Our knees are a critical part of our ability to move since they assist us in ambulating from place to place. They are called upon to conquer even the simplest of tasks requiring locomotion in day to day living, such as getting out of bed every morning, and the more daunting endeavors like running a marathon. With healthy knees, we go about our daily activities without much thought, because our knees are strong, stable, and pain-free. Healthy knees can help us conquer uneven terrain, circle obstacles, walk over wet and slippery surfaces, run, jump and twist. It takes a complex balance of coordinated efforts between all of the structures of the knee to move normally, maintain performance, and remain healthy. Once we sustain an injury, and the knee begins to hurt, we sure take notice, and even simple, every-day tasks feels daunting. Besides causing pain, an injury alters the way the knee structures work together. Any change in the structures of the knee, including the muscles, tendons, ligaments, menisci, cartilage and bone, which cooperate to ensure smooth function and the distribution of stresses, will set the once healthy knee joint up for imbalance, joint instability, further injury, and pain.
Ligaments are structures of the knee that play a crucial role in the health and stability of the knee, yet are particularly vulnerable when the loads placed on them exceed their allowed elasticity. If ligaments become injured, your knee will hurt! Why? Ligaments are full of nerve endings! When overloaded from an injury, the ligaments stretch out and weaken, creating an unstable knee joint, and causing those nerve endings to send pain signals. There are quite a few secondary conditions that arise from a knee joint that is unstable, because too much pressure is placed on the other knee structures, including patellar tendonitis, meniscal injuries, runner’s knee, jumper’s knee, patellofemoral pain syndrome, chondromalacia patella, and osteoarthritis. All of these conditions cause your knees to hurt.
Injury to the ligaments of the knee is quite common. Those who follow sports will frequently hear of athletes missing their entire season due to injuries such as an anterior cruciate ligament (ACL) tear? Since the knee structures all work together in a coordinated effort, an injury to one joint structure can also affect other structures of the knee. Sometimes that occurs at the time of the trauma, if the force is sufficiently excessive, capable of tearing the ACL along with the meniscus, and quite possibly injuring other ligaments as well. Secondary injury can also occur over time, when an injury to one structure, allows for an abnormal balance of the knee joint, negatively affecting the structures as the uneven distribution of motion causes them to work harder. The unstable knee joint transmits impaired forces to the bones, ligaments, tendons and menisci, resulting in pain, excessive joint displacement, lack of smooth motion and joint weakness. Each link is important, so if one link is affected, the dynamics of the rest of the knee are altered.
The assault to knee health doesn’t stop there. When injury to the soft tissue or articular surfaces of the knee takes place, it is very common for secondary arthritis to develop in the knee. Arthritis can occur within a few years with severe injuries, or take decades to occur when the injury is less severe. The end result is that your knee will hurt more.
Current treatment options for injured and painful knees generally focus on short-term relief of symptoms. They are utilized in an effort to stop your knees from hurting, and may include treatments like physical therapy, corticosteroid injections, NSAIDS and intra-articular hyaluronic acid injections. These treatments may provide some pain relief, and stop your knees from hurting for a time period, but not all treatments make your knee healthy. It is important to be aware that corticosteroids and NSAIDS have both been linked to the acceleration of the arthritic process, among other deleterious side effects. In the long run, they may make your knees hurt more. To stop the knees from hurting, treatments need to address the injured joint structures. The soft tissue, such as the ligaments, need to be strengthened, and most treatments are unable to strengthen them, and so they often fail to resolve the pain, since injured ligaments are often at the core of the hurting knee. A lack of knee health continues as do symptoms and progression of the disease process. If the root of the problem is not repaired, you are left with knees that continue to hurt.
Although surgical intervention may be needed in cases of fracture and complete tears, surgical arthroscopy for arthritis has been shown to lack benefit, even when compared to exercise and other non-surgical treatments.1 Repair of meniscal injuries by arthroscopic partial meniscectomy has also been questioned in studies due to lack of efficacy.2 These surgeries are also highly associated with acceleration of the arthritic process,3 which as you know, will cause your knee to hurt.
Regenerative Orthopedics addresses knee pain, because it strengthens and repairs the underlying ligament injury and weakness. As a safe and effective non-surgical treatment option, Regenerative Orthopedics, including Prolotherapy, PRP and Stem Cell Therapy, actually repairs the knee joint. It works because it promotes healing of the knee structures such as ligaments, tendons, menisci and cartilage. If knee pain has you side-lined, don’t put up with knees that continue to hurt. We can help get you back to doing the things you love, without the nuisance of painful knees!
1. Marsh JD, Birmingham TB, Giffin JR, et al. Cost-effectiveness analysis of arthroscopic surgery compared with non-operative management for osteoarthritis of the knee. BMJ Open 2016; 5:e009949.doi:10.1136/bmjopen-2015- 009949
2. Khan M, Evaniew N, Bedi A, Ayeni OR, Bhandari M. Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis. CMAJ.2014;186(14):1057-1064.
3. Berthiaume MJ, Raynauld JP, Martel-Pelletier J, et al. Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis 2005;64(4):556-563.