Knee pain when bending: causes, prevention

Author of the article: Victoria Stoyanova, category 2 doctor, head of the laboratory at the diagnostic and treatment center (2015–2016).

Article publication date: 03/15/2013

Article updated date: 05/11/2020

Acute pain always frightens a person. Moreover, if it does not allow you to walk, bend and straighten your leg. What can cause this symptom? What is dangerous about the pathology that caused the pain? How to deal with this? Let's figure it out.

The process of walking involves many joints, including one of the largest – the knees. These joints are complex in terms of functionality; they withstand enormous physical loads every day. But, despite these factors, purely anatomically the knee is a weak joint, prone to injury and degenerative (destructive) processes. If your knee hurts when bending, treatment will depend on the specific cause, which only a specialist can determine. In order not to delay seeing a doctor, you need to know why it is dangerous.

Only a doctor can make an accurate diagnosis

In what cases does knee pain occur when bending?

This problem affects both those who lead a sedentary lifestyle and those who subject their joints to increased physical stress. Among the most common reasons are:

• natural processes of aging of the body in older people;
• infectious diseases with fever (flu, sore throat, ARVI often provoke aching joints);
• injuries and excessive physical activity;
• passive lifestyle.

If the pain occurs for the first time, it is obviously associated with injury. With regular symptoms, osteoarthritis of the knee joint or other chronic pathology can be suspected. The latter are aggravated due to hypothermia, infection, overwork, lack of sleep, unbalanced nutrition or against the background of other unfavorable factors.

The earlier treatment is started, the higher the chances of success of conservative therapy

Treatment methods

In acute conditions, first aid must be provided correctly. If the leg does not bend after an injury, the injured limb must be provided with complete rest until the ambulance arrives. It is strictly forbidden to try to straighten the joint using physical force. It is also necessary to take the patient to the hospital in case of limited physical activity in combination with elevated body temperature. Main treatment methods:

• drug therapy (pain-relieving injections, ointments and compresses, hormonal drugs, injections for inflammation of the knee joint);
• physiotherapeutic procedures (acupuncture, electrophoresis and galvanization, magnetic therapy, laser therapy, ozokerite applications, UVT therapy);
• therapeutic exercises and massage (improves blood circulation, helps restore mobility);
• swimming;
• surgical intervention.

Gymnastics can be active or passive (exercises are performed with the help of an external force without the patient’s muscular participation). The second type is more often used when the leg does not bend as a result of injury. During the first period of treatment, bed rest is required. Then the joint must be developed using prescribed physical activity. The course of recovery and rehabilitation is carried out under the supervision of a doctor.

Orthopedic surgeon Andrey Yurievich Sidenkov comments:

In the absence of results from conservative treatment or in advanced pathology, surgical treatment is performed. The choice of the nature of the intervention is made by the doctor based on examinations. Prolonged immobilization of the knee may be necessary, especially if the knee does not bend completely immediately after surgery. In case of serious pathology, an operation such as prosthetics is prescribed - a complete replacement of the joint with an artificial one.

Sometimes the knee does not bend due to overwork or chronic fatigue. As a rule, establishing a sleep and rest routine helps normalize the situation with the knee joint.

What diseases can cause pain in the knee when bending?

• Injuries. The pain is sharp and growing. If you do not seek help immediately, the extent of the damage will increase, possibly causing joint displacement and serious complications.
• Hidden injuries. If you experience pain behind your knee while walking, your orthopedic traumatologist may suggest a meniscus tear, joint subluxation, or bone fracture.
• Arthrosis. Pain in the knee joint is most often associated with arthrosis. At first, the knee crunches when bent due to thinning of the cartilage tissue. Then bone outgrowths, osteophytes, are formed in it, compensating for its deficiency. A stiff knee becomes painful and less mobile, and the muscles atrophy.
• Myositis. Pain when bending and swelling without bruising indicate inflammation of the joint and nearby tissues.
• Synovitis or bursitis. Inflammation of the synovium or joint capsule is accompanied by similar symptoms. However, with such diagnoses, the body temperature rises, weakness increases, and the person is unable to lean on the affected leg.
• Arthritis. If the knee aches even at rest, especially in the evening or after walking, arthritis or arthrosis can be assumed - diagnostics will show.
• Articular cyst. It is indicated by pain when bending the knee from behind.

