Treat knee pain successfully
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Although magnetic resonance imaging (MRI) or computed tomography (CT) scans do not reveal any pathological findings in the knee joint, arthroscopy of the joint is often considered. Many of the complaints can be treated with targeted physiotherapy and surgery is often avoided.
Contents
Treating knee pain - no success
Knee problems - underestimated complications
Pain in the knee - beginning of further problems
How do you get rid of knee pain? Referral to physiotherapy
Physiotherapy for knee pain - treatment options
Exercise for knee pain? Postoperative treatment
Treating knee pain - no success
Constant pain in the knee joint is unpleasant, significantly limits mobility and quality of life and causes patients to gradually despair - literally. The dose of painkillers is constantly increased because the pain is unbearable without pills. It is understandable that patients grasp at every straw that offers hope of improvement.
Although previous examinations have shown no findings, doctors often decide to perform an endoscopy of the joint. The patient often agrees to this minimally invasive surgical procedure, which promises success. Disillusionment follows quickly when the patient's knee joint continues to be in severe pain after the completed but ineffective procedure.
Knee problems - underestimated complications
Arthroscopy is performed under partial or general anesthesia. This means that there are numerous risks that the patient is forced to take. In addition to possible cardiovascular disorders, life-threatening aspiration of stomach contents, allergic reactions to the anesthetic medication or severe nausea with vomiting after the anesthesia, there is a risk of dizziness and memory lapses. After the procedure, there can be massive fluctuations in blood pressure, which can cause the patient to simply collapse as soon as they try to get into an upright position. Standing up is therefore often impossible at first. In addition, the operated leg must not be fully loaded for the first few days. In addition, the annoying and unpleasant Redon drainage, which drains the wound secretion in the joint to the outside, severely restricts mobility.
Pain in the knee - beginning of further problems
The patient becomes less active as a result of the knee arthroscopy and uses the muscles of the affected leg less frequently than usual. These react after a very short time with temporary atrophy (wasting), which requires targeted muscle-building training. The quadriceps muscle, the four-headed thigh muscle, is particularly quickly and severely affected. It is responsible for moving the knee from flexion to extension. Its main task is also to stabilize the knee joint. If it is too weak, however, it cannot adequately protect, support and hold the knee. The patient has great difficulty climbing stairs because there is not enough strength to extend the leg. The knee can buckle again and again and the initial pain can worsen as a result.
How do you get rid of knee pain? Referral to physiotherapy
At this stage of the patient's suffering, the patient is usually referred to a physiotherapist who can offer the appropriate therapy. However, the original main problem is largely masked by other complaints caused by the procedure. The joint has suffered additional trauma and is in the healing process. At this point, the patient is often unable to distinguish which symptoms were present before the procedure and which were not.
During the physiotherapy admission, the anamnesis, possible reasons for the initial persistent pain can often be quickly identified. Overload during sport, a distortion (twisting) or compression of the joint, a fall on the knee or a torn muscle fiber can all be triggers.
Physiotherapy for knee pain - treatment options
For some knee problems, physiotherapy can prevent arthroscopy. What does the correct treatment look like from a physiotherapist? After the above-mentioned anamnesis and extensive palpation (feeling and feeling structures in the area of the knee joint), an individual treatment plan can be quickly drawn up. The therapist has a variety of options to choose from to alleviate the symptoms.
Depending on the history, it can be determined whether the pain is caused by muscle tension in the leg area, an overstretching of a ligament (ligaments, cruciate ligament), a bruise or soft tissue injury. In the case of muscular tension, heat treatments (mud packs, red light, hot roll) and massages effectively relieve the symptoms. Painless but intensive, pain-relieving and anti-inflammatory ultrasound treatment can also be used. Severe tension occurs particularly in the area of the iliotibial tract.
The pain can extend across the entire lateral thigh area. Radiating pain throughout the entire leg is possible. Trigger point treatment can provide significant relief. If the pain is caused by overstretching, shortening or irritation of a ligament, it can be treated with transverse friction or other methods of manual therapy. A bruise or soft tissue injury is usually accompanied by swelling in the affected area. Cold applications and manual lymphatic drainage are indicated until the edema subsides.
Knee problems can also be caused by a stuck patella (kneecap). If this is not mobile, this can lead to restricted movement and pain in the joint. Patella mobilization with additional soft tissue treatment is indicated in this case. An improvement in the range of motion is seen quite quickly. The longer the pain persists, the longer the healing process can take. Treatment should therefore be started promptly.
Exercise for knee pain? Postoperative treatment
Every body reacts differently to surgical interventions. The most common reaction, however, is a visible edema in the surgical area. This prevents the joint from being able to move properly and causes an unpleasant feeling of tension in the knee. Manual lymphatic drainage followed by compression of the leg up to the thigh provides relaxation and relief. If the swelling has been successfully treated, physiotherapy exercises can be started.
However, if the patient is suffering from pain, the therapist will first address this and, if possible, reduce it. Often, a cold pack is sufficient, which is applied repeatedly during the treatment. The treatment begins with tension exercises and assistive movement exercises in extension and flexion up to the pain threshold. The increase in active movements, also against resistance and with the use of aids, is gradually incorporated into the therapy program. The aim is to build up and train the atrophied quadriceps muscle in order to restore stability in the knee joint or to counteract instability.
If the patient can bear the load, the therapy can be expanded to include a trampoline, tilting board or therapy gyroscope. These are used for balance training and for extended muscle building training. Modern physiotherapy practices offer muscle building training with small sports medicine equipment to particularly sporty patients.
