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Knees Pain

Knee pain is a common reason that people visit their doctors' offices or the emergency room.

Often, knee pain is the result of an injury, such as a ruptured ligament or torn cartilage. But some medical conditions can also bring you to your knees, including arthritis, gout and infections.

Depending on the type and severity of damage, knee pain can be a minor annoyance, causing an occasional twinge when you kneel down or exercise strenuously. Or knee pain can lead to severe discomfort and disability.

Many relatively minor instances of knee pain respond well to self-care measures. More serious injuries, such as a ruptured ligament or tendon, may require surgical repair.

Although every knee problem can't be prevented — especially if you're active — you can take certain steps to reduce the risk of injury or disease.

A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursa) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Because of the knee's complexity, the number of structures involved, the amount of use it gets over a lifetime, and the range of injuries and diseases that can cause knee pain, the signs and symptoms of knee problems can vary widely.

Acute knee pain.
Severe knee pain that comes on suddenly (acute pain) is often the result of injury. Some of the more common knee injuries and their signs and symptoms include the following:

Ligament injuries.
Your knee contains four ligaments — tough bands of tissue that connect your thighbone (femur) to your lower leg bones (tibia and fibula). You have two collateral ligaments — one on the inside (medial collateral ligament) and one on the outside (lateral collateral ligament) of each knee. A tear in one of these ligaments is usually the result of a fall or contact trauma, especially in sports like football, and is likely to cause immediate pain in the injured area. The discomfort, which can range from mild to severe, is usually worse when you walk or bend your knee. If the collateral ligament on the inside of your knee sprains or tears, you may feel a ripping sensation. In some cases, this ligament may become calcified after repeated injuries.

The other two ligaments are inside your knee and cross each other as they stretch diagonally from the bottom of your thighbone to the top of your shinbone (tibia). The posterior cruciate ligament (PCL) connects to the back of your shinbone, and the anterior cruciate ligament (ACL) connects near the front of your shinbone. If you tear the ACL, either partially or completely, you're likely to know it right away. You may feel or hear a pop in your knee and have intense pain and immediate swelling. When you try to stand and put weight on your injured leg, your knee may "buckle" or at least feel as if it might give way. In most cases, you'll have to stop all activity, either because the pain is too severe or because your knee isn't stable enough to support your weight.

Tendon injuries (tendinitis.)
Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous cords that attach muscles to bone. Athletes — especially runners, skiers and cyclists — are prone to develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the larger lower leg bone (tibia). Tendinitis can occur in one or both knees and often causes pain and swelling at the front of your knee and just below your kneecap. The discomfort usually isn't constant but tends to occur when you jump, run, squat or climb stairs. The quadriceps or patellar tendons may also rupture, either partially or completely. In that case, the pain is likely to be most intense when you try to extend your knee. If the tendon is completely ruptured, you won't be able to extend or straighten your knee.

Meniscus injuries.
The meniscus is a C-shaped cartilage that curves within your knee joint. Meniscus injuries involve tears in the cartilage, which can occur in various places and configurations. For example, the cartilage may tear lengthwise or from the inside to the outside rim of the meniscus (radial tear). Although you may not notice small tears, in most cases, you'll have pain and mild to moderate swelling that develops over 24 to 48 hours. Occasionally, a lengthwise tear flips into the knee joint instead of staying around the joint's edge, an injury called a bucket-handle tear. A flap of the torn cartilage can interfere with knee movement and cause your knee joint to lock so that you can't straighten it completely. Meniscal injuries that cause locking of your knee should be surgically treated. Meniscal tears that don't cause locking, including those of a degenerative nature, can usually be managed nonsurgically.

Bursitis.
Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint. Bursitis can lead to warmth, swelling and redness over the inflamed area, aching or stiffness when you walk, and considerable pain when you kneel. Sometimes the bursa located over your kneecap bone can become infected, leading to fever, pain and swelling. When the pes anserine bursa on the lower inner side of your knee is affected, you're likely to have pain when you go up or down stairs.

Dislocated kneecap.
This occurs when the triangular bone that covers the front of your knee (patella) slips out of place, usually to the outside of your knee. You'll be able to see the dislocation, and your kneecap is likely to move excessively from side to side. You're also likely to have intense pain and swelling in the affected area and difficulty walking or straightening your knee. Unfortunately, once you've had a dislocated kneecap, you're at increased risk of having it happen again. Although you may not experience as much swelling or discomfort with subsequent episodes, repeated dislocations can lead to chronic knee pain. But good rehabilitation, with a focus on strength training of the muscles that control your kneecap, can help prevent dislocation.

Iliotibial band syndrome.
This occurs when the ligament that extends from the outside of your pelvic bone to the outside of your tibia (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners are especially susceptible to iliotibial band syndrome, which generally causes a sharp, burning pain in the knee that often begins 10 to 15 minutes into a run. Initially, the pain goes away with rest, but in time it may persist when you walk or go up and down stairs.

Hyperextended knee.
In this injury, your knee extends beyond its normally straightened position so that it bends back on itself. Sometimes the damage is relatively minor, with pain and swelling when you try to extend your knee. But a hyperextended knee may also lead to a partial or complete ligament tear, especially in your ACL.

Chronic knee pain
Sometimes an injury can lead to ongoing (chronic) knee pain. Often, chronic pain results from a medical condition such as:

Rheumatoid arthritis.
The most debilitating of the more than 100 types of arthritis, rheumatoid arthritis can affect almost any joint in your body, including your knees. In addition to pain and swelling, you're likely to have aching and stiffness, especially when you get up in the morning or after periods of inactivity; loss of motion in your knees and eventually deformity of the knee joints; and sometimes a low-grade fever and a general sense of not feeling well (malaise). Rheumatoid arthritis usually affects both knees at the same time. And although it's a chronic disease, it tends to vary in severity and may even come and go. Periods of increased disease activity — called flare-ups or flares — often alternate with periods of remission.

