KNEE PAIN
Knee pain may subside within a few days or persist for weeks or months. When the pain subsides within a few days, it is often due to minor problems such as a ‘sprain’. When the knee pain persists for a longer time, its causes can:
• Pain due to injury to the knee.
• Pain due to conditions not associated with injury.
KNEE SPRAIN
The causes and symptoms are:
• Common in day-to-day activities due to minor twisting or bending.
• Pain subsides within a few days to a week.
• Injury to semilunar cartilage.
• Caused when the knee is twisted or while landing on the knee suddenly.
• Pain may not subside within a few days.
• May give a feeling of something ‘getting stuck’ or ‘loose’ inside the knee.
• Knee may be locked in one position
INJURY TO LIGAMENTS OF THE KNEE
The causes and symptoms are:
• Front middle ligament is often injured in sports when a sudden load occurs on the knee or while jumping from a height.
• May also be due to forced twisting of the knee.
• May result in a ‘sound’ of something breaking inside the knee when the ligaments are injured.
• Rapid swelling of the knee because the blood fills the joint.
FRACTURES AND DISLOCATIONS
Fractures may involve :
• Lower end of the thigh bone
• Upper end of the bone or the kneecap
• Acute pain with immediate swelling
• Kneecap dislocation is common in adolescents
• Recurrent dislocation of the knee cap is common
OVERUSE INJURIES
The causes and symptoms are:
• Common in sports persons and military recruits due to excessive pressure on the joint.
• Pain occurs when adolescents or fresh military recruits undertake new or excessive physical activity.
• Injuries are usually due to a mild problem in the ‘design’ of the knee.
• Overuse injuries usually cause pain under stressful situations.
Injury to the knee is common in sports, accidents and sometimes day-to-day activities. It is a common cause of knee pain in younger people. There are several types of injuries to the knee joint, such as tears in the meniscus, ligaments, etc., collectively known as ‘Internal Derangement of the Knee’ (I.D.K.). Sometimes it is difficult to diagnose the exact type of derangement, and therefore some people consider I.D.K. synonymous with ‘I Don’t know’.
Some causes of knee pain are not associated with injury and often cause pain in other joints. The leading group of diseases in this category is arthritis. The word ‘arthiritis’ does not mean one disease–it means pain and swelling of a joint. There could be many reasons for this type of pain and swelling in the joint. It is important to remember that different types of arthritis occur at different ages, and each has a different outcome. Therefore, do not worry unnecessarily if your doctor says you have arthritis.
TYPES OF KNEE INJURY?
Injury to the knee joint is quite common. As mentioned earlier, this is because the knee design makes it relatively unstable.
It is also prone to injuries because of the stress the knee is subjected to. Causes and symptoms of common knee injuries have been listed before. Described below are the management options for these injuries.
Knee Sprain: Minor twisting or bending of the knee result in a sprain which indicates that some tissues around the knee are pulled. Since pain due to a sprain subsides within a few days to a week, you should consult a doctor immediately if the pain persists for more than three weeks or if the swelling around the knee increases steadily. Your doctor may recommend rest in a plaster cast or crepe bandage for a few weeks.
Injury to semilunar cartilage: The inner half-moon-shaped semilunar cartilage is more likely to be injured than the outer cartilage. Although cartilage injuries may seem insignificant, they can cause considerable damage to the structures inside the knee. Your doctor may suspect a cartilage tear if the pain does not subside in a few days. If the knee gets locked in one position, consult a doctor immediately to free it by manual manipulation.
Most injuries to the knee can cause repeated complaints. It is often difficult to pinpoint the exact nature of the damage by knowing the history of the injury and examination of the knee joint. Your doctor may then suggest a procedure called ‘arthroscopy’ in which the doctor looks directly into the joint through a thin pencil-like tube called the arthroscope. The arthroscope is introduced into the knee through a small cut in the skin. A video camera is attached to the arthroscope, which shows the inside of the knee on a screen. Through this procedure, your doctor will be able to view all the corners of the joint and may therefore be able to identify the cause of symptoms and the nature of the damage. In most cases, the fault within the joint can be corrected by ‘key-hole-surgery’ with the help of small instruments inserted through a few more small cuts. This often avoids a major operation, enables quick recovery and reduces hospital stay to less than 48 hours. Arthroscopy not only helps diagnose a problem that was not diagnosed earlier but also provides a method of performing surgery with minimum cutting. This technique is, therefore, a boon for patients with joint problems. However, presently arthroscopy facility is available only at a few centres in India.
Injury to ligaments of the knee: Minor ligament tears such as sprain may heal independently. If the tear in the ligament is complete or more than one ligament is torn at a time, the knee may not regain its normal strength. You may feel unstable from the day of the injury itself. If the front middle ligament alone is torn, there may not be any symptoms soon after the injury. After a period of time, you may feel ‘weak’ on the injured side, and knee pain may develop. Most people with torn ligaments feel better with regular special exercises and careful knee movements in day-to-day activities. However, if the weakness persists, your doctor may recommend a major operation to replace the torn ligament with a new ligament constructed from other body tissues.
Fractures and dislocations: X-rays of the knee are necessary to diagnose the extent of bone(s) damage due to the fracture. A major operation is usually necessary to fix the fractured pieces to their normal position with screws and steel plates. These steel plates result in normal movement at the knee. The pain and swelling subsides over a period of time.
Overuse injuries: Knee injuries due to new or excessive physical activity usually result from a mild problem in knee design. This problem may not routinely cause pain but can do so under stressful situations. Giving up physical activity that has resulted in knee pain may not be necessary. Instead, you should undertake strenuous physical activities only after appropriate training and avoid excessive physical stress.