The knee is a common area for us to experience pain at some point. Sometimes you have a niggle that comes and goes by the next day. Sometimes it hurts when you’re sitting down or standing up, and you have no clue why!
Knowing what’s happening and whether you need to worry about it can be tricky with all this variety.
Here are a few things you can consider to help decide if your knee pain warrants help.
1. Knee pain and activity limitation
First and foremost, how painful is it? And how much does it affect you?
The first part of that statement is easy. If you are worried because of how much pain you have, you can always book an assessment.
Even if there are no structural issues, it can grant you peace of mind and help clarify the source of pain.
The second part of that statement may be even more critical. How much does it affect you? You do not have to be in severe pain to seek help. You do not need to feel any pain at all!
If you are being limited or prevented from doing something you care about, looking at what can be done to change this is worthwhile.
2. Mechanism of a knee injury, how did it happen?
Answering this question will often lead people down one of two pathways. Either you have an apparent moment of injury, or you have no idea where your pain has come from.
The more common presentation is when you have some form of pain that slowly builds over time, and you’re only sometimes sure where it has come from.
In these cases, you need to be able to zoom out a bit and take stock of what has changed in the lead-up to your pain starting. This can be exercise-related, e.g. suddenly running 5 times per week instead of 3, or rapidly increasing weight used during resistance exercise.
It can also be a change in other areas of life, e.g. moving house and doing a lot of lifting/carrying, renovating and spending a lot of time kneeling or changing jobs and walking up 3 flights of stairs instead of going up a lift.
Outside of physical demands, your pain can also be affected by mood, stress, sleep and many other factors.
The combination of everything above can eventually lead to this pain in your knee that appears to come from nowhere. Sometimes these aches and pains are just that and resolve themselves after a few days to a week.
If you have pain that fails to resolve in this time or continues to be re-aggravated regularly, it is best to seek help to determine what is potentially leading to this and what can be done to address it.
When you have an apparent moment of injury, a specific structure at your knee is likely involved. If you have a particular mechanism of injury, please try to note how it happened.
- Do you know if it was contact or non-contact?
- In what way did the knee move?
- If there was contact, where and how were you hit?
Answering these questions makes it much easier to narrow down the likely cause of your symptoms.
In most cases, with a specific moment of injury, you will use your symptoms to guide you. Severe injuries are very apparent at the time and will warrant immediate investigation.
If it is not an extreme case, but you have ongoing issues, it is best to aim for an appointment 48 – 72 hours after the injury.
3. Giving way or knee instability
Giving way is usually something we want to investigate a bit further. When people experience a feeling of giving way, it is usually one of two things.
When you have pain or another injury around the knee, your body can try avoiding using the muscles in that area. We call this muscle inhibition. Sometimes this results in a momentary feeling of giving way or lack of control at the knee.
The other thing that will lead to giving way is if one or more of the internal structures have been injured. Everyone’s heard of ACL injuries and often knows that they can lead to feelings of instability.
Still, these symptoms also damage your MCL, PCL, meniscus and other internal structures. Anytime you have recurring feelings of instability or giving way, you should have your knee assessed to figure out what type of instability it is, what structures, if any, are involved and what the appropriate management is.
4. Clicking, locking or catching of the knee
Other symptoms we often look at are if you are experiencing any abnormal clicking, locking or catching. Nearly everyone has felt their knees click or pop, and the vast majority of the time, it is nothing to worry about.
If you have clicky knees, and you have for many years, you do not have to rush to the hospital after reading this.
The types of noises we worry about are associated with other symptoms. If every time you feel the knee clicks, it brings on severe pain and your knee swells. It can be worth looking into further.
The locking and catching we talk about is looking for times when the knee becomes truly stuck, not just really stiff.
Experiencing severe stiffness is unpleasant and worth investigating, but it does not typically indicate damage to the internal structures. If you have episodes where your knee becomes stuck in one position and needs to be physically moved by something or someone else, it is recommended to be assessed.
Final thoughts on knee pain
When you experience knee pain or any injury, getting it checked out by a qualified health professional is best.
A thorough assessment is necessary to ensure the correct diagnosis and treatment plan are provided.
Depending on the findings from the assessment, further imaging may be required. Commonly this will include x-rays or occasionally an MRI scan.
Your sports physiotherapist is trained to assess and treat knee injuries, so if you are experiencing any of the above symptoms, please do not hesitate to reach out for help.
Book an appointment if you have any questions regarding knee pain or injuries. We will provide you with a full assessment and treatment plan tailored to your needs.