Knee Pain Treatment in Annapolis, MD

Injury to the knee can be in the form of an acute or repetitive trauma.

Acute Trauma is a single incident that pushes the knee farther than its normal range of motion or causes it to move in a direction it normally does not move, thus damaging the ligaments, tendons, and muscles around the knee and/or the bones that make up the knee joint. The knee is a hinge joint and therefore can only flex and extend (bend and straighten) anything outside this movement will result in a traumatic injury.

Repetitive trauma can result from a variety of things including work related stress i.e. standing for long periods of time, bending/squatting down, walking/running on very hard surfaces etc. or from compensation from other joints. An injury or issue in the low back, pelvis, hip, ankle or foot can lead to compensation in the knee(s) which over time will cause abnormal wearing in the joint and its surrounding soft tissues.

Arthritis, by definition, is swelling of a joint. Osteoarthritis is the most common form of arthritis and occurs when the protective cartilage at the joint surfaces (ends of your bones) begin to wear down. It takes years of abnormal wearing for osteoarthritis to occur however, an injury can trigger the breakdown process to begin as well as speed it up if abnormal wearing is already occurring. Some patients have no idea they have osteoarthritis in a joint and it is only found because testing (usually imaging like X-ray, MRI, CT) for a different complaint has been done. More commonly a patient will experience one or more of the following symptoms in the affected joint; pain, stiffness, swelling, instability (sometimes described as the joint “giving out” or weakness), grinding/popping/clicking, and decreased range of motion.

Patellar bursitis occurs when one of the bursa in the knee becomes irritated, causing it to over produce fluid then swell, putting pressure on the surrounding parts of the knee. There are a total of four bursa in each knee located between bone and soft tissue to reduce friction during movement. Bursitis aka swelling of the bursa, can be caused by a variety of things including: trauma, repetitive stress/pressure on the knee like kneeling, overuse, bacterial infection, and complications of arthritis of the knee. Often the knee will look swollen and sometimes red, feel tender and warm to the touch, and pain will be increased by activity and relieved by rest.

Runner's knee is a broad term used to describe pain in the front of the knee, another name for it is Patellofemoral pain syndrome (PFPS). When the knee moves the kneecap (patella) should glide smoothly in a specific path over the end of the thigh (femur) bone. PFPS affects more than just runners, it can be caused by one or several things including; trauma to the kneecap, overuse, overloading, anatomical and/or biomechanical irregularities, and muscular imbalance. Typically pain is located in the front of the knee however pain can also be felt behind the knee, it will increase with activities that stress the knee like running, going up or down stairs, sitting with knees bent, squatting, and kneeling.

Chondromalacia patella is the softening and eventual breakdown of the cartilage underneath the kneecap (patella). Sometimes it will be referred to as Runners knee aka Patellofemoral pain syndrome (see above) due to the fact that it also can cause pain at the kneecap and can develop from an injury, overload, and anatomical and/or biomechanical irregularities. Two primary differences are that Chondromalacia patella that is not degenerative most commonly affects adolescents and young females and the pain is often so severe the individual will be quite limited on what activities they can perform. Other than pain there can also be swelling, instability, and crepitus (crunchy/grating/grinding sound or feeling).

IT band syndrome or Iliotibial Band Syndrome is described as an overuse injury with pain on the outside (lateral) of the thigh or knee. The IT band begins at the top of the pelvis, above the hip and extends along the outside of the thigh down to just below the knee joint. Repetitive stress like running, cycling, and squatting, poor biomechanics of the low back, hip, knee, foot and/or ankle as well as poor exercise regimes (i.e. over training, bad form, improper warm up and cool down, lack of stretching) all can lead to IT band syndrome.