Conditions & Treatments

Symptoms

The Treatment of Hip and Knee Pain

Here at Osteon we have some of the best therapists to help assess, diagnose and treat your painful knees, but what can cause knee pain?

Pain below the knee

Patella Tendonitis (Jumper's Knee)
This is an overuse injury where the athlete does a lot of twisting or turning at speed, jumping or heavy landing onto the legs. This causes trauma and small tears to the patella tendon. Pain is felt at the base of the knee cap.

Signs of this can be aching and stiffness after training, pain when you contract the quadriceps muscles, the patella tendon is painful to touch and it can also be associated with poor Vastus Medialis Obliquus (VMO) function.

Treatment for Patella Tendonitis

Rest from training in mild and moderate cases
Cold therapy after any training
Knee straps, kinesiology tape can help reduce the pain and ease the strain on the tendon
Physiotherapy to improve strength on the surrounding muscles
See a sports injury therapist at Osteon if pain persists

Patellofemoral Pain Syndrome
This is a generic term for pain at the front of the knee that comes on slowly and gradually gets worse. General patellofemoral pain syndrome happens when the patella does not move or there is a mistracking when the knee is being bent and straightened.

Symptoms are aching at the front of the knee; swelling sometimes happens after exercise, pain increases when walking up or down hills or stairs, and the knee clicks or grinds on bending. Runners might notice tight muscles, such as the calf muscles, hamstrings and quadriceps.

Runners that over pronate are susceptible to getting patellofemoral pain syndrome and, if you suffer with tight or weak muscles or do a lot of long distance running or hill running, then watch out.

Treatment for Patellofemoral Pain Syndrome

Rest until there is no pain.
Apply RICE (Rest, Ice, Compression and Elevation) after activity. This will help reduce pain and swelling.
Knee straps, kinesiology tape can help reduce the pain and a patella stabilising support to control excess movement.
Look at physiotherapy to help with stretching and strengthening the leg muscles, focus on the VMO and ITB, and using single leg exercises to balance out any weaknesses.
If you over pronate, then consider using orthotics or trainers with arch supports.
See a sports injury therapist at Osteon if pain persists.

Pain on the inside of the knee

Pes Anserine Tendinopathy / Bursitis
This is a repetitive strain condition can be easily mistaken for Medial Collateral Ligament (MCL) injury do to the close proximity.

In simply terms, the Pes Anserine is the point where the tendons of the semitendinosis (Hamstring), Satorius and Gracilis muscles meet and attach to the tibia on the inner part of the lower knee; this can become painful due to repetitive strain.

In this area there is also a bursa, called the anserine bursa which lies between this combined tendon and the Tibia bone underneath. This bursa may become inflamed due to repetitive friction in sports such as cycling, running.

Some symptoms of this condition are pain over the inner and lower knee, pain on climbing stairs, localised swelling, pain on contraction of the hamstrings, pain on stretching the hamstrings.

Treatment for Pes Anserine Tendinopathy / Bursitis

Rest until there is no pain.
Use cold therapy to reduce the pain and inflammation
If you over pronate then consider using orthotics, or trainers with arch supports.
The use of tape / kinesiology tape to help support the knee.
Stretching the hamstrings, quads and groin muscles effectively.
Sports massage therapy may be useful to treat the hamstrings.
See a sports injury therapist if pain persists.

Pain on the outside of the knee (ITB Syndrome)

Ilio Tibial Band Friction Syndrome (ITBFS)
Otherwise known as "Runner's Knee", this is a common and painful overuse injury that mainly affects the out part of the knee.

This common problem has many causes, people who have weak hip muscles such as the gluteus medius, or if you overpronate you can suffer from this condition and runners who do excessive training or hill running can be very susceptible.

Common symptoms for ITBFS are suffering from Pain on the outside of the knee, Tightness in the iliotibial band, pain is normally aggravated by running, particularly downhill or during flexion or extension of the knee, made worse by pressing in at the side of the knee over the sore part.

Treatment for Ilio Tibial Band Friction Syndrome (ITBFS)

Rest, or reduce the mileage
Avoid painful running, for example downhill running or running on uneven surfaces
Apply cold therapy or ice to reduce any inflammation
Iliotibial band stretches after training and throughout the day are important
Combine the stretches with the use of a foam roller for the ITB, calfs and quads
Self massage techniques can also be very helpful in correcting ITB tightness
See a sports injury therapist if pain persists

Pain behind the knee

Popliteus Strain
The popliteus muscle is a tiny muscle situated in the back of the knee joint, it assists with internal or medial rotation of the tibia and also helps unlock the knee when a runner initiates knee flexion, or bends the knee from a fully extended position.

This poor little muscle is at risk to over use injuries, and injuries that are causes by muscular imbalances around the knee, also if the knee is excessively hyper extended.

Some signs of a popliteus strain are: if the muscle is tender to the touch; if you get posterior knee pain on resisted knee flexion; if your hamstrings are excessively tight and knee extension is painful or uncomfortable.

Treatment for Popliteus Strain

Rest until there is no pain and, if you still train, avoid running down hills
Make sure you have correct footwear when training
The popliteus muscle is difficult to work on and responds well to massage therapy
Apply cold therapy or ice to reduce any inflammation
Strength programme to reduce any muscular imbalances in the leg
See a sports injury therapist if pain persists

Note - This is not an exhaustive list of knee conditions, but a guide to a few overuse injuries that are common in runners. This doesn't address direct trauma to the knee joint such as tears or ruptures as that's a whole other article. Above all, always seek medical advice from a qualified therapist if pain persists, or just pop in an see one of the team.

For more information please call us on 020 7043 6025 or click here to request a callback