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Knee Pain Clinic

Are you frustrated with your knee pain that is not getting better? Are you experiencing Knee discomfort after prolong walking, squatting or running? You are in the right place! We certainly able to help with our innovative and non-invasive (non-surgical) form of treatment. Get your knee check today. Call us at (65) 64712744 or SMS to (65) 92357641 to schedule for an appointment

Knee Pain

Knee pain refers to pain that occurs in and around your knee joint. Knee pain can be caused by problems with the knee joint itself, or it can be caused by conditions affecting the soft tissues, ligaments, tendons, or bursae that surround the knee.

The severity of knee pain can vary widely. Some people may feel only a slight twinge, while others may experience debilitating knee pain that interferes with their day-to-day activities. In most cases, self-care measures can help you cope with knee pain.

The knee consists of two long leg-bones held together by muscles, ligaments, and tendons. Many knee problems are a result of the aging process and continual wear and stress on the knee joint. Other knee problems result from injury or a sudden movement that stiffens the knee.

Some common conditions of Knee Problem include:

  • ARTHRITIS – Knee pain is a common problem in Asia, especially in individuals above the age of 40. The most common cause of knee pain is degenerative osteoarthritis. Women are more prone to the disease. It is characterized by mild to debilitating pain.

  • LIGAMENT INJURIES – Ligament injuries in the knee; such as an anterior cruciate ligament (ACL) are dreaded by professional and amateur athletes alike. They can be painful and debilitating. They can even permanently change your lifestyle.

  • MENISCAL TEAR – The meniscus is a small “c” shaped cartilage that acts as a cushion in the knee joint. They sit between the femur and the tibia bone, one on the outside and one on the inside of the knee.

  • PATELLAR TENDONITIS – Patellar tendinitis is a common overuse injury. It occurs when repeated stress is placed on the patellar tendon. The stress results in tiny tears in the tendon, which the body attempts to repair.

  • CHONDROMALACIA PATELLA – Chondromalacia patella is a common cause of kneecap pain or anterior knee pain. Often called “Runner’s Knee,” this condition often affects young, otherwise healthy athletes.

  • DISLOCATING KNEECAPS – Kneecap dislocation occurs when the triangle-shaped bone covering the knee (patella) moves or slides out of place. The problem usually occurs toward the outside of the leg.

  • BAKER’S CYST – A Baker cyst is swelling caused by fluid from the knee joint protruding to the back of the knee. The back of the knee is also referred to as the popliteal area of the knee

  • BURSITIS – A bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body.

  • PLICA SYNDROME – Often called “synovial plica syndrome,” this is a condition that is the result of a remnant of fetal tissue in the knee. The synovial plica are membranes that separate the knee into compartments during fetal development.

  • OSGOOD-SCHALLATER DISEASE – Osgood-Schlatter disease is a disorder of the lower front of the knee where the large tendon under the kneecap (patellar tendon) attaches to the bone of the leg below.

  • OSTEOCHONDRITIS DISSECANS – Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone.

  • GOUT – Gout is a rheumatoid form of arthritis that causes the inflammation, joint pain and swelling especially in the toe, knee and ankle, also reducing their mobility.

  • SHIN SPLINT – Shin splints are a member of a group of injuries called “overuse injuries.” Shin splints occur most commonly in runners or aggressive walkers

When do you need to call us about your knee pain?

If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of knee pain must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

  • Inability to walk comfortably on the affected side

  • Injury that causes deformity around the joint

  • Knee pain that occurs at night or while resting

  • Knee pain that persists beyond a few days

  • Locking (inability to bend) the knee

  • Swelling of the joint or the calf area

  • Signs of an infection, including fever, redness, warmth

  • Any other unusual symptoms

Treatments for Knee Pain

Treatment of knee pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.

Read more about patient guide to knee pain

Read more about knee pain while running

Read more about knee pain causing by heavy weight

Read more about 9 tips to avoid knee pain and injuries

Read more about Meniscus Cartilage Tear

Who is Knee Specialist?

