slowly and cracking of the knee could be
related to underlying problems in the
knee such as arthritis or wear and tear
or it could be related to injuries such
as sports injuries sustained while
playing football rugby tennis running
these could all contribute it contribute
to swelling and cracking the most
important thing is whether the cracking
is painful or painless pain and swelling
associated with arthritis is usually of
a gradual progression it happens over
time and it gets worse over time and
it's made worse by activities such as
excessive walking going up and down the
stairs or running for example or sports
activities the other side are the sports
injuries such as football rugby
attendants they could lead to injuries
to either the ligaments or the cartilage
inside the knee which can be associated
with swelling and cracking of the knee
the term bad knees is a general term
which could point to the fact that there
is a problem with the knees the way to
know if there is a problem with the
knees or the symptoms which include pain
swelling instability difficulty was
walking made worse by activities
inability to run
inability or difficulty going up or down
the stairs these are all symptoms that
would signify that there is a problem
with the knee there's no medical term
that is called bad knees but there is a
problem with the knee which could be
either related to wear and tear or could
be due related to an injury sustained in
the knee the most important factor to
know is to note is pain weather how bad
is it
how what brings it on what makes it
worse are there any aggravating factors
relieving factors and if there is any
history of trauma associated with us and
obviously following that the examination
and the imaging findings such as x-rays
or MRI scans of the knee the common
causes of knee pain are can be divided
into mainly two groups the acute
injuries and ligament injuries or
cartilage injuries or arthritis which is
wear and tear the acute injuries or the
injuries to the knee could be divided
into two groups either ligament injuries
or cartilage injuries like a torn
cartilage if you look at the knee there
are ligaments that wrap the knee from
the outside so you're the collateral
ligaments which surround the knee on
either side so the medial collateral and
the lateral collateral ligament then you
have the ligaments on the inside of the
knee which are the Crusades the anterior
cruciate and the posterior cruciate
ligament at the back of the knee itself
and they all have to function in synergy
to preserve function of the knee and to
allow us to play sports the other
structures that are important inside the
knee are the menisci or the cartilage
which act as cushions to the knee when
you run walk on them and they can be
injured and can cause mechanical
symptoms with the knee the second group
is the arthritic group or the wear and
tear group of the knee this is when the
knee starts to wear out and the
cartilage becomes thinner to the point
that it may reach the point where there
is no space at all between the two
surfaces and then you start to erode the
bone and that's sort of an indication to
proceed with surgery such as knee
replacement surgery other issues
associated with a knee and sports for
example are runner's knee where there is
friction as you run between the bones
and the soft tissues they may lead to
painful clicking either tibial band
syndrome IRA tubular band is a band of
tissue that runs across the knee towards
the tibia and there and it can also be
injured or down
or irritated by certain activities such
as squatting or lunges other conditions
for example gout Pripet elaborate
scientists or inflammation or swelling
at the front of the knee which is common
in carpenters and gardeners people who
kneel for a living and then finally
fractures or trauma pulls to the knee
such as fracture of the femur patella
the kneecap or the tibia which can
happen due to traumatic injuries such as
Falls it can happen in car accidents and
it can happen in also simple twisting
for while you're walking down the road
for example to help relieve knee pain at
home it is important to start by resting
the knee so stop
activities as much as possible to try
and allow the need to recover and give
it a room to breathe second thing is if
it's swollen then you might want to use
ice to reduce the swelling especially
after an injury while playing football
or rugby for example using an ice pack
at home can help reduce pain and
swelling at the same time sometimes we
use what we call a compression bandage
just to compress the knee and reduce the
swelling as well elevating the knee on a
stool or a couple of pillows to relieve
swelling as well helps in reducing pain
taking painkiller simple painkillers
such as paracetamol or
anti-inflammatories such as ibuprofen if
you're allowed to take it helps relieve
the pain as well and reduce the
inflammation avoid the activities that
might trigger the onset of pain for
example if you if the pain gets worse
while squatting or doing lunges then you
might want to avoid those certain
movements some people find that going
down the stairs can be a bit tricky go
