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A Comprehensive guide to Knee Pain

When working out, you might wonder why you sometimes experience knee pain even after proper warm up and stretching.  Having to deal with knee pain can be very frustrating and it’s very impossible to self-diagnose because knee pain can be caused by a great many factors.

Understanding the knee anatomy

  • There are 4 bones that meet to form the knee joint – the femur (thigh bone), the tibia (shinbone), the fibula (bone on the outside of the lower leg), and the patella (kneecap)
  • The articular cartilage covers the ends of the femur and the tibia, as well as the back of the patella. This helps the knee bones glide smoothly when you bend or straighten it.
  • We have 2 shock absorbers between the femur and tibia. This is wedge-shaped and more rubbery than the articular cartilage
  • Ligaments connect bones to other bones while tendons connect muscles to bones.

anatomy of the knee

Establishing where the knee pain comes from will reveal what we can include in your strength program in order address that weakness or imbalance.

When experiencing knee pain, it is always a good idea to get the help of a strength coach.  But if you are experiencing any of the symptoms below, it would be better to consult a physio first who can recommend a scan or rehab activities that we can certainly assist you with.

Symptoms to watch out for:

  • Do you hear a popping noise and sometimes feel your knee giving out?
  • Do you feel severe pain?
  • Do you sometimes struggle to move your knee?
  • Do you have a limp?
  • Do you have any swelling?

If you are experiencing any of these, we must first seek the help of a physio who will recommend any of the following:

 

Reducing the range of motion

Any reduction in the range of motion can be caused by either a tight fascia or tight muscles.

The fascia is a spider-web like connective tissue that runs from your foot to your head.  There are 3 layers of it running beneath the skin and some that runs deep enough through the joints.

 

Tight muscles can be caused by either of these 3 main reasons.

  • Increased nociceptor activity – nociceptors are found in the skin and tissues that provide information on dangerous stimuli and sends this feedback to the brain. This serves as a master regulator and usually signals muscle tightness with people who have stressful lifestyles.
  • Metabolic damage – this happens when you have muscle tissues that has yet to recover after you exercise. Short term damage due to going through training sessions will not have a negative effect on your movement.  However, long periods of intense training without rest will definitely have an effect on movement.
  • Shortened muscle tissue – the usual culprits for these are the adductor maanus, tight hamstrings, and tight quads.

 

Any muscle imbalance or weakness

Having an overly dominant vastus lateralis coupled with an under active VMO is the most common imbalance that causes knee pain.  This manifests as clicking or cracking outside the knee when you walk up the stairs for example.  Having fluid in the knee can also restrict movement and proper function of the quads.

 

Having inactive hip rotators in your glutes

External hip rotators function to prevent the knees from dropping in whenever you run, jump or squat.  Weak external hip rotators will restrict the proper function of the knee and will cause pain along the medial joint line.  Clamshell exercises and lateral band walks can help activate your hip rotators and relieve medial knee pain.

Understanding the overview of what causes knee pain will help you appreciate the advantage of working with a physio that can help you from the early stage of rehab right up to getting you back to full strength.