Knee injuries are all too common, can be very painful and are, in many cases, difficult to completely heal. This is due to a combination of factors, including that it’s a joint that is used all the time, the joint has a variety of points where it can be damaged and that the joint has to deal with a lot of weight and pressure.
People of all ages and activity levels may be at risk for developing knee injuries. Injuries can be the result of direct damage, such as falling or wrenching your knee, but they can also build up over time as a result of wear and tear from aging or making the same motions.
If you’re having chronic or acute knee pain, you may be able to get an idea of what the issue might be by looking at our list of the most common cause of knee pain. You’ll find out what the symptoms are, how injuries or conditions develop and treatments offered by chiropractors.
Conditions that Cause Knee Pain
Anterior Cruciate Ligament (ACL) Injuries
The anterior cruciate ligament is one of four ligaments in the knee. This ligament is found behind your kneecap, and its job is to stabilize your knee while it rotates. The ACL also works with the posterior cruciate ligament to connect your thigh bone to your shin bone.
ACL injuries are very common, and they’re increasingly common in children and teenagers due to participation in sports. Women are very liable to develop ACL injuries, and it’s estimated that they are anywhere from two to eight times as likely to suffer a torn ACL than a man.
Damage to the ACL occurs most frequently when someone is playing a sport that involves jumps or sudden movements in a different direction. Sports that are typically associated with ACL injuries include basketball, soccer, gymnastics and tennis. These injuries may also be the result of falling or something striking the knee while it is twisted.
ACL injuries may involve full or partial tears, and it’s not uncommon for other damage to the knee to occur at the same time.
Symptoms of Anterior Cruciate Ligament (ACL) Injuries
Many people report feeling or hearing a popping sound when an ACL injury takes place. Other common indications of an ACL injury include:
- Swelling or stiffness in the knee joint
- A reduced range of motion
- Grinding feelings when moving the knee
- Severe pain and problems putting weight on your knee
Treatment for Anterior Cruciate Ligament (ACL) Injuries
Since the ACL plays such an important role in stabilizing the knee, it’s an injury that often involves a long recovery time. While surgery is an option for some people, it’s not always necessary, and it is frequently for the best for individuals to avoid operations unless absolutely necessary due to the risk of complications, recovery time and pain.
If someone is able to avoid surgery, they will typically receive treatment that focuses on rest and building up the strength in the knee again after it heals. Braces and splints may help to provide extra support and reduce the amount of work that the ACL has to do while it is healing. Physical therapy can help people regain strength and their range of motion.
A Baker’s cyst, also known as a popliteal cyst, is a fluid filled sac that forms behind the knee, and it causes a bulge and tight feelings when fully extended the knee or when you’re participating in an activity that involves a lot of movement of your knee. These cysts usually form due to a problem with the knee joint, such as osteoarthritis or cartilage tears. When there is damage to the cartilage in the knee, the body may produce too much fluid, which is what causes the cyst to form.
Symptoms of a Baker’s Cyst
Not everyone who develops a Baker’s cyst will have symptoms. People who do experience problems related to the cyst may be more likely to have larger cysts that are more likely to interfere with their use of their knee joint. Common symptoms of this condition include:
- Stiffness of the knee or problems flexing it
- Pain in the knee
- A bulge behind your knee joint and/or swelling of the knee
Treatment for a Baker’s Cyst
The good news is that treatment of the underlying cause of the cyst is normally all that’s needed to reduce or eliminate symptoms. While a physical exam can normally allow a chiropractor to determine if you have a Baker’s cyst, the symptoms of this condition can sometimes emulate more serious problems, so a medical professional may recommend an MRI or other imaging scan to verify the diagnosis.
Since osteoarthritis and/or cartilage damage are usually the source of the fluid filling the cyst, chiropractors will normally focus on improving the quality of cartilage at your knee joint. Certain exercises, stretches and supplements or vitamins can help with this. The option of draining the cyst also exists if the cyst is very large.
Patellar Tendinitis (Jumper’s Knee)
Also referred to as jumper’s knee, patellar tendinitis refers to an injury to the patella, which is the tendon that connects your kneecap to your shinbone. Typically, people who play sports that involve a lot of jumping are the most likely to develop this condition; it’s estimated that nearly 15 percent of volleyball players suffer from jumper’s knee.