Osteoarthritis.
Sometimes called degenerative arthritis, this is the most common type of arthritis. It's a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age. Osteoarthritis usually develops gradually and tends to cause varying degrees of pain and swelling when you stand or walk and before a change in the weather. It also can lead to stiffness, especially in the morning and after you've been active, and to a loss of flexibility in your knee joints.

Gout.
With this type of arthritis, you're likely to experience redness, swelling and intense pain in your knee that comes on suddenly — often at night — and without warning. The pain typically lasts five to 10 days and then stops. The discomfort subsides gradually over one to two weeks, leaving your knee joints apparently normal and pain-free. Another condition, pseudogout (chondrocalcinosis), which mainly occurs in older adults, can cause severe inflammation and intermittent attacks of pain and swelling in large joints, especially the knees.

Chondromalacia of the patella, or patellofemoral pain.
This is a general term that refers to pain arising between your patella and the underlying thighbone (femur). It's common in young women, especially those who have a slight misalignment of the kneecap, in athletes, and in older adults, who usually develop the condition as a result of arthritis of the kneecap. Chondromalacia of the patella causes pain and tenderness in the front of your knee that's worse when you sit for long periods, when you get up from a chair and when you climb stairs. You may also notice a grating or grinding sensation when you extend your knee.

Risk factors
Weighing more than your ideal weight is one of the leading risk factors for knee pain. Excess weight increases stress on your knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage. Other factors that make you more susceptible to knee pain include:

Overuse.
Any repetitive activity, from cycling a few miles every morning to gardening all weekend, can fatigue the muscles around your joints and lead to excessive loading stress. This causes an inflammatory response that damages tissue. If you don't allow your body time to recover, the cycle of inflammation and microdamage continues, putting you at increased risk of injury. It's not repeated motion itself that's to blame, but rather the lack of adequate recovery time. That's why current strength training guidelines advise against working the same muscle group on consecutive days, for example.

Lack of muscle flexibility or strength.
According to experts, lack of strength and flexibility are among the leading causes of knee injuries. Tight or weak muscles offer less support for your knee because they don't absorb enough of the stress exerted on your knee joints.

Mechanical problems.
Certain structural abnormalities, such as having one leg shorter than the other, misaligned knees and even flat feet, can make you more prone to knee problems.

High-risk sports and activities.
Some sports and activities put greater stress on your knees than others. Alpine skiing with its sharp twists and turns and potential for falls, basketball's jumps and pivots, and the repeated pounding your knees take when you run or jog all increase your risk of injury.

Previous injury.
Having a previous knee injury makes it more likely that you'll injure your knee again.

Treatment

The key to treating many types of knee pain is to break the cycle of inflammation that begins right after an injury. Even minor trauma causes your body to release substances that lead to inflammation. The inflammation itself causes further damage, which in turn triggers more inflammation, and so on. But a few simple self-care measures can be remarkably effective in ending this cycle. For best results, start treating your injury right away and continue for at least 48 hours.

Protection.

The best way to protect your knee from further damage depends on the type and severity of your injury. For most minor injuries, a compression wrap is usually sufficient. More serious injuries, such as a torn ACL or high-grade collateral ligament sprain usually require crutches and sometimes also a brace to help stabilize the joint with weight bearing.

Rest.

Taking a break from your normal activities reduces repetitive strain on your knee, gives the injury time to heal and helps prevent further damage. Minor injuries may require only a day or two of rest, but severe damage is likely to need a longer recovery time.

Ice.

A staple for most acute injuries, ice reduces both pain and inflammation. Some doctors recommend applying ice to your injured knee for 15 to 20 minutes three times a day. A bag of frozen peas works well because it covers your whole knee. You can also use an ice pack wrapped in thin fabric to protect your skin. Although ice therapy is generally safe and effective, don't leave ice on longer than recommended because of the risk of damage to your nerves and skin. After two days, you might try switching to heat to relax your muscles and increase blood flow.

Compression.

This helps prevent fluid buildup (edema) in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that's lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation.

Elevation.

Because gravity drains away fluids that might otherwise accumulate after an injury, elevating your knee can help reduce swelling. Try propping your injured leg on pillows or sitting in a recliner.

Medical Massage Treatment

You may have knee pain because of musculoskeletal imbalance in your body. Massage therapy is applied to balance your pelvis, sacrum, legs, knees, ankles and your feet muscles.

Once the body is balanced, the patient is able to restore an efficient way for energy to move. Free energy is used by the body to work more efficiently and improves all physiological activities.

On the first visit the therapist evaluates the patient by screening gait patterns and measuring the positioning of the body to determine musculoskeletal distortion, biomechanical dysfunction and soft tissue pathology that causes these patterns. An exacting analysis of proper posture and biomechanics explains the cause and effect relationship to pain. Once we know how your body works, we can determine the reason why you have pain and the other symptoms.

Then the therapist develops a treatment plan that is based on the knowledge of your body. We don’t guess, we know how to treat you because of exact analysis of your body and understanding of your problem. Your therapeutic massage treatment is custom designed for you because we apply pressure and specific techniques that are unique only for your body. That’s why our massage treatment for your Knee Pain in Holistic Medical Massage Clinic is effective and different from others.















 


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