Finding the cause of your knee pain

There are a variety of knee pain causes and each requires a different treatment approach.

Determining which pathology is causing the pain is vitally important. And there are several clues and tests that can help to identify the diagnosis.

Here’s our physiotherapy team’s list of diagnostic indicators to help find your knee pain cause.

  1. Was there an incident that caused the pain initially?
    • If the pain started suddenly due to a fall, twist, impact or incident, there’s an increased chance that you’ve damaged a structure like a ligament or meniscus
    • Twisting often causes meniscal tears but can damage the ACL
    • Sideways forces can cause MCL/LCL tears on the opposite side of the knee to the impact or meniscal tears and bone bruising on the same side as the impact
  2. Is there visible swelling?
    • Swelling typically indicates damage or an inflammatory process
    • Sudden swelling after an incident (within one hour) is usually due to damage of a structure with good blood supply including ACL, bone and muscle
    • Gradual swelling (over 24hrs) is more commonly due to inflammation such as knee osteoarthritis
  3. Does it get sore after prolonged rest and first thing in the morning?
    • If it stiffen and becomes painful after rest, that’s an inflammatory pattern and suggests some element of inflammatory process. This usually means that anti-inflammatory medication will be helpful.
  4. Are you over 55 years old?
  5. Is the pain on the knee cap?
    • Pain that worsens when you’re going down stairs or hills is typically patellofemoral pain. It’s caused by loading the joint under the kneecap. It responds well to exercising with reduced knee flexion (eg. Doing deadlifts instead of squats or lunges)
  6. Is the pain below the knee cap?
    • Sharp pain below the kneecap on straightening is often a fat pad impingement and responds well to anti inflammatory medication
    • Dull pain below the kneecap during squatting can be a Patellar tendinopathy and responds better to controlled loading programs
    • Pain below the kneecap on twisting movements is often related to meniscal injuries
  7. Are you 11-14 years old?
    • Due to rapid growth spurts around this age, there is pressure on the growth plate at the top of the shin. Known as Osgood Schlatter’s Disease, this condition has no long term consequences and passes in around 6 months
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