Knee specialist is an orthopaedic surgeon specialise in disorders of the knee. They deal with conditions such as knee arthritis, and damage to the knee ligaments. The operations and treatments that knee specialists offer include total and partial knee replacement, arthroscopic knee surgery, and knee ligament reconstruction (including anterior cruciate ligament reconstruction).

CURE YOUR KNEE PAIN TODAY. GET A KNEE SPECIALIST TO RULE OUT THE CAUSES AND CURE OF YOUR KNEE PAIN. CALL US +65 64712744 OR EMAIL INFO@BONECLINIC.COM.SG TO SCHEDULE FOR AN APPOINTMENT

Preventing ACL Injuries

ACL (anterior cruciate ligament) knee injuries can cause many problems for kids who play sports. Besides the chance of having to sit out an entire season, they might face loss of scholarship funding, lowered academic performance,1 and long-term disability from osteoarthritis (a painful joint condition). More than 50,000 debilitating ACL injuries occur in female athletes at the high school and intercollegiate varsity levels in an average year.

Knee Bursitis

Knee Bursitis

Why do ACL Injuries occur in kids?

Most ACL tears do not occur from player-to-player contact. The most common causes of noncontact ACL injury include: change of direction or cutting maneuvers combined with sudden stopping, landing awkwardly from a jump, or pivoting with the knee nearly fully extended when the foot is planted on the ground.

Who is at Risk for An ACL Injury?

There is no definitive link between age and gender, and the rising rates of ACL injuries. However, landing, cutting, and pivoting maneuvers have been shown to differ between male and female athletes. For example, some female soccer players may perform playing actions with more of a knock-kneed position, or a reduced hip and knee joint range of motion, or decreased hamstring strength, any of which may underlie their increased risk for an ACL injury.

How can an ACL Injury be prevented?

It is difficult to assess how athletes can best modify their movements to prevent noncontact ACL injuries. Speaking with an athletic trainer, physical therapist, or sports medicine specialist is a good place to start. Recent research has allowed therapists and clinicians to easily identify and target weak muscle areas (e.g., weak hips, which leads to knock-kneed landing positions) and identify ways to improve strength and thus help prevent injury. In addition, other risk factors such as reduced hamstring strength and increased joint range of motion can be further assessed by a physical therapist or athletic trainer to improve performance—or rehabilitation efforts after an injury has occurred.

Current studies also demonstrate that specific types of training, such as jump routines and learning to pivot properly, help athletes prevent ACL injuries. These types of exercises and training programs are more beneficial if athletes start when they are young. It may be optimal to integrate prevention programs during early adolescence, prior to when young athletes develop certain habits that increase the risk of an ACL injury.

Summary

There are several factors that determine whether or not a young athlete will get an ACL injury. Preseason screening programs that monitor important risk factors and identify young “high-risk” athletes who would benefit from targeted neuromuscular training interventions may be the most beneficial way to reduce the risk of ACL injuries in young athletes.

Seek Professional Opinion about your ACL Injury. Call +65 6471 2744 or SMS to +659235 7641 For Appointment

Back to Sports: Advance Knee Rehabilitation

Knee injury is one of the most common injuries sustained in sports. It can be in the form of meniscal or ligamentous  injury, the most notorious being the Anterior Cruciate Ligament (ACL) tear. As a result of such injuries, athletes of ten get frustrated as they are unable to perform as their best or even engage in the sport itself. More often than not, athletes do not manage their injuries well and many will attempt to return to sports much earlier than optimal and usually end up worse than before.

Bringing a competitive athlete from injury back to sports requires much more planning than just restoring range of motion and strength. It requires a good understanding of the healing processes, in depth knowledge of strength and conditioning as well as biomechanics of the body in relation to each sport, and the most important of all, the abiloty to implement the rehabilitation process systematically and appropriatelly. It is a science all to itself.

