Knee Pain: Causes, Symptoms, and Rehabilitation Insights

Knee problems

Hello Dr.
Yin, a few days ago I visited a rehabilitation specialist due to an old knee injury (over five years ago).
The injury occurred when I fell on my knee, and since then, I have experienced weakness and slight soreness after sitting for long periods, going up and down stairs, and engaging in some physical activities.
During my recent appointment, the doctor had me lie down and bent my knee to check for specific pain, but there was none.
The doctor then applied pressure to my knee and asked me to straighten it while lying down, then released the pressure.
When my right knee was pressed down, I suddenly heard a "pop" sound when I relaxed my leg.
At that moment, I did not feel any significant pain, so I did not notice anything unusual.
However, when I got home, I realized that my right leg felt weak while walking, and my right knee was not moving smoothly when straightening or bending.
Additionally, while sitting, I felt weakness below my right knee, and the sole of my right foot was curling upwards, with tightness in my calf compared to my left leg.
I would like to ask what might be causing these symptoms, as I am a bit worried that a bone might be pressing on a nerve.
It has been about two days without significant improvement.
Thank you.

David, 20~29 year old female. Ask Date: 2016/05/25

Dr. Yin Xinbei reply Rehabilitation

Based on the described situation, it is unlikely that a nerve is being compressed, but there may be an injury to some part of the soft tissue in the knee.
It is recommended to consult a sports medicine specialist to identify the underlying issue.

Reply Date: 2016/05/25

More Info

Knee pain, especially following a previous injury, can be a complex issue that involves various anatomical structures, including bones, cartilage, ligaments, tendons, and muscles. Your symptoms of weakness, discomfort, and a feeling of instability in your right knee after the recent examination could be indicative of several underlying conditions.
Firstly, it is essential to understand that the knee joint is a complex structure that bears significant weight and is subject to various stresses during daily activities. Given your history of a fall and the subsequent symptoms, it is possible that you may be experiencing issues related to the knee's soft tissues, such as ligaments or cartilage, rather than just bone-related problems.

The "pop" sound you heard during the examination could suggest a few possibilities. It might indicate a ligamentous issue, such as a sprain or tear, particularly if there was a sudden change in tension or movement. The fact that you are experiencing weakness and a lack of coordination in your knee could also point towards potential damage to the ligaments, such as the anterior cruciate ligament (ACL) or the medial collateral ligament (MCL). These ligaments are crucial for stabilizing the knee during movement.

Additionally, the sensation of tightness in your calf and the upward tilt of your foot could suggest that there is some muscular compensation occurring due to the instability in your knee. When the knee joint is not functioning correctly, the surrounding muscles may work harder to stabilize the joint, leading to fatigue and discomfort in those muscles.

Another possibility is that there may be an issue with the cartilage in your knee, such as a meniscal tear. The meniscus acts as a cushion between your femur (thigh bone) and tibia (shin bone), and damage to this structure can lead to pain, swelling, and a feeling of instability. This could explain the difficulty you are experiencing when bending or straightening your knee.

Given that you have not noticed significant improvement in your symptoms over the past two days, it is crucial to follow up with your healthcare provider. They may recommend imaging studies, such as an MRI, to assess the soft tissues in your knee more thoroughly. This can help identify any tears, sprains, or other injuries that may not be visible on a standard X-ray.

In terms of rehabilitation, it is essential to engage in a structured physical therapy program tailored to your specific needs. Rehabilitation can help strengthen the muscles around the knee, improve flexibility, and restore function. A physical therapist can guide you through exercises that focus on strengthening the quadriceps and hamstrings, which are vital for knee stability. They may also incorporate balance and proprioception training to help improve your coordination and reduce the risk of future injuries.

In the meantime, it is advisable to avoid activities that exacerbate your symptoms, such as excessive stair climbing or high-impact exercises. Ice therapy can help reduce any swelling and discomfort you may be experiencing. Additionally, using a knee brace may provide extra support during your recovery.

In summary, your symptoms could be indicative of various knee-related issues, including ligamentous injuries, meniscal tears, or muscular compensation due to instability. It is essential to seek further evaluation from your healthcare provider to determine the exact cause of your symptoms and to develop an appropriate rehabilitation plan. Early intervention can significantly improve your recovery outcomes and help you return to your normal activities with confidence.

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