However, even individuals who don’t play sports can develop it. Injuries to the patellar tendon can occur as a result of overuse, and making the same movements over and over again can cause damage to accumulate. Along with jumping, running and tightness in your thigh muscles can put strain on your patellar tendon. Additionally, if there’s an imbalance in the strength of the muscles in your legs, this could result in overworking your patellar tendon.
Other issues may also lead to jumper’s knee. A lack of alignment of the legs can cause it to develop, and wearing shoes without enough padding or spending a lot of time on hard surfaces can also cause it.
Symptoms of Patellar Tendinitis
As with most injuries, pain is one of the first indications of jumper’s knee. The pain usually occurs where your kneecap joins your shin bone. Pain related to this condition typically builds up, first starting as an annoyance and then getting to the point that it interferes with your ability to basic things like getting up from a chair or going up stairs.
Other symptoms may include:
- Swelling of the knee cap
- A burning sensation at the knee
- Kneeling down or getting up from a squat may be especially painful
Treatment for Patellar Tendinitis
In most cases, jumper’s knee develops as a result of overuse of the patellar tendon instead of direct damage to it. What normally occurs is that small tears occur in the tendon due to excessive use. If tears build up faster than the body can repair them, pain and other symptoms will continue to get worse.
As a result, one of the main focuses of treatment is to give the body time to heal the damage that has accrued. Chiropractors will also typically try to determine what the underlying cause of the damage was.
While it’s often clear in the cases of people who play sports, the cause of jumper’s knee may not be clear if someone doesn’t frequently engage in activities that normally lead to the condition. Chiropractors will check for alignment problems in joints that could put additional strain on the patellar tendon, and they may also see if issues with other types of exercise may be causing the damage to the tendon. Knee braces, physical therapy and stretching exercises may also be recommended as part of a treatment plan.
Posterior Cruciate Ligament (PCL) Injuries
While not as common as anterior cruciate ligament injuries, posterior cruciate ligament (PCL) injuries are still a somewhat common knee injury; they make up about a fifth of injuries to the knee. The PCL works with the ACL to connect your shin bone to your thigh bone, and the two ligaments form an X in the middle of the knee.
PCL injuries tend to be more likely for people who play sports, and they typically occur when someone falls on a bent knee or when their foot is pointed down. This normally causes the shin to hit the ground first and causes it to move backwards, which can result in damage to the PCL.
Another common cause of PCL injuries is car accidents. They are normally dashboard injuries and occur when a person’s bent knee slams into the dashboard and pushes the shinbone below the knee back, damaging the PCL.
Essentially, any action that leads to the shinbone being hit just below the knee with sufficient force can cause damage to the PCL.
There are several grades or levels of PCL injuries, which are:
Grade 1: A partial tear to the PCL
Grade 2: The ligament has a more severe tear than Grade 1 and is somewhat lose
Grade 3: A complete tear that results in a knee that is unstable
Grade 4: Both the PCL and another knee ligament is damaged
Symptoms of Posterior Cruciate Ligament (PCL) Injuries
The symptoms of a PCL injury will depend on how severe the tear was and whether the issue is acute or chronic. Acute pain comes on abruptly as a result of direct injury to the knee. Chronic pain is the result of a buildup of damage to the PCL, often from repeating the same movements. Along with knee pain, symptoms of a PCL injury include:
- Swelling of the knee
- Knee instability or feelings of wobbliness
- Problems putting weight on the damaged knee
Treatment for Posterior Cruciate Ligament (PCL) Injuries
The type of treatment required for PCL injuries will depend on the extend of the damage to the ligament. If the tear is very severe, surgery may be required. However, in many cases, especially ones involving chronic pain, surgery is not necessary.
Treatment will typically focus on allowing the PCL to heal, and if the injury is chronic, to ensure that someone avoids performing the same motions that led to the buildup of damage. Chiropractors will typically check to see if other parts of the knee have been damaged because it’s very common for other soft tissues or cartilage to be damaged as well when there’s PCL damage. Proper alignment of the joints will also be verified because if joints aren’t in their correct position, it can slow down the healing process or prevent the knee from healing properly.
You have two menisci in each of your knees, and they are C-shaped tissue made of tough but flexible cartilage. Along with providing padding between your shin bone and your thigh bone, they also act as shock absorbers, stabilize the knee and help distribute weight at the knee.
