Knee pain

BETHANY AITKEN, CLINICAL SERVICES MANAGER FOR MSK

Common knee pain myths

14 June 2024

There are lots of types of knee pain. It can range in severity and, depending on the amount of pain, it can affect the ability to exercise. It can also come and go, or it can flare up suddenly after certain activities. That means there are also many possible causes of knee pain.

The medical advice and care instructions you receive will depend on your situation, so treatment paths differ from one person to the next. With so much different advice out there, it’s not difficult to see how myths and misconceptions may occur.

Let’s look at some of the common causes of the condition, and tackle some of the more common myths that accompany knee pain.

What kind of injuries cause knee pain?

Knee pain is often the result of an injury. This can be easier to identify and treat if the pain starts suddenly during a particular movement or event, such playing sport or having an accident.

These types of injuries include:

Sprains and strains

Often caused by overstretching or twisting your knee, you’ll usually feel the pain immediately. The severity of a knee strain or sprain can vary depending on whether the ligaments or muscles in the area are torn or they’ve just been overstretched. Either way, the usual first step is to treat it with RICE: Rest, ICE, Compression and Elevation.

Tendonitis

Tendonitis, specifically patellar tendonitis, causes knee pain when an injury to the patellar tendon causes irritation and inflammation.

The patellar tendon runs between your kneecap (patella) and your shinbone, so the pain is usually felt between those areas. And, as the tendon is responsible for kicking, running and jumping movements, patellar tendonitis often affects runners, basketball players and those involved in jumping sports.

Torn or damaged ligament

There are a number of ligaments that run through and around the knee. Alongside sharp pain, torn ligaments can cause your knee to be unstable or give way easily, and it’ll be difficult or impossible to straighten your leg. However, it’s worth noting that torn ligaments aren’t always that serious if you’re able to maintain muscle strength to compensate.

Torn meniscus

The meniscus is a tough, rubbery layer of cartilage between your shin and thigh bones. It acts as a shock absorber and, while it’s flexible, it can become damaged if you twist the knee suddenly, but most torn meniscus cases are a result of ageing.

The area will be painful or tender, accompanied by stiffness and swelling around your knee, though some of these symptoms may take a while to materialise. It’ll also be difficult to bend, straighten or move your knee.

Dislocated kneecap

The kneecap (patella) is a triangular shaped bone that sits at the front of the knee joint. A dislocation occurs when it moves out of place and is usually caused by a collision or sudden change in direction.

In some cases, a dislocated kneecap will return back into place on its own. If not, a doctor will need to manipulate it into position. Scans and follow up appointments might be needed to double check the area is healing properly.

What other conditions could be causing my knee pain?

Sometimes, knee pain can develop without any obvious incident or injury. In these cases, it might be a symptom of a more long-term issue, such as:

Osteoarthritis

Osteoarthritis is the most common type of arthritis in the UK.1 It develops over time so is more common the older we get, causing pain and stiffness in the joints.

>Check out our guide to osteoarthritis for more information and guidance – Osteoarthritis

Bursitis

Our joints have fluid-filled sacs (bursa) cushioning them. Bursitis is when one of these sacs becomes painful and inflamed. It’s usually a dull, aching pain and the area might be swollen and tender making it difficult to bend the knee or kneel down.

In most cases, bursitis should go away in a few weeks with rest, ice and pain medication at home.

Gout

Gout is a form of arthritis that causes sudden, severe joint pain. It usually affects joints in and around the feet, but it can occur in other areas, including the knees. You’ll feel very severe pain that comes on suddenly. Your knee may be red and feel hot.

Seven common knee pain myths

With so many possible causes, the advice you receive for one issue may be completely different compared to something else. So, it’s not surprising that there’s some uncertainty surrounding knee pain.

Let’s look at some common myths and the truth behind them.

1) Knee pain means there must be a problem with my knee

Not necessarily. In addition to all the possible causes above, pain in the knee can be referred from elsewhere. For instance, problems in the lower back can cause knee pain as it contains nerves that supply the muscles around the knee.2

2) Running will damage my knees

While knee pain or injury is a common running injury, runners also tend to have stronger muscles, bones and connecting tissues around the knee joints. This can mean that runners have strong knees, which are supported against certain injuries. Research has also shown that recreational runners tend to have lower rates of osteoarthritis than sedentary people.3

3) Knee pain is inevitable as I get older

While ageing is associated with conditions such as arthritis and weakened muscles – which can certainly impact the knees – there’s no specific direct correlation between age and knee pain. So, while it might be more likely, it’s not inevitable.

4) I can push through the pain

This is usually not a good idea and could make the situation worse. It’s important to identify the cause of any knee pain first, then adjust your behaviour appropriately. Pushing through the pain is rarely the answer…

5) It’s best to decrease or avoid physical activity when dealing with knee pain

…but at the same time, depending on the issue, it’s often important to keep the knee (and yourself) moving. Depending on the source of your pain, low impact exercise can help. Things like low resistance on a cross trainer or on an exercise bike.

6) Surgery is the best remedy

In most cases, surgery is a last resort. Although it’s necessary for some conditions, it can take a long time to recover from, so all non-surgical options should be considered first. Physiotherapy, anti-inflammatory painkillers, ice and heat, low-impact exercise and rest could all be helpful, depending on the circumstances.

7) I won’t get any knee pain if I don’t run or play sports

On the contrary, some sources of knee pain are more common among people with a sedentary lifestyle. Excess weight can overload the knees and lead to problems over time. And strong muscles and bones help prevent problems, so there’s no reason not to exercise and be active.

What should I do if I have knee pain?

Of course, every situation is different, but if you’re suffering with knee pain, you may want to start with some self-care options to see if they help. This could include rest, elevation, using an ice pack intermittently and introducing light exercise to keep the joint moving.

If the pain is excruciating, persistent or getting worse over time, you should see your GP or a physiotherapist. You should also seek immediate medical advice if:

  • you can’t move your knee or put any weight on it
  • your knee is very swollen or it’s changed shape
  • the knee locks, gives way or clicks painfully (painless clicking is normal)
  • it’s accompanied by a very high temperature, or you feel hot and shivery and have redness or heat around your knee, as this can be a sign of infection.

References

  1. Osteoarthritis - NHS
  2. Referred Pain - physio.co.uk
  3. Running Safely With Knee Osteoarthritis - Arthritis Foundation



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