Who should I see for knee pain?
There are so many structures in and around your knee that can cause you problems. Whether it’s sports, gardening, DIY or simply walking, over the course of our lives we give our knees some hammer.
As clinicians, we need to find a way to rule in or out certain problems. Fortunately, our clinical screening tool will do just that. Important questions about your knee pain or symptoms like does your knee click, clunk, feel unstable, lock in the same position, or give way can all guide us in our clinical diagnosis. Depending on your answers and lots of other variable factors allows us to determine our advice to you on who you should see.
Below, are some of the common knee issues we see in clinic.
The menisci (cartilage) are two crescent shaped structures that sit within the knee joint. These are often referred to as the “shock absorbers” of the knee as they help to absorb and spread the load and forces that we put through our knees with all weight bearing activity.
We can injure these in a variety of ways, such as twisting when playing sports like football, rugby or skiing, through forced deep, weighted bends of the knee such as gardening, or simply with wear and tear over time.
Any of these can cause tears within the meniscus, which you may find gives you knee pain or instability. Many meniscal tears settle with time and appropriate physiotherapy, but in some cases, surgery by an orthopaedic consultant may required to repair or remove the torn part of the meniscus. Surgery is only considered after looking at the integrity of the rest of your knee as well as other factors.
Ligaments are structures that help to give the knee stability. The knee is made up of four major ligaments, with several smaller ones also playing an integral role in providing knee stability.
The major ligaments within the knee are the anterior and posterior cruciate ligaments, with lateral and medial collateral ligaments providing stability on the inside and outside aspects of the knee. Due to their high tensile strength, a significant amount of force combined with a specific mechanism is usually required in order to injure a ligament of the knee, for example a complex twisting injury to rupture your anterior cruciate ligament or a sideways force to injure your medial collateral ligament.
As with meniscal tears, getting a good history means we have a good idea of finding which structures you are likely to have injured. Critically, it also helps us make recommendations for what is next.
Anterior Knee Pain
This is pain that you experience in the front of your knee and can be based on a host of factors. We may find it is related to the tracking of your knee cap across the front of your knee, muscle strength around your knee and hip, foot posture and position – even changes within your hip can give you anterior knee pain.
A thorough biomechanical assessment is vital here (and is usually carried out by an excellent physiotherapist) to establish the cause and get you started on the right recovery path. Some specialists (consultants) and clinicians dedicate large amounts of their professional career to research and improve treatments for clinical issues which can prove difficult to treat – like anterior knee pain.
This is more common the older we get, and in essence is just wear and tear of the knee joint. It can cause pain, instability, loud clicking and cracking or a “crunching” sensation and can occur in any of the three compartments of the knee.
The best course of action for an osteoarthritic knee is to restore as much normal function and activity as possible by modifying load and improving strength. In cases where the knee continues to worsen, and you find your pain starts to limit function and your quality of life, a range of surgical options may be considered by the appropriate specialist.
This is by no means an exhaustive list of the problems we see with knees, and, other injuries or issues can mask themselves within the knee.
Having a thorough clinical screening plus a review with an appropriate assessment (or sometimes investigation) by an expert clinician is usually vital to getting a good outcome. Although, sending everyone through a big fancy scanner is not always helpful and can sometimes cause more problems than it solves!
If you are living with ongoing knee pain, we can help you with a free clinical screen and advice on appropriate next steps, whether that be advice to see a physiotherapist or advice on appropriate local private specialists. Whatever the issue is, we’ll use our expert clinical skills and easy online form to help you find the right private clinician for your injury.