Has it occurred to you that you have been driving for an hour or longer, pressing your foot on the accelerator pedal while keeping a perfectly correct balance, which results in pain of your right knee, and the consequences are felt even a few days later? Driving a car is one of those classical activities that may lead to the syndrome of anterior knee pain. However, this may affect not only drivers — people of a wide range of professions, of various ages, of both sexes and varying physical fitness level may feel pain due to lengthy and undifferentiated loads on their knee joints.
Expertise shared by Andrejs Finogejevs, orthopedic surgeon at the ORTO Clinic
Not so long ago it was generally believed among doctors that the cause is underdevelopment of the leg musculature. However, realizing that even physically well-developed people and professional athletes may experience pain in their knees, the search for the cause continued until it was concluded that the most frequent cause of pain is muscle imbalance of the leg (apart from injuries).
When one works for all
The musculoskeletal structure of the thigh is very complex. Several smaller muscles form larger ones. In order to perform their function and avoid overloads, the muscles should work in a harmonized and balanced manner. In case of muscle imbalance of the thigh, if the leg needs to carry out a lengthy and undifferentiated motion, a certain set of muscles, being better developed, “undertakes” to handle this motion by itself, to put it simply, it applies too much load on itself, the knee-cap and its ligament that connects it to the femur. As a result, we feel pain, discomfort, sometimes even a small edema that goes away within a few days.
Help in an acute situation
If the situation has just occurred, a cool 20-minute application every two hours, non-prescription analgesics and relieving the leg from the load will help.
Prior to a longer car-drive, it is possible to prepare for it beforehand by means of applying knee-joint orthosis or tape. Both solutions relieve the anterior part of the knee joint and remove the pain. However, you must remember that these are temporary solutions, and when used continuously, will create excessive laxity and may aggravate the problem.
What will happen if everything is left as it is?
For an adult
For an adult, muscle imbalance of the thigh with the frequent knee pains it causes, if left unattended, may become chronic – the ligament will become thicker and inelastic, and in result pain and discomfort will be caused by even insignificant loads on the knee joint.
For children and youth
Not only adults can experience the syndrome of anterior knee pain, it may affect children and youth, as well. For them, it is mostly caused by sports-induced overloads.
For children, it should never be left untreated, because the consequences could be more serious than for adults. If for us inattentiveness could, at worst, lead to chronic ligament inflammation and pain, then for children it may result in deformities of the bone growth plate. The bones of children continue to grow on account of the growth plates at the ends of the bones. The ligament of the knee-cap is affixed near the growth plate of the femur. Frequent inflammations caused by overloads may cause damage to the growth plate.
Treatment of muscle imbalance of the thigh
Applying the solution for muscle imbalance of the thigh is much easier than dealing with the consequences caused by suffering and enduring without treatment. Balancing the work of muscles is taught by a physiotherapist.
However, before seeing a physiotherapist, it may be useful to receive a doctor’s advice. If everything is as described above, i.e., pain in the knee joint appears during or shortly after physical exertion, and no other problems are seen, you may visit a physical and rehabilitation medicine specialist. The doctor may determine muscle imbalance without any additional examinations, by listening to the patient’s complaints, assessing the knee by feeling it and conducting some clinical tests. If the cause of pain is muscle imbalance, the doctor will prescribe a physiotherapy course. Moreover, it won’t be necessary to perform the special exercises for your entire life. It will be necessary to exercise until the muscular load will be balanced, till it embeds in the muscle memory – then they will function correctly.
Whereas, if knee pains after exertion is just a complaint among many others, alongside with knee locking and catching, edemas, feeling of stiffness and instability, it is worth to make an appointment to an orthopedic surgeon, because the symptoms may indicate structural damage of the joint that requires in-depth examination, and most likely physiotherapy will not be sufficient.