Knee Pain: Causes and Care for Long-Term Discomfort

Kneeling causes knee pain?

Hello Doctor, about three years ago after giving birth, I noticed that when I kneel and carry my sleeping child to bed, I experience a sharp pain at the contact point of my left knee with the bed.
Other than that, I have no issues when walking, running, or squatting.
As my child grew and I carried him less, I felt the sharp pain decrease (I only notice it when kneeling), so I didn't pay much attention to it.
Recently, I started practicing yoga, which involves many kneeling positions, and I found that the sharp pain in my left knee has returned, although it is not as severe as it was initially (before, even kneeling on a soft mattress would cause pain).
Today, I visited an orthopedic doctor who took X-rays and found no significant issues.
The doctor believes it is inflammation and thinks that while I may have improved in the past, practicing yoga has aggravated the old injury.
He prescribed topical medication and advised me to rest.
My question is, can inflammation last for three years? What can I do to better protect my knee? Thank you.

Wendy, 30~39 year old female. Ask Date: 2019/11/14

Dr. Wang Zhaomin reply Rehabilitation

When knee pain occurs only while kneeling, it may be related to inflammation of the prepatellar bursa.
If the inflammatory condition is not completely healed, it may recur and progress to chronic inflammation.
It is advisable to avoid kneeling directly on hard surfaces; if necessary, use a soft cushion or wear knee pads for protection.
Engaging in appropriate exercises to strengthen the lower limb muscles can also reduce the risk of injury.

Reply Date: 2019/11/14

More Info

Knee pain, particularly when it arises from specific activities such as kneeling, can be a complex issue influenced by various factors. In your case, it seems that the pain in your left knee has been exacerbated by activities like kneeling, especially after childbirth and during yoga practice. This suggests that the pain may be related to overuse or strain on the knee joint and surrounding structures.

Understanding the Causes of Knee Pain
1. Overuse Injuries: The knee joint is subjected to significant stress during activities that involve kneeling, running, or jumping. Over time, repetitive stress can lead to inflammation of the tendons, ligaments, or the joint itself, resulting in pain. This is particularly relevant in your case, as you mentioned that the pain intensified after engaging in activities like yoga that require kneeling.

2. Inflammation: Inflammation can occur in response to injury or overuse. Conditions such as bursitis (inflammation of the bursae, which are fluid-filled sacs that cushion the knee joint) or tendinitis (inflammation of the tendons) can lead to localized pain. Your orthopedic doctor’s assessment that there is inflammation is consistent with these possibilities.

3. Previous Injuries: If you had any prior injuries to the knee, even if they seemed minor at the time, they could contribute to ongoing discomfort, especially if the knee has not fully healed or if compensatory movement patterns have developed.

4. Biomechanical Factors: Your body mechanics, including how you kneel or distribute weight while performing activities, can also affect knee pain. If there are any imbalances or weaknesses in the muscles surrounding the knee, this can lead to increased stress on the joint.

Duration of Inflammation
Regarding your question about whether inflammation can persist for three years, it is indeed possible for chronic inflammation to develop if the underlying cause is not addressed. Chronic inflammation can result from ongoing irritation or overuse, leading to persistent pain and discomfort. It’s essential to identify and modify the activities that exacerbate the condition to facilitate healing.

Recommendations for Knee Care
1. Rest and Modification of Activities: Since your doctor has advised rest, it’s crucial to allow your knee to recover. Avoid activities that provoke pain, particularly kneeling and high-impact exercises. Consider modifying your yoga practice to include poses that do not put pressure on your knee.

2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide targeted exercises to strengthen the muscles around the knee, improve flexibility, and correct any biomechanical issues. This can help alleviate pain and prevent future injuries.

3. Ice and Anti-inflammatory Medications: Applying ice to the affected area can help reduce inflammation and pain. Over-the-counter anti-inflammatory medications may also be recommended to manage discomfort.

4. Knee Support: Using knee pads or braces during activities that require kneeling can provide additional support and cushioning, potentially reducing pain.

5. Gradual Return to Activity: Once the pain subsides, gradually reintroduce activities. Start with low-impact exercises and slowly increase intensity as tolerated. This approach can help prevent re-injury.

6. Consultation with Specialists: If pain persists despite conservative measures, consider seeking a second opinion or consulting a specialist in sports medicine or a rheumatologist to rule out any underlying conditions.

Conclusion
In summary, knee pain, particularly related to specific activities like kneeling, can stem from various causes, including overuse, inflammation, and previous injuries. Chronic inflammation can indeed last for extended periods if not properly managed. It’s essential to rest, modify activities, and consider physical therapy to strengthen the knee and improve function. By taking these steps, you can protect your knee and potentially alleviate the discomfort you are experiencing.

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