What to do about pain in the knee

Knee pain is a very common problem in many people, regardless of gender, race or age. Obviously there are factors that can worsen or increase the risk of suffering this injury. The knee is a large and complex joint. It is mainly made up of three bone parts, the union with the femur, the union with the tibia and the patella, which is the bone that gives mobility to this joint. Therefore, in knee pain, one of these bones will be involved. And not just the kneecap or the part that bends.

In between are two cartilaginous discs called menisci. The ends of the bones are protected by cartilage, preventing the bones from rubbing together and integrated into a synovium capsule that helps prevent friction. They are specifically bags with liquid that lubricates and prevents friction. The fluid is called synovium.

On the sides and behind the knee are the ligaments. Tendons connect muscles and bones. The ligaments together with the muscles support the bones. Knee pain can be differentiated by two main types, injuries after specific efforts or exercises. With sudden pain Or due to progressive pain due to wear and tear, mostly due to age and joint wear, it starts with mild discomfort and gets worse.

The knees are one of the joints that suffer the most wear and tear and the problem of osteoarthritis and arthritis. Knee pain is very disabling, since a healthy knee can move and facilitate mobility, when there is pain, walking alone becomes a problem and even disabling.

TYPES OF KNEE PAIN

Most of the time, knee pain is due to a ligament, meniscus, or runner’s knee problem, although there are many more problems.

PAIN FROM INJURIES

• Anterior Cruciate Ligament Injury: This ligament connects the tibia and femur. This injury is very typical of soccer players, basketball players, fast sports in which directions are often changed quickly.
• Bursitis: Inflammation of the bursa, the small cushions around the knees, especially in front of the kneecap. It usually occurs when there is repeated pressure on the knee, such as kneeling for a long time. Sometimes these injuries can lead to chronic inflammation due to overloading of the same. They usually improve with anti-inflammatory drugs, rest, occlusive bandages and local application of cold.
• Patellar tendinitis: due to irritation or inflammation of the tendons that connect the muscles to the bones, it is usually frequent in sports that involve jumping, skiers or cyclists, too. It usually hurts more when going up or down stairs.
• Meniscus tear or rupture: it is a shock absorber, this cartilage can be torn especially when the knee bears weight.

PAIN DUE TO MECHANICAL PROBLEMS

• Loose small bone or cartilage: The knee is a complex joint and is made up of many small bones that can become loose due to minor injuries, these can interfere with the joint causing significant pain and disabling the joint.
• Dislocated patella: The kneecap can slip out of its normal position due to trauma.
• Hip or foot pain: if other parts of the body such as the hip or feet hurt, it can cause a change in position when walking or when resting. This position defect can cause overload or knee pain due to bad position.
• Iliotibial band syndrome: a typical problem of long-distance runners and cyclists. In which the iliotibial ligament rubs against the outside of the femur. This continuous friction with repeated flexion and extension of the knee can cause inflammation in the area.

Attrition PAIN

Osteoarthritis

One of the most frequent causes of knee pain caused by cartilage wear until it disappears. When the cartilage wears out, it does not fulfill the function it should, so the bones rub against each other in movement, this rubbing causes pain and inflammation of the knees. This continuous friction causes inflammation of the bones, which can lead to an increase in the size of the bone and even cause deformation. The pain is located mainly in front of and behind the knee.

Age, obesity, old injuries, lifestyle, very intense exercise or even genetics can more or less affect the risk of suffering osteoarthritis. The development of it is progressive, and with the advancement of the disease the pain is more intense, from pain to contact or to the simple movement of it.

Arthritis or Osteoarthritis

It should not be confused with osteoarthritis, in arthritis the synovial membrane becomes inflamed, this inflammation causes the appearance of chemical substances that destroy the cartilage. Acute inflammation of the knee or arthritis can be due to different diseases such as rheumatoid arthritis, gout or infectious processes. This inflammation causes pain.

In rheumatoid arthritis it can affect the whole body including the knees and the autoimmune system is involved. It is a chronic disease, and the pain of it is variable. Infected arthritis, when in addition to inflammation, there is pain and redness, it occurs with fever.

Gout and Pseudo-gout

Although gout usually affects the big toe, it can also affect the knee, and it is due to uric acid crystals in the joint. Pseudo-gout can sometimes be mistaken for calcium crystals in the knees, although it is still painful.

Chondromalacia

It is pain between the kneecap and femur, very common in athletes and in the elderly who have a slight misalignment of the kneecap. This displacement can cause pain of more or less intensity as the cartilage located there degenerates. The knee often causes noise when going up or down stairs or when bending the legs. It may be due to a strong blow to the bent knee, overuse of the knees, the way you walk, or due to a break or dislocation.

WHAT TO DO IF THE KNEE SUDDENLY HURTS?

• Rest and avoid intense movement for at least a few days
• Apply cold, ice, for 20 minutes every two or three hours, for two or three days until pain is reduced

When the pain is clearly due to bursitis, the ideal is to use cold, cold accumulators three or four times a day for 15 minutes. Trying to protect the skin directly from the cold and not leaving it overnight. It is important not to rest on the inflamed area, so it is advisable to put a pillow between the knees when lying down so that the contact is soft and soft. Avoid standing for as long as possible.

PREVENT KNEE PAIN

• Using support bandages or knee pads
• Keep your knee or leg elevated to decrease swelling
• Take anti-inflammatories and pain relievers such as paracetamol and ibuprofen
• Sleep with a pillow under your knees
• Know your own body, to avoid injuries due to bodily deformations such as lack of alignment or flat feet
• A shoe with a heel of the appropriate height and, if necessary, corrective footwear such as insoles
• Avoid impact, jumping or running on hard surfaces
• Avoid being overweight, since the knee needs to perform an overexertion if this is the case
• Use knee pads when the pain begins to be noticeable to protect against possible bursitis
• Keep the muscles strong, since the support will be stronger and will avoid direct impact on the joint

It is very important to strengthen the leg muscles to avoid subsequent knee pain due to wear and tear, since strong muscles provide greater support for the knee and less pressure on it. The exercise must always be gradual in intensity and always warm up before training.

If your knee hurts due to physical activity, what actions should we take when exercising?

• The correct exercise is important to improve the problem of knee pain
• Warming up is essential before exercising, as well as stretching after finishing training or exercises.
• Preferably exercise such as cycling or swimming over running
• Avoid running downhill
• Avoid running on cement or hard surfaces and/or in poor condition (holes, stones…)
• Avoid overexertion or exhaustion especially when running as it can cause postural errors that can cause injuries
• Wear good cushioning shoes if possible
• Lose weight

TREATMENTS

In addition to the aforementioned actions, when the knees hurt:

Things to do

• Applying cold temperature will help reduce inflammation and as a consequence pain in the area.
• Some people feel relief when applying hot compresses, especially in arthritis and chronic pain in which there is no inflammation.
• The use of canes or crutches can help reduce the weight on the knee, which will relieve overexertion.
• Knee pads or knee supports will prevent strain on the muscles and keep them aligned.
• Under the supervision of the physiotherapist or doctor, electrical and/or radiofrequency stimulation devices can be used.
• Some texts indicate that acupuncture is also useful for reducing pain.