This article is a transcribed edited summary of a video Bob and Brad recorded in June of 2024. For the original video go to https://youtu.be/5KSGLsL9zM0
Mike: Are you experiencing knee pain but unsure what is causing it?
Brad: That's right. So today we're going to cover 10 different diagnoses. They're all common knee pains, and you'll be able to actually get a better feel for what it is, and then find out how to treat it.
Mike: Now the first three issues we're going to talk about relate to the kneecap specifically, but they are all different diagnoses. So the first one is called patellofemoral pain syndrome. And what we're referring to is how your kneecap tracks over your knee joint itself. Brad has his taped up, but he's going to show it on Sam here.
Brad: So here, we have the patella, and then the femur underneath. Actually, these are called the condyles. How the patella tracks over the condyles here, and that's where there's cartilage.
Brad: If it doesn't track properly, it either pulls to one side or to the other. It causes pain. And where the red tape is here is, typically, you can either have pain on the inside or medial, or the outside of the kneecap, that's lateral. And there are specific exercises or stretches you can do to help work with that.
Mike: Now this is very common. It's also called runner's knee sometimes in common terms. So typically, what happens, if it's tracking medially like Brad was saying with the tape, it pushes medially when you're running, when you're squatting, doing movements consistently, rubbing on one side more than the other, or some people, it can track laterally. So typically, you're going to have pain syndromes around the tape region, Brad was talking about.
Brad: That's right. We're not going to get into treatment for this. With all of these, you can search our YouTube channel for "patellofemoral syndrome," and there will be a few complete videos with options on how to treat this and fix it yourself.
Mike: Now the second problem people may be having is located slightly above the kneecap. Normally, you don't have patella syndrome tracking the wrong way. You may, but typically it's tracking, right? You can't figure it out. This is called quadriceps tendinitis. So, Brad, do you want to explain what that is?
Brad: Yep, so here, we have the patella, but now we have the tendon. The tendon is a broad tendon. It connects to the top of the patella and actually connects to all of the quadriceps. So there's a large muscle mass. That's why it's so large, it's strong, but where it connects to the bone of the tendon right here is typically where you feel the pain.
Brad: You can see where the red mark is here above the patella; right in this area is where you feel that pain going up and downstairs.
Brad: Using it oftentimes with repetitive motion can get this started, and once it flares up, well, then it can hurt anytime with motion.
Mike: It's essentially an inflammation and irritation of this area. So most of the time, for this, you just have to get it to kind of calm down. If you have a tear, it'll be much more serious, and you'll have to go to the doctor to get that fixed.
Brad: Yeah, Bob dealt with this at one time, and he was having a hard time figuring it out, but he finally did. We have a few videos on quadriceps tendonitis. Bob is saying, yeah, he remembers that. So there we go.
Mike: The next issue is called patellar tendinitis. Now this is the bottom portion below the kneecap here, and oftentimes it can get irritated and inflamed as well.
Mike: It connects to your tibial tuberosity here, which the patellar tendon has there, and Brad is showing. The bottom very portion there, it usually gets irritated. It's very common for repetitive sports people. So, runners or jumping sports like volleyball or basketball.
Brad: That's right. So here, actually, the dark area, if you can see that, is the tendon that connects the patella to the bone right here, your tibial tuberosity. And there it is, the red mark area on my leg.
Brad: This is a nice one. I like treating it with patients because usually, you can treat it well. It's easy to access, it's superficial, in other words, right under the skin, so you can use cold on it, and a number of other treatments to get it to settle down and get you back to where you want to be.
Mike: Now the fourth condition is called Osgood-Schlatter disease. Now it is a similar pain area to what we just talked about, except this is common in adolescents between the ages of nine and 16, and it's usually caused by growing too fast too quickly.
Brad: And the location is right on the bone where the tibial tendon that we just talked about is. Now I've got a really nice example of it here under the red tape, right in this location, you'll get a significant bump there just like this. It's painful. You don't want to kneel on it. It's not fun to have. Typically, people get over it with time, and there is some treatment to help that out.
Mike: Osgood-Schlatter.
Brad: Where did that name come from?
Mike: Sounds very German to me.
Brad: I think Bob knows.
Mike: Again, things like running and jumping can exacerbate it. So maybe during the time it's painful, take rests from those activities, but once you get over it, you're typically done with it. Problem number five is typically located on the inside of the knee region here, and it's called pes anserine bursitis.
Mike: Now bursitis means there is a bursa there. A bursa is essentially a little fluid-filled sack, there are numerous ones all over your body, but they go between tendons to make sure things aren't rubbing and causing friction on each other. And in the area, it can be inflamed or irritated because you have three muscle tendons that all combine here, which they call the pes anserine.
Brad: And if you have this, you're going to feel pain there. You can see where the red tape is.
Brad: This is where it will be. You're going to actually feel, and you have a rub and put some pressure on it, it's going to hurt because those bursas have a lot of nerve endings, and they're very sensitive when they get inflamed. So you want to be careful with it. This is something you can ice, and there's some work you can do with the muscles up here. Once again, explained in the videos that you will find on our YouTube channel.
Mike: Now the next two problems are both related to ligaments. Now we have numerous ligaments in the knee, but we're going to talk about the ones on the inside and outside. So inside, we have MCL or medial collateral ligament, and outside, we have LCL or lateral collateral ligament. Typically, these get injured with a sports injury or some type of dramatic force either going in or out applied to the knee. They can happen as we age, if you happen to have some type of wear and tear, and just manage to strain it. But typically, a ligament issue is pretty painful and you normally hear a pop if you actually tore it.
