Persistent Knee Discomfort: Causes and Solutions for Active Individuals - Rehabilitation

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Knee pain


Hello Dr.
Cheng,
I am someone who loves sports, including swimming, basketball, various ball games, and jogging.
However, since I completed my military service and started working over a year ago, my physical activity has significantly decreased.
Two months ago, I began experiencing persistent and prolonged soreness in my knees without any apparent reason.
Prior to this symptom, I had not sustained any sports injuries; any occasional soreness I experienced was typically due to overexertion, which would resolve with half a day of rest.
I understand this situation.
However, after starting my job, my activity level decreased, and I spend a large portion of my day sitting in front of a computer.
I do make it a point to get up and stretch regularly.
Yet, two months ago, I inexplicably started to feel soreness in my knees, which has been consistent from morning until night.
There is no pain, but the soreness is noticeable and occurs intermittently almost every day.
During this time, I have ceased all physical activities.
I consulted an orthopedic doctor, who consistently mentioned that it might be due to ligament inflammation and advised me to rest more, receive injections, and take medication.
I expressed that my activity level is quite low, but the doctor did not provide a definitive cause.
After the first consultation, there was no improvement in my symptoms.
During the second visit, the doctor prescribed a different medication, which led to slight improvement.
However, during the third visit, the same medication was prescribed, and the level of soreness remained just as pronounced as before I sought treatment.
This ongoing issue has been troubling me, and I would like to ask about the possible causes of this condition.
Given that I have not overexerted myself or sustained any injuries, how can I improve the constant soreness in my knees? Thank you.

Hui jia zhen hao, 20~29 year old female. Ask Date: 2004/11/13

Dr. Zheng Shunping reply Rehabilitation


Hello: In response to your question...
it is difficult to determine the cause based solely on your description.
In addition to your medical history, a thorough clinical physical examination is necessary, along with further imaging studies such as X-rays, ultrasounds, MRI scans, or arthroscopy to identify the true cause.
Sometimes, even in the absence of a history of overexertion or sports injuries, minor injuries that have not fully healed, combined with repetitive use, can lead to discomfort.
I recommend that you seek assistance from a trusted physician to identify the cause before undergoing treatment to improve your condition.
Keelung Hospital, Department of Health, Executive Yuan, Zheng Shun-Ping.

Reply Date: 2004/11/13

More Info


Persistent knee discomfort, especially in active individuals, can be a frustrating and concerning issue. Given your background as an active person who enjoys various sports and physical activities, the sudden onset of knee discomfort after a period of reduced activity is noteworthy. Let's explore the potential causes of your knee discomfort, as well as some solutions and preventive measures.


Potential Causes of Knee Discomfort
1. Patellofemoral Pain Syndrome (PFPS): This condition is common among athletes and can occur due to muscle imbalances, overuse, or changes in activity levels. It often presents as a dull ache around the kneecap, especially during activities like climbing stairs or sitting for prolonged periods.

2. Tendinitis: The quadriceps or patellar tendons can become inflamed due to repetitive stress or sudden increases in activity. This can lead to discomfort, particularly if you have recently changed your activity level.

3. Bursitis: Inflammation of the bursae, small fluid-filled sacs that cushion the knee joint, can result from overuse or prolonged periods of sitting. This can cause a feeling of tightness or discomfort in the knee.

4. Meniscal Issues: Although you mentioned no prior injuries, degenerative changes in the meniscus can occur over time, especially with reduced activity. This can lead to discomfort and a feeling of instability in the knee.

5. Osteoarthritis: While more common in older individuals, early signs of osteoarthritis can manifest as persistent knee discomfort, particularly if there is a history of joint stress or previous injuries.

6. Muscle Weakness or Imbalance: A decrease in physical activity can lead to muscle atrophy, particularly in the quadriceps and hamstrings, which are crucial for knee stability. Weakness in these muscles can lead to increased stress on the knee joint.


Solutions and Management Strategies
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the knee, improve flexibility, and correct any imbalances. A physical therapist can design a personalized exercise regimen focusing on strengthening the quadriceps, hamstrings, and hip muscles.

2. Activity Modification: While it’s important to stay active, consider modifying your activities to reduce stress on the knee. Low-impact exercises such as swimming or cycling can maintain fitness without exacerbating knee discomfort.

3. Stretching and Strengthening Exercises: Incorporate stretching exercises for the quadriceps, hamstrings, and calves. Strengthening exercises, particularly for the hip abductors and extensors, can provide better support for the knee.

4. Ice and Rest: Applying ice to the knee after activity can help reduce inflammation and discomfort. Ensure you are allowing adequate rest periods between activities to prevent overuse.

5. Footwear and Orthotics: Evaluate your footwear, as improper shoes can contribute to knee pain. Consider consulting a specialist about orthotics if you have flat feet or other alignment issues.

6. Gradual Return to Activity: As you begin to increase your activity level, do so gradually. Start with shorter durations and lower intensities, and monitor how your knee responds.

7. Consultation with a Specialist: If symptoms persist despite conservative management, consider seeking a second opinion from an orthopedic specialist. They may recommend imaging studies, such as an MRI, to rule out any underlying structural issues.


Preventive Measures
1. Regular Exercise: Maintain a consistent exercise routine that includes both strength training and flexibility exercises to support knee health.

2. Warm-Up and Cool Down: Always warm up before engaging in sports and cool down afterward to prevent injuries.

3. Listen to Your Body: Pay attention to any signs of discomfort and adjust your activities accordingly. Avoid pushing through pain, as this can lead to further injury.

4. Stay Hydrated and Maintain a Healthy Diet: Proper nutrition and hydration can support joint health and overall physical performance.

In conclusion, persistent knee discomfort can arise from various factors, especially following a period of reduced activity. By understanding the potential causes and implementing appropriate management strategies, you can work towards alleviating your symptoms and returning to your active lifestyle. If symptoms persist, further evaluation by a healthcare professional is warranted to ensure a comprehensive approach to your knee health.

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