Sudden twisting motions may cause your meniscus to tear, and people who play sports, especially contact sports, are at greater risk of suffering a tear. However, as people age, tears also become more common as the quality of the cartilage that the body produces is reduce and the ability to heal damage to cartilage also suffers. Along with abrupt twisting of the knee, for older individuals, kneeling, deep squats or getting up wrong while the knee is rotated can all lead to tears.
Symptoms of Meniscus Tears
Tears can take place in several locations, and where a tear is and how deep the tear is often determines the type and severity of symptoms that someone will suffer. Tears on the outside of the meniscus tend to be less severe and heal faster, and they usually cause less pain and less severe symptoms, while tears towards the middle or inside of the meniscus are more liable to cause problems.
Along with pain at the knee, people with tears will typically also experience:
- Popping sensations
- A feeling that your knee is going to give out
- Knee instability
- Swelling at the knee
- A limited range of motion at your knee
Treatment for Meniscus Tears
If a tear is severe enough, it may require surgery to resolve the problem. This is especially true in cases where cartilage breaks off. However, many people can avoid a surgery by resting their knee and allowing the damage to heal. Braces and splints can help people continue to lead a normal life while providing support and limiting someone’s risk of doing further damage.
Along with rest and hot and cold therapy to manage pain and swelling, chiropractors may also recommend physical therapy to help restore flexibility and strength in the knee. Further, chiropractors will typically verify that the knee joint, and other joints, are aligned properly. If the knee joint is out of alignment, it can slow the healing process or prevent proper healing.
A kneecap dislocation occurs when the shin and thigh bones are wrenched out of proper alignment. There are complete dislocations as well as partial dislocations, which are referred to as subluxation. For a kneecap to be dislocated, the ligaments of the knee, which hold the knee in proper position, must be torn.
Due to the severe force required to dislocate a knee, it’s not uncommon for additional damage to take place. Sometimes the patella, or kneecap, and the ligaments connected to the patella are also damaged.
Knee dislocations are the result of excessive force being put on the knee, so they typically occur as a result of car accidents. However, they may also take place when someone playing a contact sport is tackled or someone has a severe fall.
Symptoms of a Kneecap Dislocation
One of the most obvious indications of a kneecap dislocation is extreme pain. People also typically will see extensive swelling and a knee that looks like it’s out of place. Other common signs of a dislocation include:
- Lack of feeling in the foot or anything below the knee if swelling cuts of blood flow
- Inability to straighten your leg
- Excessive mobility in your knee
Treatment for a Kneecap Dislocation
If you suspect that your kneecap is dislocated, it’s very important to seek medical treatment. Your kneecap may pop back into place, but a chiropractor will need to ensure that it’s in the correct place and lines up properly. Failing to ensure that your knee is properly back in its joint can cause severe complications in healing, and if it’s blocking proper blood flow, it could result in damage to your leg and foot.
Along with ensuring that your knee is back in its socket, treatment will typically involve immobilization of your knee so that ligaments have time to heal. Braces and splints can help with this, but people should still avoid being on their feet as much as possible. Typically, physical therapy or special exercises are required to help you build your knee back up to normal strength and flexibility after it heals.
Iliotibial Band Syndrome
Iliotibial Band Syndrome is a fairly common cause of knee pain, and it affects people who bend their knees frequently, such as runners and cyclists. More commonly known as ITB, this condition involves pain in the outside of the knee, and it’s caused by irritation, damage and/or swelling of the iliotibial band.
The iliotibial band runs from the outside of your hip bone and knee to the top of your shin bone. Typically, a bursa, which is a fluid filled sac, at your knee joint helps to prevent injury or irritation of the iliotibial band. However, if the band is too tight, a potential problem when you don’t stretch properly, or your bursa is inflamed, the iliotibial band will experience friction when rubbing across your knee.
Along with failing to stretch or problems with the bursa at your knee, other things that increase your risk of developing ITB are overexerting yourself, not giving yourself enough rest between workouts and running on uneven surfaces.
Symptoms of Iliotibial Band Syndrome
The main indication of ITB is pain that is on the outside of the knee, which is where irritation of the iliotibial band occurs. Other indications include:
- Swelling at the knee
- Pain that is increased when going up or down stairs
- Radiating pain that goes from the hip to the top of the shin
Treatment for Iliotibial Band Syndrome
The goal of treatment for ITB is to allow your body to heal the damage to your iliotibial band. Usually, rest is all that is needed, and heat and cold therapy can help to manage swelling and pain.
