​Knee pain is a common complaint that can affect people of all ages and lifestyles. There are various causes of knee pain, ranging from acute injuries to chronic conditions.  It is essential to understand the different types of knee pain to identify the underlying issues and seek appropriate treatment. We will explore some of the most common types and causes of knee pain:

Knee Injuries, Overuse or Age related

• Torn ligament -  Anterior cruciate ligament (ACL) is a band of connective tissues mainly made up of collagen fibers and its function is to control the front and back motion of the knee. ACL injuries are the most common knee injury, frequently happen during sports activities that involve sudden stops, pivots, or changes in direction. These injuries cause pain, swelling, and instability in the knee. 

 

• Torn cartilage or Meniscus tear - The meniscus is a wedge-shaped cartilage that cushions and stabilizes the knee joint. Tears can occur due to sudden twisting or rotating movements when putting your full weight on your knee.  Wear and tear on your knees over time also increases the risk of meniscus tear, causing pain, swelling, and limited knee movement.

 

• Tendonitis - The inflammation of tendons that attach muscles to bones. In the knee, patellar tendonitis (also known as "jumper's knee") is a common form of tendonitis.  This condition involves inflammation of the patellar tendon, which connects the patella to the shinbone. It often affects athletes who engage in jumping or repetitive knee movements. It is a common form of tendonitis that causes pain just below the kneecap.  An untreated patellar tendonitis will weaken the tenon overtime, thereby increasing the risk of patellar tendon rupture or tear.  

 

• Patellar tendon ruptures or tears - This is common in sports injury and it can also happen in accidents.  This happens when there is a sudden blow on the front of the knee.  When this tendon experiences a rupture or tear, it can lead to significant pain, functional impairment, and a need for specialized medical care.  When this tendon experiences a rupture or tear, it can lead to significant pain, functional impairment, and a need for specialized medical care. 

 

• Osteoporosis and Hip Fractures or other bones - Osteoporosis itself doesn't directly cause knee pain, but the compromised bone density associated with osteoporosis can make bones more vulnerable to fractures and injuries, including those of the knee joint. Additionally, changes in posture and movement due to osteoporosis-related fractures can contribute to knee pain.  Hip fractures are a common consequence of osteoporosis, and they can have a cascading impact on other joints, including the knees. A hip fracture can alter gait and overall movement patterns, leading to changes in the mechanics of the entire lower body, including the knees.

 

• Bursitis - Bursitis is a common condition characterized by inflammation of the bursae, small fluid-filled sacs located near joints that provide cushioning and reduce friction between bones, tendons, and muscles. When these sacs become inflamed, it can lead to pain, discomfort, and limited mobility.  You may experience swelling of the front kneecap, pain when bending the knee and the pain worsens in the night.

 

• Dislocation of Kneecap - Also known as patellar dislocation, that occurs when the patella (kneecap) is forced out of its normal position within the patellar groove of the femur (thigh bone). This injury can cause significant pain and instability in the knee joint, affecting individuals of all ages and activity levels.

 

• Iliotibial band syndrome (IT band) - A common overuse injury that affects runners and athletes, causing pain on the outside of the knee. IT band is a thick band of tissue that runs along the outside of the thigh, and when it becomes inflamed or irritated, it can lead to discomfort during physical activities. The pain is an aching, burning sensation that spreads up the thigh and to the hip. You may only experience the pain only when you exercise, especially during running.

 

• Patellofemoral syndrome (PFS) - Also known as "runner's knee," PFS often occurs due to improper alignment or overuse of the patellofemoral joint, leading to discomfort during activities that involve bending the knee.  PFS is characterized by pain around or behind the patella that is aggravated by activities such as running, climbing stairs, or sitting for prolonged periods. You may experience pain under the kneecap when you squat,  walk down the stairs or get up after sitting for a long period.

 

• Incorrect Posture and Biomechanics: Poor posture or improper alignment of the knees during activities can lead to increased stress on the joint, contributing to knee pain over time.  However, poor mechanics of other parts of the body such as the back and pelvis will put the knee, ankle and foot into a bad position which will cause knee pain.

 

• Strain or Sprain - A knee strain refers to the stretching or tearing of the muscles or tendons around the knee joint. It often occurs due to sudden movements, overexertion, or improper form during physical activities.  A knee sprain, on the other hand, involves the stretching or tearing of ligaments that connect the bones in the knee joint.

 History of Arthritis or Knee Arthritis

• Osteoarthritis - This is a degenerative joint disease and one of the most common causes of knee pain, particularly among older adults. Osteoarthritis results from the gradual breakdown of cartilage in the knee joint, leading to pain, stiffness, and reduced mobility.

 

• Rheumatoid arthritis - This autoimmune disease can affect any joint in the body, including the knee. It causes pain, swelling, and stiffness in the affected joint.

 

• Post-trauma arthritis - This is an inflammation of the knee joint after an injury. It is usually a temporary issue only.

 

• Gout - Gout is a form of arthritis that occurs due to the buildup of uric acid crystals in the joints, including the knees. This can lead to sudden and intense pain and swelling in the affected area.   

 
Overweight or Obesity
Carrying excess weight can put additional stress on the knees, leading to pain and an increased risk of developing osteoarthritis.  

It's important to note that knee pain can sometimes be a symptom of a more serious underlying condition, so it's crucial to seek medical attention if the pain is persistent, severe, or accompanied by other concerning symptoms. Treatment for knee pain depends on the underlying cause and may include rest, physical therapy, pain relief medications, and, in severe cases, surgical intervention.
Always consult with a healthcare professional for an accurate diagnosis and appropriate treatment for your specific condition.

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References
Knee Pain
Knee Injuries
Causes and Tips for Coping with Chronic Knee Pain
Patellar Tendon Tear
Osteoarthritis