Knee pain Archives • Page 3 of 7 • Sports Injury

Knee osteoarthritis – don’t give up your sport!

Knee osteoarthritis (OA) is a pain and stiffness of the knee joint caused by degeneration of joint cartilage
It is classified from grade 1 to 4 depending on the number of features of OA present on imaging and the depth of the cartilage loss
Risk factors for knee OA include excessive body weight, previous trauma (such as ACL rupture) and chronic hip or ankle stiffness. Note that distance running and sports with repetitive joint loading do not cause knee OA

Most of the pain associated with knee OA comes from the swelling, which causes a loss of joint range and puts pressure on the soft bone underneath the cartilage defects
- Anti-inflammatory medication is the most effective way to reduce knee swelling as it reduces the formation of new fluid
- Ice can also be helpful
- Compressive knee braces can be helpful to manage swelling as well as improving control of the knee, both of which will reduce pain. A simple knee brace made of a firm but elastic material is all that’s required, such as this one with Velcro straps for adjustable pressure and fit. Hinges or metal struts don’t assist knee movement for OA and should be avoided
Strength training is the most effective long term management strategy for both prevention and resolution of episodes of pain and stiffness. It should focus on leg strength generally and related to common functions rather than focusing on one muscle group
Consistent and regular exercise is needed to maintain joint movement and cartilage quality. Walking every day, even multiple short walks per day, is preferable to walking every 2nd day

Knee OA is not as steady decline nor is it a guaranteed road to joint replacement. Although the cartilage degeneration is not reversible, the pain and stiffness are almost always reversible
Running is not the enemy. Running has been proven to NOT cause knee OA – in fact it can actually improve joint quality and maintain strength. You just need to ease back into it slowly after an OA flare up. Start with a run:walk approach and only after you’ve started your strength training
Avoid being reactionary with your management of knee OA. Don’t wait for it to swell to start meds, use them as soon as you think you’ve overdone it. Don’t wait for pain and stiffness to start strength training, make it a weekly routine to maintain joint function and cartilage quality

Bone stress reaction causes a dull, usually prolonged, ache around the injury site
A bone stress reaction can occur due to impact loading or connective tissue traction
Reactions caused by impact loading can progress to bone stress fractures with ongoing overload

Bone stress reactions often occur with other injuries and can be difficult to diagnose in its early stage
The symptoms from bone stress reactions are significantly relieved by anti-inflammatories, however use of these medications can worsen the condition due to their effect on bone healing
The duration of soreness after activity can be an effective gauge of the severity of the reaction

Not all bone stress reactions are at risk of progressing to stress fracture. Reactions caused by the pulling force from tendons or other connective tissues cannot progress to stress fractures
Treatments that ease the symptoms, such as medication or ice packs, do not directly assist the recovery of the injury
Rest alone won’t resolve a bone stress reaction. It will ease the symptoms within a few days but the condition is much slower to respond and usually flares up soon after the return to loading