Unfortunately, knee pain is a common fact of life for a large percentage of society, especially as you age. There are many different types of knee pain that you can suffer from. The most important thing is to identify what is causing the pain, find out how you can heal or control it, and then take the steps necessary to make your life better even with knee pain.
How the Knee Works and Why It’s So Important
Your knee is essentially a hinge that connects your thigh with your shin. You have muscles connected by tendons around the knee that help you move your knee. In addition, there are many ligaments (which are bands of tissue) that connect the bones and keep the joint braced.
Plus, you have your knee cap, which has two layers and an inner membrane which lubricates the joint with its secretions. Within your knee, there is also cartilage – a flexible connective tissue that is, unfortunately, easy to damage. It’s a complicated piece of equipment that sometimes becomes damaged in different ways.
The makeup of your knee allows you to bend, kneel, squat, walk, run, and jump. Most of the time, you can do this without any issues. But, there are common problems that can affect your knee and cause pain for many individuals. With so many working parts in the knee, there are bound to be some issues for some people, especially as you get older.
Common Knee Problems
Since most people experience knee issues at some point in their lives, it’s important to understand the different things that can go wrong – and what you can do about it, if anything.
Ligament Damage
Ligament tears and sprains are usually caused by being very active; they usually occur during a sport. There are some more serious injuries such as damage to the ACL (anterior cruciate ligament), PCL (posterior cruciate ligament), and MCL (medial collateral ligament). If you damage one of these ligaments, it’s more than likely you’re going to end up having surgery. The pain is very severe and may need to be treated with drugs, surgery, and therapy.
Cartilage Damage
If you have knee pain even when you rest your knee, it can often be traced to cartilage damage. You’ll feel some pain in the joint, especially when you put weight on it. In addition, you can experience stiffness and swelling. Sometimes you’ll hear a clicking or feel a grinding sensation when you move it. The joint might even catch and feel as if it’s locked in place or give way when you try to get up and move.
Arthritis
Another common cause of knee problems is arthritis. The only thing you can do about arthritis pain is rest, ice, and possibly surgery. It depends on what type you have, which could be rheumatoid arthritis, post-traumatic arthritis, and osteoarthritis. The symptoms you’ll get are stiffness, swelling, and finding it hard to bend your knee. It is a progressive degenerative disease that you’ll have to deal with for a long time. Total knee replacement might be an option.
Tendonitis
Most instances of tendonitis are caused by repetitive movements. The tendons that connect your thigh bone to your shin are flexible bands of tissue that help connect the muscle to the bones. When you have a repetitive injury, these tendons become inflamed and the movement becomes painful. You can have swelling and pain when moving, and it will get better as you rest, ice, and elevate it.
Gout
While the most common place to experience gout is your big toe, you can also get it in the knee or any other joint. It is characterized by very intense pain. Your knee may become hot to the touch, red, swollen, and inflamed as well. This is usually caused by high levels of uric acid in the blood which forms crystals, thereby causing the inflammatory response. Typically, doctors will prescribe medication to reduce uric acid and talk to you about your diet.
The only way to know for sure what is wrong with your knee is to go to a doctor and get diagnosed. Let’s look next at what is likely to happen at the doctor’s.
How Knee Problems are Diagnosed
When you realize that you have knee problems that are causing you a lot of pain, it’s better to go to a doctor rather than trying to self-diagnose. If you read the symptoms above of each type of knee pain, you’ll probably have a suspicion of what is going on. But, you should still seek medical care.
Your doctor will check your knee for swelling, tenderness, bruising, and whether it feels warm to the touch. They’ll also ask you about your pain level, usually from 1 to 10. They may ask you to perform the movements that cause you pain. They’ll see how far they can make you move your knee in various directions to assess the damage. They may also manipulate your knee joint to try to determine the amount of damage.
In addition, if they feel that it is warranted after performing the physical and talking to you, they will conduct various tests. They may do an X-Ray, a CT scan, ultrasound, or an MRI (or more than one of these) to try to determine the exact reason for your knee pain. They may also do blood tests to rule out other problems.
