The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia). The smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) are the other bones that make the knee joint.

Tendons connect the knee bones to the leg muscles that move the knee joint. Ligaments join the knee bones and provide stability to the knee:

• The anterior cruciate ligament prevents the femur from sliding backward on the tibia (or the tibia sliding forward on the femur).
• The posterior cruciate ligament prevents the femur from sliding forward on the tibia (or the tibia from sliding backward on the femur).
• The medial and lateral collateral ligaments prevent the femur from sliding side to side.

Two C-shaped pieces of cartilage called the medial and lateral menisci act as shock absorbers between the femur and tibia.
Numerous bursae, or fluid-filled sacs, help the knee move smoothly.

Your knee joints serve a vital role holding up your bodyweight and are put through even more pressure when you walk, run or jump. Knee pain is very common, both from sport injuries and the wear and tear of day-to-day life.

Knee pain can come from injuries including sprains, swollen or torn ligaments (anterior cruciate ligament or ACL), meniscus or cartilage tears and runner’s knee.

Sports injuries tend to affect one knee at a time. Pain in both knees is more common with arthritis, osteoarthritis, gout or pseudogout, usually later in life.

Conditions that cause knee pain

• Tendonitis. This is an overuse injury causing swelling of the tendons, the bands of tissue that connect your bones and muscles. This is sometimes called ‘jumper’s knee’ as it is common in sports involving jumping, such as basketball.
• Bone chips. Sometimes, a knee injury can break off fragments from the bone or cartilage. These pieces can get stuck in the joint, causing it to freeze up. You may also have pain and swelling.
• Housemaid’s knee or bursitis is caused by kneeling for long periods of time or repetitive knee movements. Fluid builds up in the bursa, the sac of fluid that cushions the knee joints. Swelling behind the knee is called a ‘Baker’s cyst’ and may be caused by injuries or arthritis.
• Bleeding in the knee joint. This injury is also called haemarthrosis and affectsblood vessels around the knee ligaments causing the knee to feel warm, stiff, bruised and swollen. This may require hospital treatment in serious cases.
• Iliotibial band syndrome. This is an overuse injury to the iliotibial band of tissue that runs from the hip to the shin past the knee.
• Medial plica syndrome. This overuse injury affects the plica, a fold of tissue in the knee joint.
• Osgood- Schlatter Disease. This overuse condition is common in teenagers playing sport and causes swelling and tenderness over the bony bump just below the knee.
• Partially dislocated kneecap (or patellar subluxation). This is usually due to a physical condition with the legs rather than a sports injury. The kneecap slides out of position and causes pain and swelling.

Treatment for knee pain

Treatment will depend on the type and severity of the injury. Many knee injuries will get better on their own, or can be treated at home. Avoid putting weight on the injured knee as much as possible. Raise the leg with cushions and use an ice pack or bag of frozen veg wrapped in a towel held to the knee. Painkillers such asibuprofen can help with pain and swelling.

You may need to see your GP or seek medical advice if:

• No weight can be put on the injured knee
• There’s severe pain when no weight is put on the knee
• The knee locks, clicks painfully or gives way
• The knee looks deformed
• There’s fever, redness or a feeling of heat around the knee, or there’s extensive swelling
• The calf beneath the injured knee is painful, swollen, numb or tingling
• Pain is still there after three days of home care treatment

A doctor will carry out a physical examination of the injured knee and may arrange some extra tests, including blood tests, an X-ray or MRI scan.

Treatment may involve physiotherapy, painkillers and sometimes an arthroscopy – a form of keyhole surgery that is used to look inside a joint and repair any damage that has occurred.

When will my knee pain feel better?

Recovery from knee pain will depend on the type and severity of the injury.

If recovery prevents you doing high impact sport such as running, try a low impact one like swimming.

Preventing knee pain

Knee pain cannot always be avoided, but good precautions include stretching, warming up and cooling down around a workout or playing sport. Having the right equipment, such as trainers designed for running and kneepads for jobs involving kneeling can help.

Stop exercising if you feel pain in your knee.

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