Brad: That's right. So, Sam here actually has a very nice model of the MCL. The ligament is a narrow band. It's flat and it's very strong.
Brad: It keeps your knee joint from going like this, opening up like a barn door as my professor in college always talked about.
Brad: And then over here, the same thing, here is the LCL or the outside ligament which stabilizes a knee in this direction.
Brad: Now on me, you can see them here. We've got the piece of tape here and the piece of tape on the other side.
Brad: If they get strained and they're not torn, but they're inflamed, you can feel or palpate over that and have tender spots where it's inflamed and tender. If it's unstable, you're going to feel like your knee may be unstable when you walk and it's just an eerie feeling. You don't like it. And if it's torn right apart, you really need to get to a doctor because you do not want to let that knee get open and damage one of the other ligaments.
Mike: Now the difference, if you're curious, between a ligament and a tendon, is a ligament purely connects a bone to a bone. A tendon connects a muscle to a bone. So we obviously don't have his quad muscles here, but that's why this is called a tendon and these are ligaments.
Brad: Ah, good point, Mike. We learn something new every day on this channel.
Mike: Okay, for numbers eight and nine, we're going to combine them again, and this has to do with your joint line and your meniscus. Now to find your actual joint line, you will find kind of some bony prominences around it and your kneecap kind of in the center.
Mike: Brad has it outlined nicely on his knee, but you'll feel a little groove in between all of that. That is where your joint line actually is. To test if you're having some pain in this area, most of the time, once you bend your knee more to 90 degrees and start pushing or palpating, that's when you will feel the pain come about.
Brad: That's right. Now meniscus has always been a challenge for me to describe to patients, although I did not have Sam here. So if we open up the knee and look at it, you can see the green line. That's actually the meniscus. It's a cartilage tissue, and it stabilizes a knee. You can see that it forms cups, and the condyles of the humerus or the femur fit in there, and you have a nice stable joint as a result.
Brad: So there we go. That's the meniscus. They're shaped like horseshoes, and they have medial and lateral, all kinds of medical names we do not need to know about, but Mike did a nice job. When I had meniscus problems, the surgeon would just go in there and push deep into the joint line looking for tenderness.
Brad: The other key thing with meniscus is if you have a rip or a tear, or a fold in a meniscus, which is common, your knee has a tendency to lock up. Oftentimes, going up and downstairs. It's painful when it locks. And usually, if you wiggle it around a little bit and move it, the fold of the tear will go back into place, and then it's okay just like that. That's probably a meniscus problem. You need to see a doctor, or a therapist, to get good tests done. It's kind of hard to do meniscus tests as a layperson.
Mike: Now if you're not experiencing any catching or locking. Another issue you may have is just some arthritis developing in your knee joint itself. So that's a little different. But again, that would be pretty painful in your joint line region.
Brad: That darned arthritis.
Mike: Now the last problem area we're going to talk about is the back of the knee. There can be numerous issues going on. So we're actually going to discuss three common issues that may be happening here. The first one is you may actually have a hamstring strain or possibly a tear. You have three hamstring muscles. They run from your ischial tuberosity down to the inside and outside of your knees. You have one that runs outside and you have two that run inside. So if you're experiencing pain on the outside, it might be your biceps femoris hamstring. If on the inside, it's either your semimembranosus or tendinosis hamstring muscles.
Brad: There you go. So I have the line representing or right over the tendon of this muscle, and the two here.
Brad: If those tendons are strained or slightly torn, they can be painful. Hopefully, you don't rupture one because then you're gonna have a gap there, and the muscle belly of the muscle will actually ball up. That's a problem. You really need to see the doctor and get that taken care of. So there you go. We also have the popliteus muscle, which is a small little muscle that is just in this area.
Brad: And it's really important for the mechanics of your knee, particularly when you're walking. And it actually does a slight rotation, so the mechanics work well with your knee and your knee lasts for a long time. It's painful. It can tighten up, and simply massage. Oh, we don't want to get into the treatment yet, but we'll talk about it. You can massage that area. And sometimes, that's enough to loosen that muscle up. Get it back to normal. Mike, go ahead. I'm taking the show again.
Mike: Yeah, the popliteus actually runs diagonally across both bones. So that's why it's good to focus on not straightening your knee as much when you have problems there. Now the last issue people have is pretty obvious, it's called a Baker's cyst, or a popliteal cyst is the more medical term for it. So you'll have a growth or a cyst behind your knee. That's why it's pretty obvious if you have it. You actually have synovial fluid all within your knee joint. That's completely normal. It gets produced more with movement with a Baker's cyst. What can happen, it can kind of start producing and pooling in one specific area. That's what caused the cyst to form. And you really need to go see a doctor.
Brad: But wait, Mike, we have to show something. Cut. So here's a simple model of a common location for a cyst. It is fluid-filled, and it can be a problem. You don't want to just leave it there. Have it looked at by a doctor and have it treated as appropriate.
Mike: Now this is commonly caused by osteoarthritis or rheumatoid arthritis, possibly a meniscal tear as well. But usually, they take a while to develop, and you can notice it coming.
Brad: So obviously, this is very comprehensive about all the problems that you could have with your knees. Go ahead, look at them. Hopefully, we've helped you out, but we've got another video that can even give you more help.
Mike: Yes, if you're having knee pain while walking or even stairs, you can check out our video "Fast Fix For Knee Pain With Stairs Or Walking! 55 And Older." That video goes much more in-depth on exercises and proper walking mechanics.
Brad: There you go.
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