Knee Pain and Clicking Sounds: Your Symptoms at 19

Knee pain with a subtle ache and audible sounds during bending?

Hello Doctor, I am a 19-year-old female in my second year of college.
My knees make a sound when I bend them, and I have been experiencing occasional dull pain since high school.
Sometimes, they even swell slightly, and I feel a bit of discomfort while walking, especially after intense physical activity.
However, around the time I started college, I noticed that my knees become mildly sore after walking for a long time.
Additionally, flying or cold weather causes significant discomfort in my knees.
I have O-shaped legs, but it's not severe.
I'm not sure if this could be a contributing factor.
During high school, I loved playing basketball and would play for about three hours each week, but since starting college, I have hardly played basketball, and my knee issues seem to have worsened.
I am uncertain whether this is related to jumper's knee or another condition, or if it is simply due to overexertion.

A Hong, 10~19 year old female. Ask Date: 2016/04/12

Dr. Hong Ximing reply Orthopedics

Based on your condition, it is likely that the angle of your body's center of gravity is causing misalignment of the patella, which can lead to patellofemoral syndrome and cartilage softening.
It is advisable to avoid direct pressure on the patella and activities involving uphill or downhill movements, as this may improve your symptoms.
For a more detailed assessment, you should consult an orthopedic specialist.

Reply Date: 2016/04/12

More Info

Knee pain and clicking sounds, especially in a young individual like yourself, can be concerning and may indicate underlying issues that need to be addressed. At 19 years old, experiencing these symptoms can be attributed to several factors, including previous sports activities, anatomical variations, and possibly overuse injuries.

From your description, it seems that your knee pain and the clicking sounds occur primarily during movement, particularly when bending the knee. This could suggest a few potential conditions. One possibility is patellofemoral pain syndrome (PFPS), commonly known as "runner's knee." This condition often arises from overuse, particularly in individuals who engage in activities that involve repetitive knee bending, such as basketball. The pain typically manifests around the kneecap and can be accompanied by a clicking or popping sound due to the misalignment of the patella (kneecap) as it moves over the femur (thigh bone).

Your mention of having O-shaped legs (genu varum) could also play a role in your knee symptoms. This anatomical alignment can alter the mechanics of the knee joint, potentially leading to uneven wear on the cartilage and increased stress on certain structures within the knee. Over time, this can contribute to conditions like chondromalacia patellae, where the cartilage under the kneecap softens and deteriorates, leading to pain and clicking sounds.

Additionally, the fact that your symptoms worsen with prolonged walking or during colder weather suggests that there may be some underlying inflammation or sensitivity in the joint. Cold weather can exacerbate joint pain due to changes in barometric pressure and increased stiffness in the muscles and tendons surrounding the joint.

Given your history of playing basketball extensively, it is also worth considering the possibility of overuse injuries. While you may not have experienced acute injuries, repetitive stress on the knee joint can lead to conditions such as tendinitis or bursitis, which can cause pain and swelling.

To address your symptoms, here are some recommendations:
1. Rest and Modify Activities: Since your symptoms seem to worsen with activity, it may be beneficial to reduce high-impact activities like basketball for a while. Instead, consider low-impact exercises such as swimming or cycling to maintain fitness without putting excessive strain on your knees.

2. Strengthening Exercises: Focus on strengthening the muscles around the knee, particularly the quadriceps, hamstrings, and hip muscles. Stronger muscles can help stabilize the knee joint and reduce pain. Physical therapy can be very beneficial in guiding you through appropriate exercises.

3. Stretching: Incorporate stretching into your routine to improve flexibility in the muscles surrounding the knee. Tight muscles can contribute to improper knee mechanics.

4. Ice and Compression: If you experience swelling or pain after activities, applying ice and using compression wraps can help reduce inflammation.

5. Consult a Specialist: Given the persistence of your symptoms, it would be wise to consult an orthopedic specialist. They may recommend imaging studies, such as X-rays or an MRI, to assess the condition of your knee joint and rule out any significant injuries or degenerative changes.

6. Consider Orthotics: If your O-shaped legs are contributing to your knee pain, custom orthotics or supportive footwear may help improve alignment and reduce stress on the knees.

In conclusion, while your symptoms may be related to previous sports activities and anatomical factors, a thorough evaluation by a healthcare professional is essential to determine the exact cause and appropriate treatment plan. Early intervention can help prevent further complications and improve your quality of life.

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