Knee Weakness After Kneeling: Causes and Solutions

Q: Knee Weakness After Kneeling: Causes and Solutions

Hello： Based on your description, it seems that there is a knee joint injury, potentially resulting in a torn cruciate ligament or a meniscus tear. <br>You should consult an orthopedic surgeon to confirm whether there is knee instability and quadriceps atrophy (measure the circum

Kneeling down and then standing up can cause the knees to feel weak or unstable due to several reasons. One common cause is a temporary drop in blood pressure, known as orthostatic hypotension, which can occur when changing positions quickly. Additionally, muscle fatigue or weakness in the quadriceps or hamstrings may contribute to this sensation. Joint instability or previous injuries to the

Dr.
Lai: Hello, Doctor! I came across some information online and would like to consult you regarding my knee issues.
I am in my thirties and rarely exercise, as I work in an office.
I travel to mainland China every two months for work, often lifting heavy objects.
I have a valgus deformity in my hands and flat feet.
Many years ago, I fell and got injured but did not receive any special care.
Seven years ago, my knees started making occasional sounds, but I did not feel any pain.
Over time, it has changed; when the weather shifts (especially in winter) or when I am in an air-conditioned environment, my knees feel "loose," as if something is stuck.
Suddenly, there is a sharp pain after a popping sound, and it feels like my knee is separating from my thigh and calf.
After about two minutes, the pain subsides, and I can walk normally again.
I have gotten used to this pain and weakness in my legs.
Now, after my knees make a sound, I no longer experience severe pain, but sometimes it feels like something is floating in my knee.
However, there is no pain; if I move my calf a bit, that sensation seems to disappear.
Recently, a few times in the morning when getting out of bed, it feels like something is stuck in my foot, but there is no pain.
If I carefully move my leg, that sensation goes away, and I can get out of bed normally.
My knees seem less flexible than before; when I get up from a seat in a theater or from my desk in the office, I feel unstable and need to hold onto the chair or desk to walk, as it feels safer.
Occasionally, when hiking with friends, I have no problem going uphill, but coming down, my legs shake significantly, and I walk stiffly like a robot.
I once traveled to Beijing and climbed a section of the Great Wall at Badaling.
I had no issues going up, but when returning, I had to hold onto the handrails attached to the wall to come down, or else I felt like I would fall, and my legs would shake severely.
After resting for ten minutes, I returned to normal.
Recently, I noticed that when I kneel or squat for about ten minutes, my knees feel sore and weak when I stand up, and I experience a shaking sensation in my legs, which only goes away after resting for a while.
Doctor, do you think there is something wrong with my knees? Is it joint degeneration, or is there another issue with my knees that requires surgery? Should I see a chiropractor? Would practicing yoga help improve my condition? Thank you for your guidance.
Sincerely, a reader who is afraid of seeing a doctor, muumi.

muumi, 30~39 year old female. Ask Date: 2008/04/10

Dr. Lai Qiren reply Orthopedics

Hello: Based on your description, it seems that there is a knee joint injury, potentially resulting in a torn cruciate ligament or a meniscus tear.
You should consult an orthopedic surgeon to confirm whether there is knee instability and quadriceps atrophy (measure the circumference of the thigh).
If these conditions are present, an MRI can be arranged to confirm the diagnosis, after which treatment options can be determined.
Thank you for your question.

Reply Date: 2008/04/10

More Info

Knee weakness and discomfort after kneeling can be a complex issue, especially considering your history of knee problems and the physical demands of your lifestyle. Based on your description, it seems that you are experiencing a combination of symptoms that may be related to previous injuries, joint instability, and possibly degenerative changes in the knee joint.

Potential Causes of Knee Weakness
1. Previous Injuries: You mentioned a history of falls and knee injuries. Past trauma can lead to long-term changes in the knee joint, including damage to ligaments, cartilage, or menisci. These injuries can result in chronic instability or weakness in the knee.

2. Degenerative Changes: Given your age and the symptoms you've described, it is possible that you are experiencing early signs of osteoarthritis. This condition can lead to joint pain, stiffness, and a sensation of instability, particularly after periods of inactivity or after kneeling.

3. Muscle Weakness: A sedentary lifestyle, combined with the physical demands of your job, may have contributed to weakness in the muscles surrounding the knee. The quadriceps and hamstrings play crucial roles in stabilizing the knee joint. Weakness in these muscles can lead to a feeling of instability and difficulty with movements like kneeling or standing up.

4. Patellar Tracking Issues: The sensation of something "floating" or catching in the knee could be related to patellar tracking issues, where the kneecap does not move smoothly in its groove during knee movement. This can cause clicking or popping sounds and may lead to pain or weakness.

5. Flat Feet: You mentioned having flat feet, which can contribute to knee problems. Flat feet can alter your gait and put additional stress on the knees, potentially leading to discomfort and weakness.

Recommendations for Improvement
1. Consult a Specialist: It is advisable to consult an orthopedic specialist or a sports medicine physician who can perform a thorough evaluation of your knee. They may recommend imaging studies, such as X-rays or MRI, to assess for any structural issues.

2. Physical Therapy: Engaging in a structured physical therapy program can be highly beneficial. A physical therapist can design a rehabilitation program tailored to your needs, focusing on strengthening the muscles around the knee, improving flexibility, and enhancing overall stability.

3. Strengthening Exercises: Incorporate exercises that target the quadriceps, hamstrings, and calf muscles. Exercises like straight leg raises, wall sits, and step-ups can help build strength without putting excessive strain on the knee.

4. Stretching and Flexibility: Regular stretching can improve flexibility in the muscles surrounding the knee, which may alleviate some of the tightness and discomfort you experience after kneeling.

5. Weight Management: If applicable, maintaining a healthy weight can reduce the stress on your knees and improve overall joint function.

6. Yoga and Low-Impact Activities: Yoga can be a great way to improve flexibility, strength, and balance. However, it is essential to choose poses that do not exacerbate your knee pain. Consult with a qualified instructor who can modify poses to suit your condition.

7. Bracing or Orthotics: Depending on the assessment by your healthcare provider, using a knee brace or orthotic inserts for your shoes may provide additional support and alleviate some of the discomfort associated with flat feet.

8. Pain Management: If you experience pain, over-the-counter anti-inflammatory medications may help. However, consult with your healthcare provider before starting any medication.

Conclusion
Your knee symptoms are likely multifactorial, stemming from previous injuries, potential degenerative changes, and muscle weakness. A comprehensive approach that includes medical evaluation, physical therapy, and lifestyle modifications can significantly improve your knee function and reduce discomfort. It is crucial to address these issues proactively to prevent further deterioration and enhance your quality of life.

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