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Knee Problems and Injuries

Structures of the knee, Opens dialog

Hamstring stretch in a doorway, Opens dialog

Single knee-to-chest stretch, Opens dialog

Overview

Most people have had a minor knee problem at some time. Most of the time our body movements don't cause problems. But sometimes symptoms develop from everyday wear and tear, overuse, or injury. Knee problems and injuries most often occur during sports or recreational activities, work-related tasks, or home projects.

The upper and lower bones of the knee are separated by two discs (menisci). The upper leg bone (femur) and the lower leg bones (tibia and fibula) are connected by ligaments, tendons, and muscles. The surface of the bones inside the knee joint is covered by articular cartilage. It absorbs shock and provides a smooth, gliding surface for joint movement.

Knee problems are often caused by an injury to one or more of these parts of the knee. But they may be caused by things other than injuries. Some people are more likely to have knee problems than others. Many jobs, sports and activities, getting older, or having a disease such as osteoporosis or arthritis increase your chances of having problems with your knees.

Sudden (acute) injuries

Injuries are the most common cause of knee problems. Sudden (acute) injuries may be caused by a direct blow to the knee. Or they may be caused by abnormal twisting, bending the knee, or falling on the knee. Pain, bruising, or swelling may be severe and occur within minutes of the injury. Nerves or blood vessels may be pinched or damaged during the injury. The knee or lower leg may feel numb, weak, or cold. It may tingle or look pale or blue. Acute injuries include:

Sprains, strains, or other injuries to the ligaments and tendons that connect and support the kneecap.
A tear in the rubbery cushions of the knee joint (meniscus).
A torn ligament, such as the anterior cruciate ligament (ACL). The medial collateral ligament (MCL) is the most often injured ligament of the knee.
Breaks (fracture) of the kneecap, lower portion of the femur, or upper part of the tibia or fibula. Knee fractures are most often caused by abnormal force. Examples include falling on the knee, a severe twisting motion, severe force that bends the knee, and the knee forcefully hitting an object.
Kneecap dislocation. This type of injury occurs more often in active teens and young adults.
Pieces of bone or tissue (loose bodies) from a fracture or dislocation. They may get caught in the joint and interfere with movement.
Knee joint dislocation. This is a rare injury that requires great force. It's a serious injury. It requires medical care right away.

Overuse injuries

Overuse injuries occur with repetitive activities or repeated or prolonged pressure on the knee. Knees can get irritated and inflamed when you climb stairs, ride a bike, jog, or jump, putting stress on your joints and other tissues. Overuse injuries include:

Inflammation of the small sacs of fluid that cushion and lubricate the knee (bursitis).
Inflammation of the tendons (tendinitis) or small tears in the tendons (tendinosis).
Thickening or folding of the knee ligaments (plica syndrome).
Pain in the front of the knee from overuse, injury, excess weight, or problems in the kneecap (patellofemoral pain syndrome).
Irritation and inflammation of the band of fibrous tissue that runs down the outside of the thigh (iliotibial band syndrome).

Conditions that may cause knee problems

Problems not directly related to an injury or overuse may occur in or around the knee.

Arthritis, especially osteoarthritis (degenerative joint disease). This may cause knee pain. It often occurs at the site of a previous injury.
Osgood-Schlatter disease. This causes pain, swelling, and tenderness in the front of the knee below the kneecap.
A popliteal (or Baker's) cyst. This causes swelling in the back of the knee.
Infection in the skin (cellulitis), joint (infectious arthritis), bone (osteomyelitis), or bursa (septic bursitis). This can cause pain and decreased knee movement.
A problem elsewhere in the body. Things like a pinched nerve or a problem in the hip can sometimes cause knee pain.
Osteochondritis dissecans. This causes pain and decreased movement when a piece of bone or cartilage (or both) inside the knee joint loses blood supply and dies.

Treatment

Treatment for a knee problem or injury may include first aid, rest, bracing, physiotherapy, and medicine. In some cases, surgery is needed. Treatment depends on:

The location and type of injury, and how bad it is.
Your age, health condition, and activity level (such as work, sports, or hobbies).

Check Your Symptoms

Do you have a knee injury or other knee problem? Review health risks that may make any symptom more serious.

Yes

Knee problem or injury

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

Your age. Babies and older adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Pain in adults and older children

Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Major trauma is any event that can cause very serious injury, such as:

A fall from more than 3.1 m (10 ft)[more than 1.5 m (5 ft) for children under 2 years and adults over 65].
A car crash in which any vehicle involved was going more than 32 km (20 miles) per hour.
Any event that causes severe bleeding that you cannot control.
Any event forceful enough to badly break a large bone (like an arm bone or leg bone).

