Knee Pain: Causes, Symptoms, and Treatment Options

Knee problems

On September 16, I fell and hit my knee.
At that time, there was a large bruise on my knee.
I applied heat and used topical medication, but now, on October 7, when I kneel, I feel something stuck in that area and experience pain.
If I'm on the floor, the pain intensifies, but if I ignore it, there is no pain.
It's not the entire knee that hurts, but rather a specific point, approximately in the upper middle of the knee, where the pain is more pronounced next to the protruding area.
I would like to know how to address this situation (the symptoms have persisted for 22 days).
Additionally, since childhood, my knees have made sounds when I squat, similar to bone sounds.
Is that normal? Thank you!

A-Jie, 10~19 year old female. Ask Date: 2022/10/07

Dr. Shi Guozheng reply Orthopedics

1.
Alternating hot and cold compresses for knee joint rehabilitation exercises.

2.
Noises without pain are also considered normal.

Reply Date: 2022/10/07

More Info

Knee pain can be a complex issue, especially following an injury like a fall. Based on your description, it seems you are experiencing localized pain in your knee, particularly around the area just above the kneecap, which may indicate a few potential underlying causes. Let's break down the possible reasons for your pain, the symptoms you are experiencing, and the treatment options available.

Causes of Knee Pain
1. Soft Tissue Injury: After a fall, it's common to sustain soft tissue injuries, such as sprains or strains to the ligaments and tendons around the knee. These injuries can lead to inflammation and pain, especially when pressure is applied, such as when kneeling.

2. Cartilage Damage: The cartilage in the knee can be damaged during a fall, leading to conditions like chondromalacia patellae (softening of the cartilage under the kneecap) or meniscus tears. This could explain the sensation of something "catching" in your knee when you move it in certain ways.

3. Bursitis: Inflammation of the bursa (small fluid-filled sacs that cushion the knee joint) can also cause localized pain. This is often exacerbated by activities that put pressure on the knee, such as kneeling.

4. Patellar Tendonitis: This condition, often referred to as "jumper's knee," occurs when the tendon connecting the kneecap to the shinbone becomes inflamed. It can cause pain at the front of the knee, especially during activities that involve bending or putting weight on the knee.

5. Osteoarthritis: Although you mentioned that this pain started after a fall, it’s worth noting that if you have a history of knee issues or if you're experiencing sounds like popping or cracking when moving your knee, it could indicate early signs of osteoarthritis.

Symptoms
The symptoms you describe, such as localized pain when kneeling and a sensation of something being "caught," suggest that there may be an issue with the soft tissues or cartilage in the knee. The fact that the pain intensifies when kneeling on a hard surface indicates that pressure is aggravating the underlying condition.

Treatment Options
1. Rest and Activity Modification: Avoid activities that exacerbate the pain, particularly kneeling or putting pressure on the knee. Allowing time for the injury to heal is crucial.

2. Ice Therapy: Applying ice to the affected area can help reduce swelling and alleviate pain. Aim for 15-20 minutes of ice application several times a day.

3. Compression and Elevation: Using a compression bandage can help manage swelling. Elevating the knee can also assist in reducing inflammation.

4. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help manage pain and inflammation. However, consult with a healthcare provider before starting any medication.

5. Physical Therapy: Once the acute pain subsides, physical therapy can be beneficial. A physical therapist can guide you through exercises to strengthen the muscles around the knee, improve flexibility, and restore function.

6. Imaging Studies: If symptoms persist, it may be necessary to undergo imaging studies such as X-rays or an MRI to assess for any structural damage to the knee, including cartilage tears or ligament injuries.

7. Consultation with a Specialist: If conservative treatments do not provide relief, it may be beneficial to consult an orthopedic specialist. They can provide a more detailed evaluation and discuss further treatment options, which may include injections or, in some cases, surgical intervention.

Sounds in the Knee
Regarding the sounds you hear when squatting, it is not uncommon for knees to make noises such as popping or cracking. This can be due to various factors, including the movement of tendons or ligaments over the bones or the presence of air bubbles in the joint fluid. However, if these sounds are accompanied by pain or swelling, it is advisable to seek medical attention.

In summary, while your knee pain may be related to the recent fall, it is essential to monitor your symptoms closely and consider seeking medical advice if the pain persists or worsens. Early intervention can help prevent further complications and promote a faster recovery.

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