Expert Knee Physiotherapy for Knee Pain Essendon, Niddrie and North West Melbourne.

What is knee physiotherapy?

The knee is one of the most complex joints in the human body.

Knee pain is a common presentation we see here at Keilor Road Physiotherapy.

When you first arrive for your knee physio appointment with us, you can expect some questions about your knee pain - such as what makes it sore? How long has it been a problem? - which we then use to inform our hands-on assessment. This can involve muscle testing, testing of the ligaments supporting the knee, as well as other areas which can play a part in your control of the knee joint.  

From there, you will be educated and a clear, concise explanation of your problem will be explained to you, making sure you understand exactly what is happening, 100% of the time. This is provided in the form of a take home Tailored Health Plan, designed specifically for you.

In the first few sessions, you can expect hands-on treatment - such as massage or joint mobilisation - as well as a functional exercise plan to help relieve your pain and improve strength and control at the knee joint.

See our blog ‘What Causes Knee Pain?’ for an in depth look into the causes of knee pain. Being a hinge joint it is structured to perform two principle actions, flexion (bending) and extension (straightening). The muscles which act at the knee are predominantly the Quadriceps (extension) and the Hamstrings (flexion).

The knee is comprised of the bottom end of the Femur (thigh) and the upper end of the Tibia (shin) and the Patella (knee cap). The major ligaments of the knee are the Anterior Cruciate (ACL), the Posterior Cruciate (PCL), and the Medial (MCL) and Lateral (LCL) collateral ligaments. These, along with the muscles acting on the knee provide the joint’s stability.

Knee pain Physiotherapy.

The causes of knee pain

Joint stability at the knee is often compromised by excessive stress on the stabilising structures which results in:

• ACL or PCL sprain or rupture

• MCL or LCL sprain or rupture

• Meniscus sprain or tear

• Fracture

• Quadriceps or hamstring muscle strains or tears

Knee joints are also prone to injury due to wear and tear, resulting from excessive load and overuse. These include:

• Patellar tendinopathy or tendinitis (Jumpers knee)

• Patellofemoral joint syndrome or chondomalacia patella

• Illiotibial band (ITB) friction syndrome (Runners knee)

• Hoffa’s fat-pad impingement or anterior knee pain

• Osgood Schlatter’s disease

• Osteoarthritis

• Baker’s cyst

While knee pain is relatively common, there are a myriad of causes that can contribute to the painful knee.

These commonly include:

1. Knee Osteoarthritis (OA)

2. Patellofemoral Pain Syndrome

3. Patella Tendinopathy

4. Traumatic Joint Injuries 

Knee Osteoarthritis

The knee joint is lined with cartilage which helps to cushion and protect the joint surface of the femur (thigh bone) and tibia (shin bone). As we age, this cartilage undergoes changes. However, sometimes this can become irritated, inflamed and painful. This sensitisation is what we call Knee OA. This can result in:

• Pain on weight-bearing

• Increased joint stiffness (difficulty fully straightening or bending the knee) 

• Swelling and redness through the knee

• Pain first thing when you wake up.

Patellofemoral Pain Syndrome (PFPS)

The patella or kneecap, sits at the front of your knee. It helps to increase the force that your quads can produce. It forms a separate joint, the patellofemoral joint, with the femur and it moves as we walk or bend and straighten the knee.  

• PFPS relates to pain that arises from the patellofemoral joint itself. Similarly, it refers to the painful sensitisation of these structures, and commonly can be caused by either direct trauma, rapid changes in load, or muscle and biomechanics changes.  

Commonly, this will present with: 

• Pain around the front of the kneecap. Sometimes it can be quite difficult to pinpoint an ‘exact’ spot.

• Swelling around the kneecap.

• Pain going up/downstairs or sitting for long periods

Patellar Tendinopathy

The patella tendon runs from the base of the patella or kneecap onto the tibia (via the tibial tuberosity) and forms the attachment onto the shin. When we run and jump, we ask this tendon to stretch and absorb force (like a spring) and then release it to help us be more efficient with our movement. Sudden changes in load through the tendon though - such as beginning a new jumping class at the gym, or a recent return to basketball - can sensitise the tendon, and cause pain. This pain is common during the activity, and less likely to be tender to touch or swell up.  

This may result in: 

• Pain over the patellar tendon, which is made worse with jumping, running or landing.

• Less diffuse pain than PFPS - commonly, you can point to ‘the exact spot’. 

• Stiffness first thing in the morning

• Potential loss of quadriceps muscle flexibility or size.

Acute Ligament Injuries

The knee joint gets its stability from both our active structures (muscles) and passive structures (ligaments). At the knee, we have ligaments that stop the tibia moving forward (Anterior Cruciate Ligament; ACL), backward (Posterior Cruciate; PCL), and then to the sides (Medial and Lateral Collateral Ligaments; MCL & LCL).  