When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

There are other reasons for colour and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal colour returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Pain in children 3 years and older

Severe pain (8 to 10): The pain is so bad that the child can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and sleep, but the child can tolerate it for hours or days.
Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.

Symptoms of infection may include:

Increased pain, swelling, warmth, or redness in or around the area.
Red streaks leading from the area.
Pus draining from the area.
A fever.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
Long-term alcohol and drug problems.
Steroid medicines, which may be used to treat a variety of conditions.
Chemotherapy and radiation therapy for cancer.
Other medicines used to treat autoimmune disease.
Medicines taken after organ transplant.
Not having a spleen.

With severe bleeding, any of these may be true:

Blood is pumping from the wound.
The bleeding does not stop or slow down with pressure.
Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may be true:

The bleeding slows or stops with pressure but starts again if you remove the pressure.
The blood may soak through a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be true:

The bleeding stops on its own or with pressure.
The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

Passing out (losing consciousness).
Feeling very dizzy or light-headed, like you may pass out.
Feeling very weak or having trouble standing.
Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

Passing out (losing consciousness).
Being very sleepy or hard to wake up.
Not responding when being touched or talked to.
Breathing much faster than usual.
Acting confused. The child may not know where he or she is.

Post-Operative Problems

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Self-Care

Try the following tips to help relieve knee pain, swelling, and stiffness.

Rest.
It's important to rest and protect the affected area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
When you rest, place a small pillow under your knee.
Use ice.
Put ice or a cold pack on your knee for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake).
Wrap the affected area.
Compression, or wrapping the area with an elastic bandage (such as an Ace wrap), will help reduce swelling.
- Don't wrap it too tightly, because that can cause more swelling below the affected area. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, and swelling in the area below the bandage.
- Don't expect the bandage to protect or stabilize a knee injury.
Elevate the affected area.
Try to keep the area at or above the level of your heart to help reduce swelling. Prop up the area on pillows while you apply ice and anytime you sit or lie down.
Try not to put weight on your knee.
Do this until you can get advice from your doctor.
- Use a cane or crutch in the hand opposite your painful knee.
- Use two crutches, keeping weight off the leg with the sore knee. You can get canes or crutches from most drugstores. Crutches are recommended if a cane causes you to walk with a limp.
Avoid more swelling.
For 48 hours, avoid things that might increase swelling. These things include hot showers, hot tubs, hot packs, and drinks that contain alcohol.
Apply heat.
- After 2 or 3 days, you can try applying heat to the area that hurts. Types of heat therapy include microwavable packs and disposable heating patches.
- Apply heat for 10 to 20 minutes at a time.
- You might also try switching between cold and heat.
Rub the area.
Gently massage or rub the area to relieve pain and encourage blood flow. Don't massage the affected area if it causes pain.
Do exercises to keep flexibility.
Try these stretches:
- Hamstring stretch in a doorway
- Single knee-to-chest stretch
Avoid high-impact exercises.
These include running, skiing, snowboarding, and playing tennis. Don't try them until your knee is no longer painful or swollen.
Don't smoke or use other tobacco products.
Smoking slows healing because it decreases blood supply and delays tissue repair.

If you need to use a wrap for more than 48 hours, you may have a more serious injury that needs to be checked by a doctor.

Signs of possible abuse

Most injuries are not caused by abuse. But bruises are often the first sign of possible abuse. Suspect physical abuse of a child or vulnerable adult when:

Any injury cannot be explained or does not match the explanation.
Repeated injuries occur.
Explanations change for how the injury happened.

You may be able to prevent further injuries by reporting abuse. Seek help if:

You suspect child abuse or elder abuse. Call your local child or adult protective agency, police, or a health professional, such as a doctor, nurse, or counsellor.
You or someone you know is experiencing intimate partner violence (IPV).
You have trouble controlling your anger with a child or other person in your care.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

New or worse pain or swelling.
New signs of infection, such as redness, warmth, pus, or a fever.
New or worse numbness, tingling, or cool and pale skin.
Movement or strength decreases.
Symptoms occur more often or are more severe.

Learn more

Over-the-counter medicines

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RICE: Rest, Ice, Compression, Elevation, video

Information about Knee Problems and Injuries

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Credits

Current as of: July 31, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

This information does not replace the advice of a doctor. Ignite Healthwise, LLC, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.

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Knee Problems and Injuries

Overview

Structures of the knee, Opens dialog

Hamstring stretch in a doorway, Opens dialog

Single knee-to-chest stretch, Opens dialog

Overview

The upper and lower bones of the knee (Figure 1) are separated by two discs (menisci). The upper leg bone (femur) and the lower leg bones (tibia and fibula) are connected by ligaments, tendons, and muscles. The surface of the bones inside the knee joint is covered by articular cartilage. It absorbs shock and provides a smooth, gliding surface for joint movement.