Nagging Knee Pain.
What could it be? What can I do about it?
Nagging knee pain effects as much 25% of the population over the age of 50.
The most common cause of nagging knee pain in the over 50’s population is osteoarthritis (OA).
In fact, OA affects approximately 2 million Australians, and for many its impact is severe and disabling.
What is Osteoarthritis?
In normal joints, a firm, rubbery material called cartilage covers the end of the bones.
Healthy cartilage provides a smooth, gliding surface for joint motion and provides shock absorption to the joint.
OA is a process degenerative breakdown of the structure of the cartilage which results in a reduced capacity of the cartilage to provide shock absorption and smooth joint movement.
Typically, OA of the knee will present as pain, swelling and stiffness of the knee that tends to develop over time, rather than being associated with a particular incident.
Symptoms tend to appear after extended periods of weight-bearing activity or when you ask the knees to get moving after extended periods of inactivity.
Common risk factors for the development of knee OA include:
– previous knee injury
– weak thigh muscles
– a family history of OA
How can I find out if OA is the cause of my nagging knee pain?
The diagnosis of OA is most commonly made by an experienced health professional based on your symptoms and a thorough examination in the clinic.
In most cases further investigations such as an x-ray are not required, as research studies demonstrate a poor relationship between changes that can be seen on scans and the degree of symptoms that you are experiencing.
Is there anything that I can do about my nagging knee pain?
Thankfully, the vast majority of people struggling with OA of the knee respond well to simple conservative management and are able to limit the impact that OA has on their lives.
Evidence based, conservative management strategies are best described as pharmacological and non-pharmacological.
Of course the pharmacological aspects of management- the use of medications and supplements- are best discussed with your GP and pharmacist.
Allied health professionals, such as your physiotherapist, exercise physiologist and dietician are well positioned to help you with the non-pharmacological aspects of management- education, exercise, weight loss, and the uses of aides and braces.
– Education: having a thorough understanding of your knee problem empowers you to make the best decisions possible when it come to the management of your knee.
– Weight loss: even when we perform everyday activities such as simple walking or climbing the stairs, our knees have to handle forces several times our own body weight. Small reductions in weight can result in significant reductions in the forces that are transmitted across out knee joint. In fact, weight loss of 5% in previously overweight people with OA related knee pain has been demonstrated to significantly reduce their pain and stiffness.
– Exercise: regular exercise incorporating aspects of cardiovascular training, strength training, and stretching/mobility exercises are vital for the health and function of your knee. However; it is vital that your exercise program is tailored to your specific requirements to get the best results. What works well for one person is often quite provocative of knee problems in another.
In general terms, steering towards exercise that does not expose the joints to high impact loads is beneficial, for example; swimming and water based exercise, riding, and rowing. Strengthening of the muscles around the hip, thigh, and lower leg helps to ‘shield’ the knee joint from impact forces that might otherwise provoke it.
For some useful knee strength training ideas check out our free Physio report ’10 Ways to Improve your Knee Pain’ on our website: http://myphysiosa.com.au/knee-pain-free-physio-report/
– Braces: the use of a knee brace can help to unload the sensitive areas within the knee and may allow you to perform tasks such as walking and squatting more comfortably. It is important that you are properly assessed and fitted to ensure you get maximum benefit from the brace and that you don’t waste your money on a brace that is ineffective and unsuited to your needs.
Our experienced Physiotherapists and Exercise Physiologists at myPhysioSA are experts at helping you to get on top of your nagging knee pain and we would love to help you!
For more information, check out the free report ’10 Ways to Improve your Knee Pain’ on our website: http://myphysiosa.com.au/knee-pain-free-physio-report/
Tom Peters, myPhysioSA Senior Associate and SANFL Physiotherapist North Adelaide