Knee Pain When Straightening: Possible Causes and Solutions

Experiencing pain when straightening the knee?

In middle school, I experienced intense physical activity during winter sports events and team practices, which led to knee pain.
I consulted a traditional Chinese medicine doctor who suggested that I might have chondritis.
At that time, I received heat therapy and topical medication.
However, I felt fine afterward and resumed running in relays.
Occasionally, my knee would ache slightly in cold weather, but it wasn't severe.
When I fully extended my knee, I would feel tightness and soreness, but it wasn't a daily occurrence.

Now, due to daily practice in my high school drill team, I have to stand straight against a wall and exert force to straighten my knees while keeping my feet tightly together.
However, whenever I apply force to straighten that particular leg, it hurts, and the pain seems to be worsening day by day.
The previous pain was not as severe.
What could be wrong with me? Thank you.

Irene, 10~19 year old female. Ask Date: 2015/09/19

Dr. Shi Guozheng reply Orthopedics

It may be inflammation of the cartilage, requiring medication or the use of a knee brace.
An X-ray of the knee joint can be taken to check for any valgus deformity or other issues.

Reply Date: 2015/09/19

More Info

Knee pain, particularly when straightening the leg, can be a frustrating and debilitating issue, especially for someone who is active in sports or physical activities. Based on your description, it seems that you may be experiencing symptoms related to patellar tendinopathy, cartilage inflammation, or even early signs of osteoarthritis, especially considering your history of knee pain and the physical demands of your current activities.

Possible Causes of Your Knee Pain
1. Patellar Tendinopathy: This condition, often referred to as "jumper's knee," is common among athletes who engage in activities that involve repetitive jumping or running. It occurs due to overuse of the patellar tendon, which connects the kneecap (patella) to the shinbone (tibia). Symptoms typically include pain at the front of the knee, especially when straightening the leg or during activities that put stress on the knee.

2. Cartilage Inflammation: Given your history of knee pain and the diagnosis of potential cartilage inflammation, it is possible that you are experiencing chondromalacia patellae, where the cartilage under the kneecap becomes soft or damaged. This can lead to pain during movement, especially when straightening the leg or engaging in activities that require knee flexion.

3. Osteoarthritis: Although you are relatively young, repetitive stress on the knee joint can lead to early signs of osteoarthritis, characterized by the degeneration of cartilage and changes in the underlying bone. Symptoms include stiffness, swelling, and pain during movement.

4. Iliotibial Band Syndrome: This condition occurs when the iliotibial band, a ligament that runs along the outside of the thigh from the hip to the shin, becomes tight or inflamed. It can cause pain on the outer side of the knee, especially during activities that involve bending and straightening the knee.

Recommendations for Relief
1. Rest and Activity Modification: It is crucial to give your knee some rest, especially from activities that exacerbate the pain. Consider reducing the intensity and frequency of your training sessions. Instead of high-impact activities, focus on low-impact exercises like swimming or cycling that do not put excessive strain on your knees.

2. Ice Therapy: Applying ice to the affected area can help reduce inflammation and alleviate pain. Use an ice pack for 15-20 minutes after activities that aggravate your knee.

3. Strengthening Exercises: Strengthening the muscles around the knee, particularly the quadriceps and hamstrings, can provide better support to the joint. Consult a physical therapist for a tailored exercise program that focuses on strengthening and flexibility.

4. Stretching: Incorporate stretching exercises for the quadriceps, hamstrings, and iliotibial band to improve flexibility and reduce tension around the knee.

5. Footwear: Ensure that you are wearing proper footwear that provides adequate support and cushioning. Poor footwear can contribute to knee pain, especially during physical activities.

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

7. Consult a Specialist: If your symptoms persist or worsen, it is essential to seek medical attention. A healthcare provider may recommend imaging studies, such as X-rays or MRI, to assess the condition of your knee and provide a more accurate diagnosis.

Conclusion
Knee pain when straightening the leg can stem from various causes, including tendinopathy, cartilage issues, or early signs of arthritis. By modifying your activities, incorporating rest, and focusing on strengthening and flexibility, you can alleviate some of the discomfort. However, if the pain continues, it is crucial to consult a healthcare professional for a comprehensive evaluation and tailored treatment plan. Taking proactive steps now can help prevent further injury and ensure you can continue participating in your activities without pain.

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