However, it’s also important to determine the cause of your ITB or the symptoms will simply return. Along with trying to figure out what makes your symptoms worse, which are often the movements that are causing the damage, chiropractors will also verify that joint problems aren’t a culprit. When joints don’t line up properly, it can make your body move in ways that it’s not supposed to. If alignment issues aren’t resolved, along with ITB syndrome symptoms continuously coming back, other repetitive motion injuries may also develop.
To provide cushioning and shock absorption for you knee, there is a synovial membrane, which is filled with fluid, that surrounds the knee joint. There are folds in the membrane called plicas, and most people have four of them. Their job is to allow you to easily bend and move your leg.
Of the four folds, typically the medial plica is the one that gets damaged, and when it does, it’s called plica syndrome. The medial plica is located at the bottom of the kneecap, and it attaches to the lower end of the thighbone.
There are several ways that plica can be damaged, and damage typically builds up over time from activities like running, biking or using a stair machine. In some cases, an abrupt increase in the amount of exercise you do can also cause damage. Falling on your knees or injuries to your knees can also cause plica syndrome to develop.
Symptoms of Plica Syndrome
As is typical of knee injuries, pain is one of the most obvious indications of a problem, although many people with this condition note the pain tends to be achy rather than sharp. If the injury builds up over time, so will the pain. Other common indications of plica syndrome include:
- Popping or clicking sounds when using the knee
- Instances where the knee locks up
- Instability of the knee
- Swelling of the knee
Treatment for Plica Syndrome
Typically, surgery is not required to resolve even severe cases of plica syndrome. However, getting plica syndrome accurately diagnosed can be difficult since its symptoms are so similar to a variety of other knee-related conditions. X-rays and MRIs may be required to rule out other potential problems.
Once diagnosed with plica syndrome, you will normally be urged to rest your knee until pain is diminished. However, there are a number of exercises and stretches that may also be suggested to help build up muscles in your knee and help reduce the risk of pain returning.
Shin Splints (Medial Tibial Stress Syndrome)
Medial Tibial Stress Syndrome, better known as shin splints, affect the lower leg instead of the knee, but pain can start to radiate to the knee when damage is sufficient. Typically, people with shin splints have pain along the inside of their shin bone, and it’s most common in people who exercise a lot. Runners in particular are prone to developing shin splints as are people who start a new exercise regimen and are too aggressive when they first start working out.
Pain from shin splints is the result of inflammation of the muscles, tendons and tissues around the tibia, and pain is usually focused around the inner border of the bone where muscles attach. However, some have suggested that it may also be due to small tears in the muscle. Damage usually occurs as a result of overwork and repeated motions. Other potential causes of shin splints are flat feet and worn out or bad shoes.
Symptoms of Shin Splints (Medial Tibial Stress Syndrome)
Most people only have shin splints in one leg, which is their dominant one. Your dominant leg is usually on the same side as your dominant hand. The most common symptom of the condition is pain that is sharp or throbbing and occurs alongside the shin bone.
Pain also may be made worse by touching the area that hurts, but pain will normally not be acute. If you have a very sharp and intense pain when touching the area that hurts, its more likely that you have a stress fracture.
Treatment for Shin Splints (Medial Tibial Stress Syndrome)
Since shin splints are usually caused by too much stress put on your body before it has adapted to a type of exercise, rest is usually key. Treatment also usually involves heat and cold therapy to help manage pain and swelling.
Chiropractors will also typically ask you about when your pain started and what makes it worse to determine if it your condition is being made worse by how your doing certain activities or if footwear might be a culprit.
Additionally, chiropractors will also normally check for alignment issues in your back and joints. Lack of alignment could cause joints to move in ways that they aren’t supposed to, which can lead to irritation of tissues. Resolving alignment issues can help speed up healing and prevent problems from coming back.
Patellofemoral Pain Syndrome (Runner’s Knee)
Chondromalacia, which is also referred to as Patellofemoral Pain Syndrome, or runner’s knee, is a condition where the cartilage under the kneecap is softened. In some cases, damage to the cartilage under the kneecap will cause the same problems.