There are three phases in the rehabilitation process; healing and restoration phase, sports conditioning phase. Healing and restoration phase usually takes about four to six weeks and aims to get the athlete back to full range of motion and normal gait. Strength and conditioning phase takes another six to eight weeks with the aim of helping the athlete regain about 80% strength, and at the same time progressively improve their cardiovascular endurance. Finally, the sports conditioning phase aims to improve agility, balance, power and coordination. The phases are not distinct but overlap. With a thorough rehabilitation process, the athlete would be able to return to his sports with a firm foundation in all the key components of physical fitness, allowing him to ease into his sports training with confidence.

Healing and restoration phase (Week 0-4); Aims:

  • Reduce swelling and effusion to minimum
  • Restore normal gait pattern
  • The management of a knee immediately post-operatively focuses on the reduction of swelling and effusion and restoration of range of movement. Exercise such as isometric knee extension is introduced as well to reduce the rate of muscle control.

Strength and Conditioning phase (Week 4-12); Aims:

  • Full range of motion and minimal swelling
  • Unilateral knee exercises
  • Achieving 80% muscle strength of the non injured knee

Once the swelling has reduced significantly, full extension restored with flexion achieved to about 100-120 degrees, and normal gait almost regained, the athlete is then put through other strengthening exercises which can including cycling, leg press, step downs, mini squats (0-45 degrees flexion). All these exercises should be done with both legs, with emphasis on smoothness of execution of movement. The athletes are loaded with low weights at first and then progressed gradually to higher weights with low repetitions. Cardiovascular endurance exercises are also started at this place.

Unilateral knee exercises can be started once the athlete has sufficient muscle control to do a single knee squat of 0-45 degrees flexion. Once the quadriceps and hamstring muscles of the operated knee can achieve about 80% strength of the uninvolved knee, it is time to move on the next phase. The strength of the uninvolved knee, it is time to move on to the next phase. The strength of the knee can be easily gauged by testing the knee on a leg press machine, comparing the weights that be achieved by each knee on a single set of 15 repetitions. A much more accurate test of the strength of the muscles can be done using the isokinetic machine.

The isokinetic strength test is widely used in sports clinics to evaluate the strength of muscles pre and post operatively. However the main drawbacks of the test are that the data does not accurately determine the different performance between athletes of varying skill levels and do not correlate strongly with functional tasks.

Sports Conditioning Phase (Week 12 onwards); Aims:

  • Achieve 90-100% muscle strength in quadriceps and hamstrings
  • Achieve 90-100% in functional testing
  • Athlete is able to perform sports specific movements with ease

Once the athlete can achieve 80% of quadriceps muscle strength and good control over single leg exercise, the next step will be to do functional tests to gauge the performance of the knee. Functional tests have been devised for athletes who has ACL reconstruction done. The tests include jumps, hops, agility and quickness in navigating turns. Various components of physical fitness listed above are tested i.e agility, balance, power and co-ordination. As such, the tests are also suitable to be applied to chart the progress of athletes recovering from post-operative meniscal repair, menisectomy and other ligamentous injury. Being functional, the tests would also be more meaningful as they mimic the movements that would be performed during the sport itself. At this phase, the athletes will be continuing to increase the basic muscle strength through the similar exercises listed in phase 2. These strengthening exercises will form the foundation from which the athletes will be trained in the other components.

Balance is a state of equilibrium, the ability to control the body’s position at rest or in motion. The athlete starts his balance training through balancing on 1 leg on a flat surface before progressing to balancing on unstable surface such as a wobble board. Subsequently, single leg hopping exercises will be introduced and progressed to multi-directional movements, where the level of difficulty is increased.

