“Knee”d to Know

Knee pain is a common problem for which people seek medical care.  Sometimes it is acute and abrupt, accompanied by swelling and the infamous “popping” sensation, and occurred because of a traumatic event.  Sometimes it is non-specific and seems to occur out of nowhere.  Other times, it is more chronic, with aches and pains happening on a regular basis, and progressively limiting a person’s ability to function in their daily routines.  Although different types of conditions, all are limiting and all can be addressed with help from a physical therapist.

The knee is a hinge-type joint with some minor rotation built in.  Ligaments hold the bones of the knee in place, but a forceful twist or torque can cause the fibers of the ligaments to pull and sometimes tear.  The severity of the injury depends on the amount of fibers torn.  Other structures work cohesively with ligaments to keep the knee stable, including muscles on the front and back of the leg keep the knee moving properly, and help keep the kneecap positioned where it belongs.  The knee does not work independently; what happens at the hip and the foot and ankle can impact how well the knee functions.  The lower back and pelvis can also be related to the knee.

A thorough, individualized evaluation by a physical therapist is a great start to sorting through an episode of knee pain.  As an initial entry point into the healthcare system, a physical therapist will perform a comprehensive assessment and perform appropriate musculoskeletal tests, recommend treatment strategies, and customize a plan for recovery.  Many injuries and many conditions that produce knee pain can be managed very effectively this way.  However, if the therapist identifies findings during the assessment that warrant care beyond that which a physical therapist can provide, he or she will refer the patient to the appropriate medical provider.

Physical therapists treat many knee conditions exceptionally well – as PT’s are THE musculoskeletal experts.  Highly educated and skilled in their assessment, they analyze gait mechanics, strength, mobility, movement of the joints, and look for evidence of serious injury or pathology.  They will look at the ankle, hip, and pelvis and spine as possible contributors to the knee pain.  PT’s can identify imbalances, areas of mechanical stress, or structures functioning sub-optimally which may be contributing to the knee pain and subsequently, to the limited functional performance of the person seeking care.  The physical therapist will be able to explain the findings and what options for treatment are best to help facilitate improvement and goal achievement.   Treatment strategies may vary from clinician to clinician, but all will likely include some type of therapeutic exercise, which is intended to create an environment conducive to improving symptoms and function and engage the patient in helping the recovery process along.  The patient will need to participate fully in the recommendations, not only with the prescribed treatment strategies, but with appointments and home program follow-through as well for a maximal benefit.



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