The best thing to do is go to your doctor and be honest about your situation and describe the pain as carefully and as descriptively as you can so that they can help you. Then, follow their instructions to get better.
Types of Knee Surgery
Sometimes, surgery is the only way to cure your problem, or at least make it better so that you can have a higher quality of life. There are many different types of surgery that you might be recommended – more than can be listed here. But, let’s talk about the types of surgery that you might get for some of the more common knee problems that are mentioned above.
Meniscectomy
This surgery is when they remove part of your meniscus cartilage from the knee joint. This is the part of your cartilage that acts as shocks for your knee, absorbing a lot of the pressure that you put on your knee as you run, walk, and jump. This is usually done for a small meniscus tear to relieve pain.
Depending on your doctor, you may do this surgery under either regional or general anesthesia. Sometimes it can even be under local anesthetic. You may or may not need crutches directly after surgery. There may be a few activity restrictions, but usually not that many. Most people return to normal activities within four to eight weeks.
Meniscus Repair
This surgery is used when the cartilage needs more repair than just a little trim. This surgery is performed under general anesthesia and it takes longer to heal. Sometimes it can’t even be done on some patients who instead try physical therapy, strengthening exercises, anti-inflammatory medications and perhaps cortisone injections. But surgery can be an option for some.
This surgery can fix problems with not being able to bend or straighten your knee. It can also cure the popping or clicking sound that you may hear when you try to move your knee. Instead of removing the torn meniscus, they will try to repair it. If the tear is near the outer edge, you’re a good candidate because there is more blood going to this area which allows it to heal. This surgery requires extensive rehab to be successful.
Lateral Release
This surgery fixes the kneecap when it’s not aligned properly. If you’ve dislocated your kneecap and can’t get it back in place without surgery, it can be very painful. This outpatient surgery will repair the problem and let the kneecap go back to its correct position, thus removing the pain.
There are different procedures of this surgery depending on how they need to cut to get your kneecap to move back to where it goes – without releasing it too much so that the kneecap doesn’t get out of place too easily after surgery.
Meniscus Transplant
If a patient has enough issues, a doctor might decide that the meniscus needs to be replaced. This is done when the entire meniscus must be removed due to persistent unrelenting pain from your injury. Usually, they use a cadaver donor for this procedure for patients who are still wanting to be very active, as an artificial replacement may not be the right choice.
ACL Reconstruction
This surgery is common in athletes. ACL reconstruction involves a cadaver donor graft or even from your own body. Often when this surgery is done, other surgeries are performed simultaneously, depending on the amount of damage.
Depending on the surgeon and your issues, you may end up with a screw or staple in there to hold the graft in place for up to a year until they’re sure the graft is working. A lot of rehabilitation is necessary for this; expect not to be normal for a year to two years.
Partial Knee Replacement
When a patient has loss of cartilage in a small part of the knee, the option might be a partial knee repair. A surgeon can replace just the worn-out parts rather than the entire knee when this is the right thing. It is not an option for patients with widespread arthritis.
What’s interesting is that partial knee replacement is getting more popular due to robotics. Robots assist surgeons in these more complex procedures, making them easier to perform and more accurate.
Full Knee Replacement
Patients can get a full knee replacement which replaces the entire knee joint, starting at the cartilage at the end of the thigh bone and ending at the shin bone. Surgeons use a metal and plastic implant to accomplish this. Sometimes they must replace the kneecap surface too.
This surgery can restore alignment of the knee joint, and make sure you can bend it and walk normally. It is performed under general anesthesia and will take weeks of physical therapy and recovery, but most of the time the prognosis is good.
There are many other types of surgery that you can get depending on the type of damage or injury that you have suffered. You and your doctor will decide what is best for you, depending on your lifestyle, insurance, and several factors.
Post-Op Knee Strengthening Tips
Anytime you get any type of operation, it’s imperative that you listen to your surgeon and the team taking care of you. You will only get better if you are a full participant in the process. So, listen carefully and ask a lot of questions when you’re not sure.
