Knee pain elliptical machine
The most common cause of this knee pain is osteoarthritis. Osteoarthritis is sometimes referred to as "degenerative joint disease", or wear-and-tear arthritis. The main problem in osteoarthritis is degeneration of the articular cartilage that covers the joint. This results in areas of the joint where bone rubs against bone. Bone spurs may form around the joint as the body's response. Osteoarthritis may result from an injury to the knee earlier in life. Fractures involving the joint surfaces, instability from ligament tears, and meniscal injuries can all cause abnormal wear and tear of the knee joint. Not all cases of osteoarthritis are related to prior injury, however. Research has shown that some people are prone to develop osteoarthritis, and this tendency may be genetic. Osteoarthritis develops slowly over several years. The symptoms of osteoarthritis are mainly pain, swelling, and stiffening of the knee. The pain of osteoarthritis is usually worse after activity. Early in the course of the disease, you may notice that your knee does fairly well while walking, then after sitting for several minutes the knee becomes stiff and painful. As the condition progresses, pain can interfere with even simple daily activities. In the late stages, the pain can be continuous and even affect sleep patterns. This pain probably does not come from the covering of the joint, the articular cartilage, because this tissue does not have a nerve supply. Sources of pain may be due to: • Inflammation in the lining of the joint, called the synovium. The diagnosis of osteoarthritis can usually be made on the basis of the initial history and examination. X-Rays are helpful in the diagnosis and may be the only special test required in the majority of cases. Unfortunately, x-ray findings tend to occur late. In some cases of early osteoarthritis, the x-rays may not show changes typical of osteoarthritis. Evidence suggests magnetic resonance imaging is more suitable for detecting early disease. Knee pain from osteoarthritis may be confused with other common causes of knee pain such as a torn menicus or kneecap problems. Sometimes, an MRI scan may be ordered to look at the knee more closely, particularly if structures other than the cartilage may be involved. . An MRI scan is a special radiological test where magnetic waves are used to create pictures that look like slices of the knee. The MRI scan shows more than the bones of the knee. It can show the ligaments, articular cartilage, and menisci as well. The MRI scan is painless, and requires no needles or dye to be injected. If the diagnosis is still unclear, or the patient does not respond to non-operative treatment, arthroscopy may be necessary to actually look inside the knee and see if the joint surfaces are beginning to develop changes from wear and tear. Arthroscopy is a surgical procedure where a small fiberoptic television camera is inserted into the knee joint through a very small incision. The arthroscopist can then move the camera around inside the joint while watching the pictures on a TV screen. The structures inside the joint can be evaluated with small surgical instruments to see if there is any damage. Looking directly at the articular cartilage surfaces of the knee is the most accurate way of determining how advanced the osteoarthritis is. Arthroscopy also allows the surgeon to debride the knee joint. Debridement essentially consists of cleaning out the joint of all debris and loose fragments. During the debridement any loose fragments of cartilage are removed and the knee is washed with a saline (salt) solution. The areas of the knee joint which are badly worn may be roughened with a burr to promote the growth of new cartilage - a fibrocartilage material that is similar scar tissue. Debridement of the knee using the arthroscope is not always successful. If successful, it usually affords temporary relief of symptoms for somewhere between 6 months - 3 years. Another type of knee pain that occurs in younger more active people is anterior (front of the knee) pain. Anterior knee pain (pain in front of the knee) is the most common knee injury in athletes. Anterior knee pain usually develops gradually due to the repetitive motion of the patella (knee cap) sliding up and down, rather than due to a single, sudden injury. This occurs most often in sports requiring a great deal of running and jumping. Here is a typical progression of the symptoms of anterior knee pain: 1) Sitting for an extended period of time causes an ache or stiffness, often behind the kneecap. This pain goes away when the joint is "warmed up" and during exercise. A few hours after exercise the stiffness returns. Athletes may be able to prevent anterior knee pain by identifying the cause. Training errors, poor foot biomechanics, weak quadriceps (the muscles in the front of the thigh), a "loose" knee cap, or muscular imbalances of the hamstring and quadriceps' muscles are the common causes of anterior knee pain. Training errors include increasing the intensity of exercise too rapidly or using one training technique too much, i.e., constantly running on the same side of the road, which puts stress on the knees. Training errors can often be corrected by slowly increasing the intensity of workouts and paying attention to training techniques that may put undue, consistent strain on the knees. Poor foot biomechanics usually refer to excessive pronation of the foot (rolling too far inward each time it strikes the ground) which puts additional stress on the knee. Foot biomechanics can often be corrected by taping the arch or using over-the-counter or custom-made orthotic shoe inserts. Keys to preventing anterior knee pain include wearing the proper shoes for the activity, warming up before exercise, maintaining the appropriate strength balance between the quadriceps and hamstring muscles, limiting the length and duration of activity, and maintaining flexibility. A neoprene knee sleeve with an opening for the kneecap, or a strap to help keep the knee cap in the correct position, may help relieve some symptoms of anterior knee pain, but they will not cure the problem. A sports medicine professional can help determine whether a brace could be effective. The goal in treating anterior knee pain is to restore pain-free range of motion, increase flexibility and improve functional strength & endurance. Treatment usually begins with rest, ice, and the use of nonsteroidal anti-inflammatory medications. Rest may require the athlete to change their training routine to avoid activities which are painful, or to stop all activity for a period of several weeks, or longer. Ice should be applied several times a day, and always after doing stretching or strengthening exercises. Medications should only be prescribed by a medical professional and should be used only as prescribed. Stretching exercises should emphasize stretching the quadriceps, hamstring, and calf muscles. All stretches should be pain-free. Stretches which require the knee to be bent more than 90 degrees may aggravate anterior knee pain. Stretching exercises that cause pain will slow the healing process and delay the return of the athlete to full participation. Stretching exercises should continue even after return to normal activity. Strengthening exercises should concentrate on the quadriceps and hamstring muscles. All strengthening exercises should be pain-free. Strengthening exercises that cause pain will slow the healing process and delay the return of the athlete to full participation. Strengthening exercises which require the knee to be bent 90 degrees, or more, may aggravate anterior knee pain. If one exercise causes pain, another may be substituted in its place. If all strengthening exercises cause pain, only pain-free stretches should be done. When performing strengthening exercises, a ratio of 2/3:1/3 should be maintained between quadriceps and hamstring muscle strength. Low weight, and high repetition exercises are the best. Weights which are too heavy will cause pain and slow the healing process. Consultation with a sports medicine professional is recommended for specific treatment guidelines. Some long-term solutions to help manage knee pain include: • Control pain and inflammation. Aspirin, Advil and Aleve are available over-the- counter. Prescription strength anti-inflammatory medicine is also available.
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