Pain when bending occurs not only after injuries

Rehabilitation

Rehabilitation will be effective only if it is carried out comprehensively. It consists of various techniques that can be used either independently or combined with others prescribed by a specialist. To obtain effective results, you must use the methods presented:

• Drug therapy.
• Massage treatments.
• Therapeutic exercises.
• Physiotherapy.

The use of each of the above methods will depend on the situation and the testimony of the traumatologist.

Diagnostic features

Depending on the nature of the pain, you should contact one of the doctors:

• if your knee hurts after a blow, injury or awkward movement, see a traumatologist;
• if there are no visible reasons for pain, see an orthopedist or neurologist;
• If hematomas or spider veins appear on your legs, see a phlebologist.

To clarify the diagnosis, the specialist may order an X-ray, MRI or CT scan, ask for an ultrasound of the joints, a blood or urine test, or biomaterial for joint puncture. Collection of joint fluid is necessary for synovitis and bursitis to check for the presence and type of infection. Before treating osteoarthritis, MRI is used to determine the degree of joint space narrowing, the nature of osteophytes, bone tissue destruction and other factors.

The knee is hurt? Feel free to ask questions to an orthopedist or traumatologist

Methods of therapy

What to do if your leg hurts?

If the knee does not fully straighten and this causes discomfort, altering gait and posture, this defect can be eliminated using the following methods:

• It is important to protect the leg from active loads: place the limb horizontally using a bolster; if the patient must sit, the leg must be placed on a chair.
• It is recommended to apply a bandage to the injured joint.
• It is necessary to take painkillers, anti-inflammatory drugs, and you can also get rid of pain and swelling by using cold compresses.
• Use folk remedies, for example, making bandages from cabbage, raw potatoes or nettles.
• After consulting with your doctor in advance, use warming or cooling ointments. They quickly restore joint function and help get rid of pain and swelling.

Why are physiotherapeutic procedures necessary?

Physiotherapy is necessary to remove inflammation, as well as for prevention when the leg bends poorly or the knee buckles. The trainer develops an individual set of exercises and monitors their implementation. If the patient is not comfortable or uncomfortable, then the exercise is replaced with another, more suitable one, otherwise gymnastics will worsen the patient’s condition. As soon as the patient began to do gymnastics correctly, without the help of a doctor, he is allowed to do exercises at home. But sometimes the trainer must make sure that the treatment is effective. Charging must be done regularly, otherwise it will not help.

Development

Contracture of the knee joint

After the orthosis or plaster cast is removed from the injured limb, the traumatologist will prescribe the patient special therapeutic exercises and massage procedures so that the patient can develop the joint.

Why is it necessary to do this? While the limb is immobile, blood circulation and metabolic processes in the muscle and tendon tissues slow down in the knee joint. If the cast has to be worn for a long time, the atrophic process begins. As a result, contracture appears, which does not allow the injured lower limb to fully bend and unbend. This process most often causes cicatricial tightening of the epidermis, tightening of the tendon or muscle apparatus, or pain.

You can restore mobility to the articular joint only by performing special exercises and massage procedures. They help improve blood flow in damaged tissues, improve metabolic processes, increase muscle tone, relieve contracture, strengthen the ligaments and menisci, and also improve the general condition of the patient.

Massage procedures also help in developing articulation. They are carried out even when the lower limb is in the orthosis, and after its removal, massage is a mandatory component of the recovery process.

It is necessary to take into account that you can massage not the knee itself, but the areas surrounding it. Massage has an antispasmodic effect, removes swelling and algia. With its help, you can prepare and warm up the muscular system before performing gymnastic exercises.

