Knee pain is often the result of an imbalance in tension of muscles. When certain muscles are tighter or weaker than others, it affects the way the joint moves. When we assess someone who has knee pain, we often find that their patella, or the knee cap, is not tracking properly due to tight connective tissue. When the kneecap rubs against the sides of the knee joint, it can cause irritation and pain. This is called patellofemoral knee pain.
A condition we often treat at LSTC is patellofemoral pain syndrome or Runners’ Knee. The muscles and tendons attached to the kneecap can pull it in adverse directions and inhibit it from tracking properly in its designated groove. While runners’ knee is a common condition in athletes, it’s not uncommon to see this in patients who sit for long periods of time during the day. Sitting for extended periods of time puts lots of stress on the knee joints because the joint is bent. If left untreated, patellofemoral pain syndrome can lead to more serious problems like ACL tears.
The iliotibial band, or IT Band, can also cause knee pain. The iliotibial band runs over the outer portion of both the hip and knee joint. When this is tight, it can limit mobility in those joints and can even cause a snapping or popping feeling on the side of the joints. The way you walk, run, sit and exercise can all contribute to what we call Iliotibial Band Syndrome.
Knee pain, when left untreated, can lead to inflammation of the tendinous structures that attach muscles to the bones and inflammation of the bursa that cushion the bones. Patellar tendonitis is a condition in which irritation of the patellar tendon causes pain below the knee cap.
You may feel this type of pain with weight-bearing activities, such as walking, running or jumping. Knee bursitis can occur in multiple places around the knee, including over the kneecap, under the kneecap and at the inside of the kneecap. Physical therapy is a very effective treatment option to help alleviate knee pain and can often avoid painful injections or surgery.
Dancers are athletes who can be particularly prone to knee pain. Dancers often experience knee pain with grand plies and landing jumps, or experience knee clicking and cracking when bending and extending the knee. Dancing, especially ballet dancing, requires significant strength of certain muscles (i.e. “turnout” muscles), which can lead to overuse injuries. Lifting the leg, and holding it for an extended period of time, as dancers must do, requires a lot of leg strength and control. Without proper strength and control of the hips, dancing can cause twisting and poor mechanics of the knees leading to injuries. While leg strength is key in dancing, core strength is just as critical to helping dancers avoid injury. When a dancer lacks strength in this area, that’s when we start to see various compensatory movements to help them maintain leg height:
- Hip Hiking
- Pelvic Rotation
- Trunk Leaning
Whether you’re a dancer or not, how can you tell if you are at risk for a knee injury? Keep reading for exercises to try:
Single Leg Squat:
- Stand in front of a mirror, on one leg.
- Slowly bend your standing leg.
Does your knee stay directly over your toes? Or does it deviate towards the other leg? If you are unable to keep your knee over your toes, your may be at risk for a knee injury.
Single Leg Sit Test:
- Stand in front of chair on one leg.
- Slowly sit down on the chair in a controlled manner.
Did you drop or plop into the chair? If you were unable to do this move in a controlled manner on either knee, you may be at risk for a knee injury.
Step Test:
- Stand at the bottom of your stairs. Step up with the right leg and slowly lower yourself back down.
- Repeat on the left leg.
Do you have knee pain when ascending and/or descending stairs? If you have pain or difficulty with this task, you may be at risk for a knee injury.
If you are a dancer, try these exercises:
Plie:
- Stand sideways in front of a mirror, in first position.
- Plie and watch your knee alignment.
Do your knees stay directly over your toes? Or do they shift forward? If you have difficulty keeping your knees over your toes, you may be at risk for a knee injury.
IT Band Test:
- Lay flat on your back and cross one leg over your body.
Did you feel tension down the outer side of your thigh? If so, your IT band may be tight and contributing to your knee pain.
Turns and Jumps:
When you land turns, do you have difficulty coming to a slow, controlled stop?
Next time you’re in dance class, pay attention to your knee alignment when landing turns and jumps. Do your knees stay over your toes? If you have trouble controlling your landing with turns and jumps, you may be at risk for a knee injury.
If you are having pain or difficulty preforming any of the tests above, our expert physical therapists can evaluate your pain, determine the cause and help you figure out what the best treatment method is to handle that problem.