• While these are very strong, they can be injured if subjected to a significant amount of strain/tension. This can result from a collision, because of a fall, or without any trauma at all, such as a rapid twisting motion or change of direction.  

• Injury severity can vary between a grade 1 sprain (where no fibres of the ligament are torn, just sensitive), right up to a grade 3 sprain (where 100% of the fibres are torn).  

This may result in: 

• Sensations of instability 

• Pain over the injured ligament

• Swelling (which usually develops rapidly after the injury) and is large and tense.

• An audible ‘pop’ or ‘snap’ or sensation of ‘tearing’ when the injury occurs. 

Knee pain treatment.

How does a physio help knee pain?

The first thing we do here at Keilor Road Physiotherapy is establish and explain an accurate diagnosis of your knee pain. We make sure you know EXACTLY what is happening with your injured knee, what treatment here at Keilor Road Physiotherapy will mean for you and how long you can expect your return to 100% to take. We work with you to form a Tailored Health Plan that will see you reach your specific goals. 

• Our aim is to keep you moving and enjoying life while at the same time helping to reduce your pain levels. Your physio may use some hands-on techniques (massage, joint mobilisations, stretching) in order to help reduce your acute pain, as well as advice on modifications that can be made in the short term to help reduce your symptoms while still doing the things you love.  Additionally, we may use adjuncts like taping or compression to help in the short term.

• We know that knee pain can cause muscle and control changes around the knee - even if it has only just started to feel sore - so you will receive specific exercises to address these changes and other deficits that may be found in our initial assessment to limit secondary change in the early stages of your injury.

•  Exercise has also been shown by a significant body of evidence to be the most effective strategy in the prevention of injury. With our onsite, fully equipped strength and conditioning gym, we can offer a comprehensive rehabilitation and ongoing maintenance plan to limit the risk of a recurrence of your knee injury.

Exercises for knee pain

Exercise should be a significant part of the front-line management of any knee pain - but there’s so many options - which is best? 

• Certain knee injuries respond to exercise better in different knee positions (for example, PFPS can be aggravated when starting with the knee bent) - so knee position and the amount of range of movement are important considerations when starting exercise. 

• In the early stages of a knee injury, isometric exercises (where the joint isn’t moved through range) are important to limit the effects of muscle inhibition and swelling. They are often useful for pain relief themselves. Off-loaded exercises like Pilates, hydrotherapy and cycling may also be indicated in the early stages after injury, particularly to decrease swelling and promote range of movement.

• As your Tailored Health Plan progresses, so too will your rehabilitation goals. In the subacute stage, where your pain has subsided but your function still isn’t at 100%, we will identify any ongoing dysfunction and address underlying areas of concern, that could influence your ability to achieve maximal recovery. This is the perfect time for us to perform an Axit Assessment, where we can measure baseline strength and power, imbalances of muscles and movements and progression and improvement in strength over time.

Lastly, we aim for individualised peak performance. This is where we prepare you for individualised functional movements and activities, speed and agility drills, dynamic movements, functional strength and endurance and sport specifics. It is also the perfect time for an AxIT super session if you demonstrated deficits on your initial AxIT assessment.

What you can do at home for knee pain

In the early stages, pain and inflammation control is key using an update on the R.I.C.E. principle; the P.O.L.I.C.E. principle:
- Protection – use crutches or bracing while engaging in daily tasks.
- Optimal Loading – small amounts of loading, that don’t exacerbate symptoms are important in the early stages of healing.
- Ice
- Compression
- Elevation

Importantly, getting professional advice in the early stages will lead to a better long-term outcome for your knee. Here at Keilor Road Physiotherapy, we’ll listen to you, assess you as a whole person and then provide you with an evidence based rehabilitation program, centred on providing optimum strength and balance to your injured knee. 

KRP also specialises in physio of knees after surgery. Including return to full-function after:

• ACL repair or knee reconstruction

• Meniscal repair or meniscectomy

• Arthroscopy

• Total or partial knee joint replacement

• Osteotomy

• Fractured femur, tibia or fibula

• Synvisc injections

Contact our friendly expert physios at KRP

Keilor Road Physiotherapy offers the best treatment for knee pain, providing effective knee joint pain relief. Our expert team has 100 years of combined experience in knee pain management and knee pain treatment. We’ll listen to you, assess you as a whole person and then provide you with an evidence based rehabilitation program, centred on providing optimum strength and balance to your injured knee.

Servicing Niddrie, Essendon, Airport West, Keilor & the Northern suburbs for over 40 years, you can book with one of our highly trained knee experts online here or call 93794557 to speak to one of our admin superstars and get your independence back.