STOP YOUR KNEE PAIN TODAY. CALL +65 6471 2744 or Email to info@boneclinic.com.sg for appointment

Knee Injuries

There are many different structures inside and outside your knee. These include ligaments, which connect your bones together, articular cartilage, which covers the end of your shin bone and thigh bone in your knee joint, and a crescent-shaped disc called a meniscus. This is made from cartilage and acts as a shock absorber and helps to stabilise your knee. Injury to your knee may damage any one of these structures.

Knee ligament injuries

Your knee ligaments help to keep your knee stable.

The medial collateral and lateral collateral ligaments are found on either side of your knee joint, and act to limit the amount it can move from side to side. You can sprain or tear your medial collateral ligament if you twist your leg while it’s straightened, for example, when being tackled in rugby. Your lateral collateral ligament isn’t usually damaged on its own, but you may need to have it repaired if you have damaged other ligaments.

Your anterior cruciate ligament and posterior cruciate ligament form a cross (cruciate) inside your knee. They help to keep your knee stable when the joint is moving backwards and forwards. Anterior cruciate ligament injuries are one of the most serious types of knee injury.

If you have injured your medial collateral or lateral collateral ligaments, your doctor may grade your injury according to how severe the damage is.

  • Grade 1 is a stretch of the ligament without tearing.
  • Grade 2 is a partial tear of the ligament.
  • Grade 3 is a complete tear of the ligament.

Other soft tissue injuries

Apart from ligaments there are other soft tissues around your knee that can be injured. Soft tissue means any tissue in your body that isn’t bone.

You may tear the meniscus in your knee. You can damage it if you play a sport that involves twisting your upper leg while your foot is planted on the floor. As you get older, your meniscus may become slightly thinner or have micro tears (degenerates). This makes it more likely to tear after a very minor injury.

If you use your knee a lot, for example if you run, you can irritate or tear the tendon that connects your kneecap (patella) to your thigh muscle. This tendon is called the patella tendon and the condition is patella tendonitis.

Symptoms of knee injuries

You may feel or hear a popping or snapping sensation at the time of the injury. You may also find that you can’t stand properly on the affected leg, or put your full weight on it.

The symptoms for most ligament injuries will be similar, no matter which one has been damaged. These may include:

  • pain
  • swelling
  • instability – you may feel like your knee is giving way

You may feel a tearing sensation and severe pain if you injure the meniscus in your knee. Pain may develop towards the inside, outside or back of your knee joint (depending on which menisus you injured) and you may see some swelling.

If you have any of these symptoms, visit your GP or physiotherapist for advice.

Causes of knee injuries

You may injure your knee if:

  • an impact moves your knee beyond its usual range of movement, for example if you have a fall or land awkwardly
  • you play a sport that combines running, jumping and stopping with quick changes of direction, such as football
  • you have a condition such as arthritis or gout, which can affect your joints, or are very overweight, which can put pressure on your knees
  • your knees hit the dashboard in a car accident – posterior cruciate ligament damage is sometimes called the ‘dashboard injury’ as this is often how it occurs
  • you wear footwear that doesn’t match the shape of your feet or have poor training methods or flexibility, which can lead to overuse injuries of your knee

Diagnosis of knee injuries

Your doctor or physiotherapist will ask about your symptoms and examine you. This may include feeling for fluid in your knee joint by pressing gently around your kneecap. He or she will also ask you to describe how your injury happened, where your pain is and what type of pain it is.

Your doctor or physiotherapist may ask you to walk, sit or lie down so he or she can test for injury to your knee ligaments or soft tissues. He or she will bend and flex your knee and move your leg into different positions. Your physiotherapist may also ask you to step, squat or hop.

Your doctor may refer you for other tests in a hospital or clinic. These may include an MRI or ultrasound scan, and occasionally an X-ray. These tests can help to diagnose more complicated or severe injuries.

Treatment of knee injuries

There are different types of treatment that your doctor or physiotherapist may suggest, depending on the type and severity of the damage to your knee. It’s important to be patient when recovering from a knee injury. Your injury may take time to fully repair itself, so you may not be able to do all the things you are used to doing for some time.

