There are a number of structures in and around the Knee, Thigh & Shin that can cause pain and to identify which one is affecting you there are a few questions that we need to ask:

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 is 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 associated ligaments.

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 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 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 or surrounding muscles. A dull, tooth ache or throbbing pain in a very general sense is attributed to overuse injuries effecting tendons 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 ankle) or from a different source e.g. the lower back.