Low-impact exercises that cause you to bend and straighten your knee are good for helping you build up the muscles surrounding the knee in your thigh and your calves. This is going to help you support your knee better. Examples of low-impact exercises are squats, hamstring bridges, and step-ups.
Squats
You can do squats with the support of a chair until you feel steady. The trick with squats is to squat down without allowing your knees to go over the tips of your toes. Keep your core tight, and squat down slowly and come back up slowly. You can do these as single or double squats too.
Hamstring Bridges
You can use a chair, your coach, or a yoga ball for this. You can even use the floor if you’re not ready to use the equipment. Lie down on your back with your knees bent. Push both of your feet on the couch, chair, yoga ball or floor, lifting your bottom off the floor while pushing down. Hold the position for a count of three, then slowly lower.
Step-Ups
You can use the steps in your house or you can buy a stepper. This involves just stepping up, then down. Do it ten times, in sets of three. Do this exercise slowly, controlling the step-up as much as you control the step-down for best results.
Stretches
You can do a lot of stretches just sitting on your couch, your easy chair, or a straight back chair. Simply sit up straight, then lift your leg and stretch it out and hold it if you can for a count of 10. When you first start, you can stretch your knee out using a chair to support it and just sit there for 10 minutes. Do this five times, then move up to as many as 50 times as you recover.
Walking
One of the best things you can do for yourself, no matter what the reason, is to walk. You may have to start slow, but the goal is to build up to at least ten thousand steps a day. You may have to start with walking to and from the bathroom, then walking to your mailbox, then walking down the street and so on. Talk to your doctor about how far you can walk, because you don’t want to overdo it. But you do want to walk daily and build up a little more each day.
Water Therapy
At some point, usually within two to three weeks after your operation, your stitches will be removed and you’ll be cleared for getting wet. This is a good time to start water therapy. Water is wonderful for helping you keep your balance, letting you stretch out with less pain due to not having to deal with gravity. While you’re in there, you can work out all parts of your body easier.
Any type of movement you can do that helps you strengthen all your muscles, increase movement in your entire body, and help heal your knee, is going to be beneficial – as long as you’ve been cleared by your doctor to do it.
Tips for Faster Surgery Recovery
In addition to specific exercises depending on your surgery, there are general tips that will help you recover faster from any type of surgery. Surgery alone isn’t really a cure for anything. It’s how you treat yourself after that will make all the difference, especially when it comes to knee surgery.
Do Not Smoke
If you smoke, stop at least six weeks prior to surgery and don’t start back while you’re recovering. Smoking can limit the oxygen that you get to the injury site, causing problems with recovery.
Stay Hydrated
Drinking enough water will also help your body heal faster. If you are dehydrated, your body must send resources elsewhere. But, if you stay hydrated, your body can focus on healing.
Sleep
Try to sleep eight hours a night while you’re recovering, if not nine. The reason is that your body does a lot of interesting things while you’re sleeping. Your heart rate slows and your organs and muscles get to rest and build instead of fighting off attacks. Plus, your body sends out growth hormones that can help heal cuts, and yes, surgery damage.
Move
We talked about exercise, and it’s important. It can be hard to make yourself move and do what you’re supposed to do. But now more than ever after surgery, you need to move, as you’ll avoid complications such as poor blood flow and blood clots. You will also speed up healing.
Eat Right
Think about the nutrition that you need. After surgery, you should eat more protein. The trick though is to choose lean, healthy proteins. You can even include vegan proteins like tofu and beans, but consider doubling your protein intake for about eight weeks after surgery if you don’t have any kidney issues; it will help you heal better and build more muscle.
Add Vitamins
Consider, if your doctor approves, adding Vitamin C, A, D3, and B12 to your vitamin regimen to also boost your nutrition and help you heal faster. Vitamin D has been shown to reduce recovery time after surgery.
Knee problems and knee pain can really set you back in terms of your lifestyle and health, but thankfully there are ways to make it easier for you and take care of yourself.