Lymphatic drainage massage technique is used to eliminate swelling. Later, manual techniques are used to speed up the process of developing the joint.

One of the most important techniques used for knee injuries is therapeutic exercises. Exercises to develop the knee joint allow you to relieve not only the contracture, but also return the muscular system to functionality after the plaster cast has been removed. The rehabilitation specialist will decide what kind of gymnastics the patient should perform. The first time after removing the orthosis, the patient needs to perform simple isometry. Next, the load must be increased by adding exercises with dynamic and static functions.

If the patient feels pain during gymnastics, then they need to be performed using special CPM devices. Such devices allow you to perform passive gymnastics, which does not cause pain or muscle tension.

A week after removing the orthosis, you can begin to perform active exercises. During the first week, you cannot lean on the injured limb and you can only walk using crutches.

Most often, to develop a damaged knee, rehabilitators prescribe the following therapeutic exercises:

• Before performing exercises, the limb must be warmed up. To do this, lie on your back and unclench your toes for about a minute, and then make ten circular movements of your feet. Warming up is necessary to improve blood flow. It protects against damage to weakened tendons and ligaments after wearing an orthosis.
• Next comes restorative gymnastics. We lie on our back, straighten the injured limb, tense our thigh muscles and raise our leg. It must be held suspended for about five seconds, then placed on the floor and relaxed. You need to perform the exercise ten times.
• In the next exercise, the position does not change. We bend the lower limbs at the knee joints so that this movement does not cause discomfort. The heels must be pressed against the gymnastics mat and the thigh muscles must be tense. We hold them in a tense state for about five seconds, then you can relax. This exercise is performed ten times.
• The situation remains unchanged. We bend the injured lower limb at the pelvic and knee joints, while supporting the leg under the knee. Slowly straighten your leg at the joint and hold it in this position for about five seconds. Let's relax. We repeat the exercise ten times.
• We stand against the wall. We straighten the damaged leg at the joint by forty-five degrees. We hold the limb suspended for about seven seconds, then slowly lower it back. We repeat ten times.

It is necessary to perform gymnastics in a leisurely manner. You need to increase the amount of exercise only when your doctor tells you to do so. It is also necessary to fix the knee with elastic bandages.

Peculiarities

Plaster is applied for different periods, which can range from thirty days to a couple of months. All this time, the knee will be completely immobilized, and the epidermis under the bandage will be deprived of oxygen.

After the plaster cast is removed, the patient will face several problems at once. Firstly, the skin on the leg will become dry and begin to peel off, since air has not been supplied to it for a long time. To eliminate peeling, the skin must be washed with soap and water and treated with a softening lotion. Secondly, contracture, atrophic process of muscle tissue and thromboembolism of the vascular network of the limb may develop. The longer the leg was in a cast, the greater the possibility that the complications described above may occur.

If the doctor diagnoses hemarthrosis of the knee joint after removing the plaster, then repeated hemorrhages in the articular joint are possible, which will recur in the future. In this case, it is necessary to wear an elastic bandage for some time (from two months to six months). How much time is needed for the recovery process will depend on the reasons that provoked the illness and the individual characteristics of the patient’s body.

To reduce possible complications to a minimum, immediately after removing the plaster cast, it is necessary to begin to develop the knee joint, and this is only possible if complex rehabilitation measures are taken, which were already mentioned above.

How quickly complete recovery occurs will depend on the patient and compliance with the instructions left to him by the traumatologist.

Consequences

For minor injuries, recovery will last up to 1-2 weeks. However, if you ignore treatment of the injury, the consequences of the disease may worsen and provoke habitual dislocations and chronic pain.

Inflammatory and degenerative diseases without timely treatment are fraught with gradual destruction of the joint, loss of elasticity, and in some cases, ossification. Patients with advanced pathological processes lose the ability to move normally and often become disabled.