Our knees are the most important joints that keep us upright and allow us to move. Our knees, which often have to carry 5-6 times our body weight, can become painful over time for many different reasons. Knee pain can be the biggest problem that directly affects our quality of life.
Our knees play very important roles not only in activities such as walking and running, but also in many activities such as bending, standing, squatting, balancing. It has a very complex structure that is open to damage at any time.
Knee pain causes may differ according to age.
While knee pain may be due to structural problems or sports injuries in young people, reasons such as wear and muscle weakness appear as the cause of knee pain as age progresses. Let’s take a brief look at the diseases that cause knee pain the most…
Chondromalacia patella occurs due to the incompatibility of the kneecap cartilage with the knee joint. It is very common at a young age, especially in those with weak upper leg muscles called quadriceps, in those with long legs and in women due to hormonal reasons. The most common cause of knee pain in this age group is chondromalacia patella.
Structurally, the kneecap is not fully seated in its socket in the knee joint, and pain is triggered by keeping the knee bent or standing in a fixed position for a long time. The patient feels severe pain on the first knee movement after a long period of inactivity, the pain decreases as the knee moves, but it does not go away completely. Patients also complain of difficulty in going up and down stairs and a feeling of sudden discharge in the knees.
Treatment should be planned multi-faceted. In order to fit the kneecap into its socket in the knee joint, the knee and upper leg muscles should be strengthened, the kneecap should be supported with a knee brace or special taping methods, the cartilage nourishing glucosamine and collagen supplement should be made in order to eliminate the damage that causes pain in the kneecap cartilage. Ergonomics training should be provided.
In chondromalacia patella, the pain is in front of the knee.
Knee calcification occurs at an early age in untreated patients.
Menisci are structures in the form of auricle that provide load distribution within the knee, prevent the knee cartilages from rubbing against each other, and allow us to balance during walking. Each knee has two menisci, inner and outer.
Meniscus tears can be seen due to sudden blows to the knee, especially at young ages, and due to water loss and wear in advanced ages. Being overweight paves the way for a meniscus tear.
The patient with a meniscal tear complains of a feeling of sudden discharge in the knee, difficulty in going up and down the stairs, occasional stuttering in the knee, and severe pain.
Patients with a meniscus tear often feel the pain at the back of the knee. Difficulty in going up and down stairs and feeling of discharge in the knee are quite typical complaints.
Meniscus tear is seen quite frequently in the society. Not every meniscus tear is treated. If there are the complaints I mentioned above, it is necessary to treat the meniscus tear.
In the treatment, if the tear is small, muscle strengthening around the knee and intra-knee PRP or STEM CELL applications are preferred. In larger tears, the torn meniscus should be cleaned with arthroscopy surgery. Untreated tears can cause severe locking and pain.
3-Anterior Cruciate Ligament Injury
The anterior cruciate ligament is the most important knee ligament that holds the knee in place. It serves to control the knee like a horse’s bridle, and to prevent excessive load on the knee in sudden movements. The anterior cruciate ligament can be torn as a result of direct blows to the knee, or an uncontrolled fall, especially in people who do active sports.
In people with ruptured anterior cruciate ligament, knee pain may occur due to excessive movement in the knee and wear of other structures of the knee over time. This feeling of pain or discomfort is more pronounced in sudden movements or when the person runs or jumps uncontrollably. A feeling of discharge may occur frequently in the knee. There may be excessive swelling in the knee from time to time.
MR image of ruptured anterior cruciate ligament
Untreated anterior cruciate ligament ruptures almost always cause knee calcification at an early age. It should be treated especially in people under the age of 45, engaged in active sports and professional athletes. In patients diagnosed after the age of 45-50, conservative treatment, weight loss and exercise can be recommended depending on the degree of their complaints.
4-Cartilage Wear in the Knee Joint (Calcification)
Knee osteoarthritis occurs as a result of many knee problems and is the reason for almost half of the patients over 50 years of age to consult a doctor.
Being overweight, not doing sports, female gender, working on the knee all the time are the reasons that increase the possibility of knee arthritis. Knee injuries at a young age, knee surgeries, and congenital deformity of the knee anatomy also cause cartilage wear in the knee joint.
Obesity has emerged as the most common cause of knee osteoarthritis in recent years.
Patients complain of not being able to walk long distances, not being able to bend their knees comfortably, having occasional swelling in their knees and pain. Most of the time, these complaints are so severe that the patient cannot do their daily work.
In patients with cartilage wear or calcification in the knee joint, the primary goal is to change the factors that can be changed for the patient. Patients are strongly advised to lose weight. With physical therapy, it is aimed to reduce the load on the patient’s knee by strengthening the upper leg muscles and the muscles around the knee. In addition, the treatment is supported with glucosamine, collagen and hyaluronic acid supplements that will increase cartilage production and function. Again, painkillers can be given to the patient at certain intervals during periods of severe pain. The use of painkillers must be controlled in these patients, otherwise it may cause kidney failure, osteoporosis and stomach bleeding!
The quadriceps muscle is located in the upper leg, just above the kneecap. Weakness in the quadriceps muscle causes pain, especially in the kneecap.
The quadriceps muscle group is one of the most important structures that keeps the kneecap in place. In weakness, anterior knee pain appears.
The quadriceps muscle can be weak, especially in people who do not do sports. Weakness in this muscle paves the way for knee injuries. In addition, damage to the nerves that feed this muscle can cause muscle weakness and knee pain. This muscle is weak in patients with polio sequelae. Patients with herniated disc may sometimes come with knee pain due to muscle weakness without back pain.
In its treatment, it is recommended to correctly identify the cause of muscle weakness and then to treat the underlying disease or exercise to eliminate the cause.