one step at a time avoid any activities
where you might need to do a sudden
change of direction on the knee and try
and do linear exercises physiotherapy
helps and it helps to strengthen the
muscles and the envelope around the
to try and provide strength to the need
to be able to cope with stresses so it's
important to start physiotherapy
whenever you're able to do so wearing
the right shoe wear is very important
especially if you run quite a lot I
would encourage you to get a fitted
running shoe to allow you to run if you
do a lot of running
sometimes taping patellar taping can
help and also stretching of the tendons
using either dynamic or static taping
can help reduce some of the swelling or
pain around the knee you might have seen
this on football players the blue tape
or black tape that's applied which is
also used on the shoulders and as well
as the knee you need to seek medical
advice when you have a problem with your
knee that is not getting better or a
problem with your knee that's associated
with instability mean giving way
problems with going down or up the
stairs general reduced mobility pain
especially at nighttime or pain on
certain movements if you're getting
sharp pain and clicking at the same time
if you're getting pain and recurrent
episodes of swelling in the knee then
it's important also to seek help the
symptom these are all symptoms that
could delineate that there is a problem
which could be either due to either as
an injury such as an acute injury or a
chronic injury which has become worse
over time the pain associated with
arthritis of wear and tear is usually of
a gradual onset which becomes worse over
time and can reach a point where you
have pain at rest or pain at night if
you notice that your walking distance is
decreasing if you have problems going up
inclines or they are going down hills if
your knee is starting to give way
regularly if it's not holding your
weight and associated senses of
instability if the patella or the
kneecap is dislocated moving sideways
more than normal and its associated with
painful
clicking if there is associated swelling
mechanical symptoms in the knee then it
is important to seek out new pain is
treated by conservative options and
surgical options the conservative
options include the easy options weekly
rest elevation allowing the need to
settle down compression using a soft
bandage and using ice in an acute injury
or what we call the rice regime to rest
ice compression elevation followed by
painkillers which include paracetamol
anti-inflammatories these reduce the
inflammation and reduce the swelling and
also help to control pain symptoms
followed by injections injections to
help especially if the underlying
pathology is wear and tear there are
various types of injections the
commonest injections that we have are
local anesthetic plus steroid injections
but there are other forms of injections
that are being more commonly used with
varying levels of evidence including
platelet-rich plasma or PRP which is an
extract from your blood that's injected
into the need to allow to reduce the
inflammation and reduce pain there is
varying evidence some people are for it
some people are against it in certain
pathologies it does help such as
patellar tendinopathy for example or
quadriceps tendon or the-- which is
where there is inflammation of the
tendons around the knee there is some
evidence that it might help in arthritis
as well now if the pain is sharp and
intermittent and its associated
mechanical symptoms such as the knee
giving way collapsing on you or
instability then it might need further
imaging such as x-ray or an MRI scan of
the knee to see if there is any evidence
any evidence of cartilage damage or
ligament damage which might require
surgical intervention there are other
types of injuries such as sports
injuries such as a runner's knee
frictions in Rome highly tibial band
these are certain these are
positive injury repetitive injuries
associated with certain sports which if
you rest and avoid certain activities
and do some exercises to help stretch
the muscles and tendons do get better
what doesn't get better obviously or
cartilage tears and the ligament
injuries especially ACL injury or a torn
medial meniscus or torn cartilage these
may require surgery in the form of
arthroscopic or keyhole minimally
invasive surgery when you develop
arthritis it can be either mild moderate
or severe when it reaches the severe
point specially when you have pain at
rest or pain at night or your exercise
tolerance decreases to less than 100 or
200 yards then it becomes important to
treat the problem and if there's severe
arthritis both clinically and on the
x-ray and the symptoms are fairly
suggestive of this surgery I in the form
of either a partial or a total knee
replacement is indicated in those cases
according to the latest paper
publication by The Lancet knee
replacements to reasonably well and if
you have a knee replacement in this day
and age your chances of surviving for 20
to 25 years or eight out of ten which is
a good statistic two helpful
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