tear. A series of injections of cartilage substitute may be recommended in that case to delay the replacement.
Why do footballers develop cartilage problems?
The knee is not made for twisting movements such as when playing football. Soccer players particularly are constantly twisting and turning at speed.
Squash and badminton players are also likely to suffer from cartilage problems later in life because of the heavy impact on their knee joints.
Other common causes of knee pain:-
Cruciate ligament injury or tear Meniscus tear Collateral ligament injury
What is the cruciate ligament?
We have two cruciate ligaments, one at the front and one at the back of the knee. The two ligaments cross each other inside the knee joint, hence the name ‘cruciate’.
The one at the front stops the lower leg bone ( the tibia) from moving forward and is the one that usually tears. The ligament tears when the foot gets stuck and the knee twists badly. This injury used to be the reserve of soccer and gaelic players but the would–be James Bonds are now giving them a run for their money.
What’s the best course of action if it’s torn?
The first thing is to have it scanned. If there is a possibility of a tear the GP or physiotherapist/physical therapist will usually recommend a scan. If the ligament is indeed torn, the orthopaedic surgeon will advise whether to have surgery or not. An operation is always recommended for a professional sports person but if you are not heavily involved in sports, conservative treatment involving the strengthening of the leg muscles may be advised. The cruciate ligament does not grow back!!
What is a Meniscus?
We have two menisci in our knees. They are discs(half moon or c-shaped) which glide on top of the cartilage. Damage to one or both menisci usually occurs as a result of a trauma or sports injury. If torn they can cause sharp pain.
How do I know if it’s torn?
Again the only definite answer is by having a scan.
What is the best treatment?
You don’t have a choice on this one. Keyhole surgery is the only form of treatment but the good news is that you will be back on your feet within days.
What are the Collateral ligaments?
On either side of the knee there are ligaments that support the knee and stop it from moving sideways(similar to the cruciate ligament which stops the knee from moving forwards and backwards). These ligaments do not easily tear but can be strained during sport.
What is the best treatment?
If swollen-RICE R-Rest I-Ice C-Compression E-Elevation OR
Manual Lymph Drainage
This is a wonderful treatment(rather like a very gentle massage) and is used to drain the Lymphatic System. It is the treatment of choice for swellings and acute sports injuries in Germany. If it’s not swollen but the mobility is reduced then you need physiotherapy/physical therapy.
Next month will include other knee pain syndromes such as runner’s knee, jumper’s knee as well as how emotional issues and stress can affect the knee. Until then.
Article by Colum Slevin
Colum Slevin
- Qualified as Physiotherapist in Germany 1999
- Member of Irish Society of Chartered Physiotherapists
- Qualified Manual Therapist
- Qualified Cranio Sacral Therapist with world renowned therapist Dr.Richard Royster
- Qualified Tuina (Chinese Massage) Therapist
- Qualified Acupuncturist with the Acupunture Association of Chartered Physiotherapists
- 8-times Irish National Table Tennis Champion
- Played 12 years professional Table Tennis in Germany
- 400 caps for Ireland
- European Senior Champion Over 40 2007
- Irish National Coach 2000-2007
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