There are a number of structures in and around the knee joint that can cause pain and the following questions will help identify which one may be affecting you:
(click on the individual terms in the text or on the right for more information)
1: Where is the pain?
One of the most common presenting knee complaints is at the front of the knee around or under the knee- cap and is termed patellofemoral pain, however pain beneath the knee- cap into the shin can be due to patellar tendinopathy. Fat pad impingement also causes pain in this area but discomfort tends to be located slightly more to the outside of the knee. One of the most common running injuries is along the outside border of the knee joint and lower thigh, this is iliotibial band friction syndrome. Pain on either side of the knee can also occur following damage to the major ligaments of the knee (ligament sprains and tears).
More diffuse pain that is difficult to pin- point but feels ‘deeper’ within the knee is often attributed to some form of joint pathology including meniscal tears and cartilage damage or osteoarthritis. Major traumas to the knee that effect multiple structures will also fall into this category e.g. ligament damage, fractures and cartilage injuries.
2: How and when did the pain start?
Did you suffer a trauma to the knee i.e. a fall, tackle or sudden twist or hit? A sudden tear or pop following a trauma is considered a ligament tear ,(often the anterior cruciate ligament or ACL) unless proven otherwise. Twisting injuries also commonly account for meniscal tears. A more gradual onset of pain with sport or increased activity will be seen with patellofemoral pain, patella tendinopathy and iliotibial band friction syndrome.
3: What type of pain are you getting?
Sharp, stabbing pain is more frequently described with traumas to the affected joint, ligaments (ligament tears) or surrounding muscles. Iliotibial band friction syndrome can also cause a sharp, stinging pain at its worst and will often lead to runners having to stop and walk. A dull, tooth ache or throbbing pain in a very general sense is attributed to overuse injuries effecting tendons e.g patella tendinopathy or soft tissues but will also occur with joint instability (after a trauma has been sustained and the acute injury has settled) following ligament damage. Pins and needles, zinging or numbness are signs of nerve irritation and this can be a problem locally (around the knee) or from a different source e.g. the lower back.