As a result of this softness or damage, the thighbone and kneecap aren’t able to move against each other smoothly when you walk or move your leg. This usually results in irritation and pain, and runner’s knee is one of the leading causes of chronic knee pain.
Typically, this condition is caused when the kneecap isn’t aligned properly. Lack of alignment is fairly common in runners, especially those who have flat feet. Individuals who play sports that involve a lot of running or jumping may also be prone to developing the condition. This is likely due to the fact that high impacts can cause the alignment problem associated with runner’s knee. Individuals who have had knee injuries are also susceptible to developing runner’s knee because cartilage may not completely heal or heal properly.
There are four grades of runner’s knee, which are:
Grade 1: There has been a softening of the knee cartilage.
Grade 2: Along with a softening of the knee cartilage, there are also abnormal surface characteristics of the cartilage and tissue erosion occurs.
Grade 3: Cartilage begins to thin while tissue starts to deteriorate.
Grade 4: Due to excessive wearing away of cartilage, bone is exposed to and rubbing up against another bone in the knee.
Symptoms of Patellofemoral Pain Syndrome (Runner’s Knee)
The most common sign of runner’s knee is pain in the knee, but there are several other common symptoms, which including:
- Cracking or grinding feelings in the knee
- Pain that gets worse after sitting or kneeling for extended periods of time
- Inflammation of the knee
Treatment for Patellofemoral Pain Syndrome (Runner’s Knee)
Treatment for runner’s knee typically involves a combination of rest and helping to build up the muscles around the knee. Building up the support structures of the knee is important because it helps to keep the knee joint in place, reducing the damage to cartilage.
Chiropractors will also typically work to resolve any knee joint alignment issues and verify that other joints have not been affected. If alignment issues with the knee joint and other joints aren’t resolved, movements of the knee will more than likely continue to cause irritation and/or damage to cartilage.
Knee Arthritis, Tendonitis and Bursitis
While knee arthritis, bursitis and tendonitis are different conditions that affect different parts of the knee, their causes are often similar as are their symptom. Additionally, treatment tends to be similar for each.
The causes of arthritis, tendonitis and bursitis of the knee are often the same, which is a build up of damage from repeated motions. Further, direct injuries may also cause any of these conditions to develop or more than one at the same time.
Knee tendonitis refers to inflammation of the tendons at the knee. Tendons are a strong fibrous material that holds muscles to bones. Repeated movement of a tendon against a bone can cause small tears or irritation of the tendon.
Knee bursa are fluid filled sacs that help to provide cushioning for the knee joint and allow the joint to move smoothly. Bursa can become inflamed due to kneeling on hard surfaces for extended periods of time, direct injury or repeated motions that irritate them.
Osteoarthritis of the knee is the result of the cartilage at your knee being damaged or worn down. Cartilage, similar to bursa, help to reduce friction at the knee, but it’s made of a flexible connective tissue instead of being a fluid sac.
Cartilage can be worn down through repeated motions or direct damage, but it is more liable to do so as people age. When people get older, their body isn’t as able to repair damage as quickly, and the cartilage the body produces is more brittle and prone to cracking and flaking.
Symptoms of Knee Arthritis, Tendonitis and Bursitis
Symptoms for each condition tends to be similar. Whether you have arthritis, bursitis or tendonitis, you are likely to feel pain at your knee. If the condition is due to direct damage, pain will typically be acute.
However, since these conditions are normally due to repeated motions or wear and tear, most people have chronic pain. Certain movements or being in particular positions for extended periods of time may make pain or other symptoms worse.
Along with pain, other indications of these conditions include:
- Swelling of the knee joint
- The knee being tender to the touch
- Limited range of motion
- Weakness or instability of the knee
Treatment for Knee Arthritis, Tendonitis and Bursitis
Once someone has had arthritis, tendonitis or bursitis of the knee, they are often more liable to develop the condition again. Therefore, even if someone has developed one of these conditions due to a direct injury, they may still have flareups again if they overwork their knee.
Resting the knee is an important part of allowing damage to heal, and knee braces can help to reduce strain put on the knee and allow someone to move about more. Hot and cold therapy are also usually recommended as are stretching and certain types of low impact exercise. Exercise – of the right type and in moderation – can help ensure that blood flow to damaged areas is maintained so healing is as rapid as possible.