Our knees are a critical part of our ability to move, especially since they assist us in getting around from place to place. Our knees are called on so we can conquer even the simplest of tasks. We can’t really accomplish our day to day living without them. How else can we get out of bed every morning? And for those who choose the more daunting endeavors like running a marathon, working knees are pretty important. Painful knees can sure get in the way!
When our knees are healthy, we go about our daily activities without much thought. That’s because our knees are strong, stable, and pain-free. Healthy knees can help us conquer uneven terrain, move around obstacles, walk over wet and slippery surfaces, run, jump and twist. It takes a complex balance of coordinated efforts between all of the structures of the knee to move normally, maintain performance, and remain healthy.
But once we sustain an injury, all of that changes. When our knees begin to hurt, we sure take notice! It’s then that even simple, every-day tasks feels daunting. Besides causing pain, a knee injury alters the way the knee structures work together. Any change in the structures of the knee set it up for imbalance. That’s because the muscles, tendons, ligaments, menisci, cartilage and bone cooperate together to ensure smooth function. And when they are injured, the distribution of stresses changes, allowing for instability of the knee, further injury, and pain.
Ligaments are structures of the knee that play a crucial role in the health and stability of the knee. Yet they are particularly vulnerable when the loads placed on them exceed their allowed elasticity. If ligaments become injured, your knee will hurt! Why? Ligaments are full of nerve endings! When overloaded from an injury, the ligaments stretch out and weaken. And that creates an unstable knee joint, which causes those nerve endings to send out pain signals.
There are quite a few secondary conditions that arise from a knee joint that is unstable due to too much pressure placed on other knee structures. Some examples include conditions like patellar tendonitis, meniscal injuries, runner’s knee, jumper’s knee, patellofemoral pain syndrome, chondromalacia patella, and osteoarthritis. All of these conditions arise from altered joint mechanics and injured soft tissue of the knee which end up causing painful knees.
Injury to the ligaments of the knee is quite common. Those who follow sports will frequently hear of athletes missing their entire season due to injuries like anterior cruciate ligament (ACL) tears? Since the knee structures all work together in a coordinated effort, an injury to one joint structure can also affect other structures of the knee.
Sometimes the injury to the other structure(s) occurs at the time of the trauma. For example, if the force during the injury is sufficiently excessive, it is capable of tearing the ACL along with the meniscus, and quite possibly injuring other ligaments as well. Secondary injury can also occur over time. This can happen when an injury to one structure allows for an abnormal balance of the knee joint. The imbalance negatively affects the structures as the uneven distribution of motion causes them to work harder.
The unstable knee joint transmits impaired forces to the bones, ligaments, tendons and menisci, resulting in pain, excessive joint displacement, lack of smooth motion and joint weakness. Each link is important, so if one link is affected, the dynamics of the rest of the knee are altered.
The assault to knee health doesn’t stop there. When injury to the soft tissue or articular surfaces of the knee takes place, it is very common for secondary arthritis to develop in the knee. Arthritis can occur within a few years with severe injuries, or take decades to occur when the injury is less severe. The end result is that your knee will hurt more.
Current treatment options for injured and painful knees generally focus on short-term relief of symptoms. They are utilized in an effort to stop your knees from hurting. Examples include treatments like physical therapy, corticosteroid injections, NSAIDS and intra-articular hyaluronic acid injections. These treatments may provide some pain relief, and stop your knees from hurting for a period of time.
But not all treatments make your knee healthy. It is important to be aware that corticosteroids and NSAIDS have both been linked to the acceleration of the arthritic process, among other deleterious side effects. In the long run, they may make your knees hurt more.
To stop the knees from hurting, treatments need to address the injured joint structures. The soft tissue, such as the ligaments, need to be strengthened. And unfortunately, most treatments are unable to strengthen them. And so they often fail to resolve the pain, since injured ligaments are often at the core of the painful knee. A lack of knee health continues as do symptoms and progression of the disease process. If the root of the problem is not repaired, you are left with knees that continue to hurt.
Although surgical intervention may be needed in cases of fracture and complete tears, surgical arthroscopy for arthritis has been shown to lack benefit, even when compared to exercise and other non-surgical treatments.1 Repair of meniscal injuries by arthroscopic partial meniscectomy has also been questioned in studies due to lack of efficacy.2 These surgeries are also highly associated with acceleration of the arthritic process,3 which as you know, will cause your knee to hurt.
The knee needs to be repair and regeneration! Regenerative Orthopedics does just that. And it addresses knee pain, because it strengthens and repairs the underlying ligament injury and weakness. As a safe and effective non-surgical treatment option, Regenerative Orthopedics, including Prolotherapy, PRP and Stem Cell Therapy, actually repairs the knee joint.
It resolves the problem because it promotes healing of the knee structures such as ligaments, tendons, menisci and cartilage.
If knee pain has you side-lined, don’t put up with knees that continue to hurt. We can help get you back to doing the things you love, without the nuisance of painful knees!
Click here for more articles by Dr. Fields
1. Marsh JD, Birmingham TB, Giffin JR, et al. Cost-effectiveness analysis of arthroscopic surgery compared with non-operative management for osteoarthritis of the knee. BMJ Open 2016; 5:e009949.doi:10.1136/bmjopen-2015- 009949
2. Khan M, Evaniew N, Bedi A, Ayeni OR, Bhandari M. Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis. CMAJ.2014;186(14):1057-1064.
3. Berthiaume MJ, Raynauld JP, Martel-Pelletier J, et al. Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis 2005;64(4):556-563.
