Why does the knee joint to the left of the cup hurt when walking?

The knee joint is the largest after the hip. The knee has a wide range of motion:

• flexion;
• extension;
• turn;
• incline.

This multidimensionality is ensured by the anatomical structure of the joint. The ligaments, tendons and muscles provide stability to the knee and prevent unnatural movements and damage.

The ideal structure of the knee joint allows a person to jump and run without receiving any injuries. But if one of the parts of the complex structure of the knee fails, sooner or later the problem will make itself known, and then pain appears above, below, or inside the knee.

Pain in the knee while walking or bending the joint may indicate serious problems that require immediate medical attention.

Knee pain when bending, causes

If pain in the knee often occurs when straightening the leg or bending the knee joint, then the cause may be:

• muscle strain;
• arthritis;
• gonarthrosis;
• tendinitis;
• meniscus injuries and other pathologies.

Muscle strain in the knee area is considered the most common problem. Moreover, a sprain can be obtained not only as a result of injury (a blow, a fall), but also during a prolonged monotonous position, for example, when sitting on an uncomfortable chair, digging up a plot of land.

After physical training, cycling, running or squats, muscle fibers become overstrained and pain appears, which is mistaken for joint pain. But in the case of repeated micro-strains and micro-tears of tendon and muscle fibers over a long period of time, it leads to pathological processes:

• Regular pain appears when straightening or bending the knees.
• Visually, the knee joint looks reddened, there is swelling, and a local increase in skin temperature. In case of injury, scratches and abrasions are inevitable.

These signs indicate a slight sprain in the knee joint. This problem can be solved independently at home without the help of doctors:

• cold compresses, after a few days replace them with compresses with heated pine needles or sea salt;
• gentle treatment of the damaged joint;
• tight bandage;
• To drain blood, it is recommended to lie with your knee elevated for several hours.

If after these procedures there is no relief and pain in the knee remains, then the problem is more serious than a simple sprain and you need to consult a traumatologist.

Choice of treatment tactics

In the presence of a bony abnormality or dysfunction of the patellar retinaculum, conservative treatment may be less successful. However, surgical treatment should only be considered when individuals with correctable anatomical abnormalities have failed conservative therapy.

Physical therapy

Knee Mobilization Technique
To achieve long-term results, you must first correct postural imbalances and altered movement patterns before moving on to a strengthening program. When assessing functional impairment and compensatory patterns, the entire lower extremity should be tested. Significant discrepancies in leg length should be corrected as this is a precipitating factor. Eng et al. believe that for patients with BPACS, orthosis along with exercises gives better results compared to exercises alone. However, any exercise and/or stretching program should be individualized depending on the symptoms and movement dysfunctions present.

If the patellar retinaculum is tight and negatively affecting the patellofemoral joint, manual techniques and McConnell knee taping can be used. There is evidence that knee taping combined with exercise provides superior pain reduction compared to exercise alone. Treatments such as proprioceptive training, taping and orthotics are best used as an adjunct to traditional physical therapy—research shows they are not as effective when used alone.

Improving eccentric muscle control is more effective than concentric exercises. Moreover, exercises in a closed kinematic chain are more functional and minimize the load on the patellofemoral joint. Patients with BPACS show decreased knee extensor strength as well as vastus medialis strength, although Witvrouw et al. came to the conclusion that the vastus medialis muscle cannot work in isolation. Vastus medialis weakness is thought to be caused by neuromuscular dysfunction.

The length of the hamstrings, the gastrocnemius and rectus femoris, influences patellofemoral mechanics. Tight hamstrings lead to increased reaction force at the patellofemoral joint level, since in this case the quadriceps muscle works with greater force. Therefore, regular stretching of hamstrings is recommended.

However, according to Mason et al, who compared the effectiveness of stretching exercises, quadriceps strengthening exercises, and taping (isolated and in combination), isolated stretching and quadriceps strengthening resulted in better results than taping. They also concluded that a combination of these techniques is recommended as an initial approach to treating patellofemoral pain, but that further individualized treatment is more functional. Global treatment is also important.

Conclusion

Anterior knee pain is a symptom, not a diagnosis. Making a diagnosis requires taking into account many pathologies that may be suspected during the analysis of the clinical picture and testing of the patient. There is also a high correlation between BPACS and hip biomechanical impairment, so any assessment must include the entire kinetic chain. Treatment is highly individualized and the European Rehabilitation College guidelines are a useful tool for choosing a non-operative treatment protocol.