Self help

You should follow the PRICE procedure to manage any type of soft tissue injury to your knee. PRICE stands for the following.

  • Protection. Protect your injury from further harm.
  • Rest. Rest the injury for the first two to three days, then reintroduce movement so you don’t lose too much muscle strength.
  • Ice. Apply a cold compress such as ice or a bag of frozen peas wrapped in a towel to help reduce swelling and bruising. Do this for 15 to 20 minutes every two to three hours. Don’t apply ice directly to your skin as it can damage your skin.
  • Compression. Compress the joint by bandaging it to support the injury and help decrease swelling. Don’t leave this on while you sleep.
  • Elevation. Elevate your knee by resting it above the level of your heart and keeping it supported.

There are certain things you should not do in the first three days after your injury so you don’t damage your knee further. These can be remembered as HARM.

  • Heat. This includes having a hot bath or using a heat pack.
  • Alcohol. Drinking alcohol can increase bleeding and swelling in the affected area.
  • Running or other forms of exercise.
  • Massaging the injured knee. This can cause more swelling or bleeding.

If you’re having difficulty bearing weight on your knee, you may need to use crutches or wear a brace to make sure that you keep weight off the affected knee.

Medicines

You can buy over-the-counter painkillers such as paracetamol to treat mild and moderate pain. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and ketoprofen can help to reduce inflammation and swelling, as well as relieve pain. NSAIDs are available as gels, creams and sprays that you can put directly onto your skin and gently massage in, as well as tablets or capsules that you take by mouth.

Your doctor may prescribe stronger painkillers if your pain is severe. Always read the patient information that comes with your medicine and if you have questions, ask your pharmacist or doctor for advice.

Physiotherapy

If your injury is more severe or complex, your doctor may refer you to a physiotherapist (a health professional who specialises in movement and mobility). You can also choose to see a physiotherapist privately. He or she will develop a programme of rehabilitation exercises to gradually strengthen your knee and stretch your muscles. These exercises will vary depending on the type of injury you have and how severe it is. Your physiotherapist may also use various techniques to help speed up the healing of your knee.

Braces or strapping to support your knee are occasionally used during rehabilitation, usually when an injury has been severe.

Surgery

For some types of knee injury, our doctor or physiotherapist may recommend that you have surgery to repair the injury to your knee – especially if other forms of treatment haven’t worked. Your doctor will refer you to an orthopaedic surgeon for assessment.

The surgeon is more likely to suggest surgery if you have one of the following injuries.

  • You have torn your anterior cruciate ligament and you do a lot of sport or have also torn the meniscus or your medial collateral ligament. Anterior cruciate ligament reconstruction involves taking a piece of tendon (usually from your hamstring) to replace the damaged ligament.
  • Your knee remains painful or locks after an injury to your meniscus.

Rarely, surgery may involve opening up your knee joint to repair it, or you may be able to have a type of keyhole surgery called knee arthroscopy to access the damaged area of your knee.

Prevention of knee injuries

There are some precautions you can take to try to reduce the risk of damaging your knee ligaments.

  • Exercise regularly to maintain a good level of fitness. This will mean your muscles are stronger and better able to support your joints, including your knees. If you haven’t been active for a while, start gently and gradually increase the intensity.
  • Spend five to 10 minutes warming up before exercise to increase blood flow to your muscles and reduce the chance of an injury. Many sports professionals advise stretching your muscles after warming up and again after cooling down; however, the benefit of stretching before or after exercise to prevent soft tissue injuries is unproven.
  • Wear correct footwear. There are many different models of trainers available, but the best is one that matches the shape of your feet. If you’re not sure, it’s a good idea to go to a specialist sports shop and ask for advice.

To Check on Your Knee, Call us at +65 6471 2744 (24 Hours) / info@boneclinic.com.sg