Symptoms of knee damage

There are symptoms that clearly indicate serious problems and the need to see a doctor:

• There is absolutely no mobility in the knee joint.
• Painful sensations prevent you from transferring weight to the affected leg.
• The skin in the area of ​​the knee joint is severely hyperemic to the point of hematoma formation, the knee is swollen.
• Flexion and extension movements cause severe pain.
• Noises or clicking noises are heard in the knee while moving.
• At rest and when walking, periodic muscle spasms, numbness, weakness, and tingling are felt.

These symptoms not only cause inconvenience and constant discomfort to a person, but can also indicate sprains, microtears and tears of the ligamentous apparatus or muscles.

Which doctor should I contact?

If your right knee hurts on the left, you cannot ignore the symptom, since inflammation or degenerative changes in an advanced stage are difficult to treat.

• A rheumatologist specializes in diseases of the knee joints.
• A traumatologist helps to deal with traumatic injuries to the knee joints.
• A physiotherapist helps restore the functionality of the knee joints: he draws up a program of exercise therapy and physiotherapy.
• A chiropractor conducts a course of massage procedures.

If your knee hurts to the left of the cup when walking, it is recommended to do an ultrasound or CT scan.

What is gonarthrosis

In addition to the traumatic factor in the formation of pain in the knee joint, joint diseases of various etiologies can be a source of decreased motor activity of the knee. For example, nagging pain in the knee can be caused by chronic degenerative processes, which are accompanied by the destruction of the cartilaginous layers of the joint. If pain appears at rest and intensifies with movement, most likely the doctor, after examination, will diagnose gonarthrosis (arthrosis).

Orthopedic doctor Andrey Sergeevich Litvinenko comments:

It is pain in the knee joint that is decisive in the diagnosis of arthrosis. It should be emphasized that the pain is constant, and with minimal physical activity it intensifies.

The early stages of gonarthrosis are characterized by the following symptoms:

• some intermittent swelling of the joint;
• moderate pain at rest;
• increased pain when moving up stairs, when bending the knee at a right angle;
• There is no deformation or crunching.

In case of further progression of the disease, the patient’s condition worsens:

• restriction of joint movement;
• crunching when moving the knee;
• sharp pain during active movement;
• the knee hurts severely when bending even less than at an angle of 90 degrees;
• The x-ray shows thickening of the bones.

In advanced cases, gonarthrosis leads to blocking and deformation of the joint. Such processes are associated with the almost complete destruction of the cartilaginous surfaces of bones. This pathological process is accompanied by the following symptoms:

• Movement in the joint is reduced to a minimum.
• Both at rest and while walking, as well as at night, there is constant severe pain.
• Deformation of the joints leads to valgus or varus curvature of the legs.
• The articular space is practically invisible on the x-ray.

Without treatment, gonarthrosis progresses to the last stage, in which the joint is completely blocked, and instead of a cartilaginous layer, calcifications grow:

• joints are blocked in an extended or slightly bent state;
• unnatural gait on half-bent or fully straightened legs;
• The ligamentous apparatus and muscles undergo atrophic processes;
• Genarthrosis of the last stage in the picture is expressed by complete closure of the joint space by osteophytes.

Ligaments and muscles are constantly under tension when the joint is in a non-physiological position, which leads to injury and aggravation of the situation.

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Arthritis of the knee joint

A distinctive feature of arthritis is discomfort at rest, and its weakening during movement. If arthritis continues to progress, the processes of deformation of the articular surfaces and destruction of cartilage tissue begin. At this stage, acute pain appears when the joint is extended, and redness of the skin in the knee area is noted due to inflammatory processes.

Arthritis is not limited only to local symptoms; the disease also affects other systems and organs:

• disturbances in the functioning of the cardiovascular system;
• hyperthermia with signs of intoxication;
• genitourinary system disorders, skin rashes and other symptoms.

In some cases, arthritis is aggravated by exposure to atmospheric conditions.

Diagnostics

If disturbing signs appear in the knee area, you should consult a specialist. The doctor will collect anamnesis, conduct an examination, and palpate. He will also refer you for instrumental and laboratory diagnostics:

1. MRI.
2. X-ray.
3. Radiography.
4. Joint punctures.
5. Analyzes.

X-ray

This research method is indispensable when examining knee injuries. It is used for degenerative-dystrophic processes. X-ray allows you to make an accurate diagnosis, establish the stage of development of the pathology, and monitor the therapy.

The method allows you to detect:

• Violation of bone integrity;
• sprain, rupture of ligaments;
• dislocation;
• osteomyelitis;
• arthrosis;
• osteoporosis;
• osteochondropathy;
• foreign bodies;
• cysts;
• arthritis;
• tumors;
• patellar injury.

CT scan

A CT scan is performed using x-rays. The procedure is prescribed for the following symptoms:

1. Injuries;
2. knee pain;
3. suspected fracture;
4. suspicion of dislocation;
5. the presence of fluid inside the joint;
6. Baker's cyst;
7. connection clicks;
8. a fragment of bone inside the joint;
9. arthrosis, arthritis;
10. control over the operation.

Magnetic resonance

MRI is considered a very popular method for diagnosing pathologies and injuries of all elements of the joint. It is prescribed if there are the following indications:

• Unstable functioning of the joint;
• formation of liquid inside the connection cavity;
• bruises, injuries;
• knee pain;
• presence of infection;
• fractures;
• patellar trauma;
• formations of a benign, malignant nature.

Signs of tendonitis

Tendinitis is an inflammatory lesion of the ligamentous apparatus of the knee joint. The disease belongs to the category of occupational pathologies among athletes and people engaged in heavy physical labor.

Knee tendinitis develops for two reasons:

• Degenerative – impaired elasticity of ligaments due to age-related changes, metabolic disorders.
• Mechanical – constant overloads lead to gradual thinning of the tendons, and subsequently to rupture of the ligaments.

In the initial stage of tendinitis, the patient complains of mild pain after physical activity, the pain worsens both with extension and flexion of the joint.

When visiting a doctor, tendonitis is diagnosed using the following methods:

• when palpating the knee joint and pressing on the hole from the outside, the pain worsens - the disease spreads into the deep tendons;
• the patient, in a sitting position, tries to straighten the leg, and the doctor applies pressure, preventing extension - painful sensations are characteristic of partial damage to the tendons.

Articular cartilage disorder

The reasons for this disorder can be various: physical activity, lack of important vitamins and minerals, a sedentary lifestyle, a tendency to be overweight, arthrosis, poor blood circulation, and various injuries. The pain is aching, mechanical in nature, manifests itself during movement and a strange crunching or crackling sensation may be felt. Depending on the reasons, therapy will be prescribed: physiotherapy, special massages, therapeutic mud, lotions, enhanced nutrition, abolition of physical activity. In complex advanced situations, surgical intervention is possible.

Flat feet - the cause of knee pain

Each human joint ensures organic movement in space. Deformation of one of the joints of the lower extremities reduces motor activity, disrupts gait, and over time leads to atrophic processes in other joints of the legs - ankle, knee, hip.

A arched foot provides shock absorption when running and walking. This relieves the muscles and ligaments of the joints. In the case of flat feet, shock absorption functions are disabled, and the load on the muscles, ligaments, and cartilages of the knee and ankle joint increases significantly. This leads to gradual wear and tear of all joint tissues.

The ankle joints are the first to undergo pathological changes, and later the knee joints. When the disease affects the knees, pain appears during flexion and extension movements in the joint.

Types of knee injuries

Lower extremity injuries are the most common cause of knee pain. Sharp pain with blocking of joint movement indicates a partial or complete tear of the meniscus. The blockage is explained by the fact that part of the damaged meniscus enters the joint space, jamming it.

Symptoms of a meniscus tear are:

• edema and hemarthrosis;
• upon palpation below the patella, the pain worsens;
• Functionality tests by rotation and extension.

Violation of the integrity of the ligaments can also cause joint blockage. The following characteristic signs are noted:

• extension or collapse of the knee;
• deviation of the joint inward or outward;
• pain when moving.

When the ligaments are torn, the knee joint is not secured and upon examination, free mobility appears, as in a joint dislocation.

Epidemiology/Etiology

The etiology of anterior knee pain (AKP) is multifactorial and not well defined due to the variety of symptoms, location of pain, and level of pain experienced by the patient. The underlying factors may be patellar abnormalities, muscle imbalances, or weakness that cause the patella to malalign when the knee joint flexes and extends. This also includes overuse and related conditions: tendinopathy, insertional tendinopathy, patellar instability, chondral and osteochondral damage.