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Associated articles:
General Knee Pain and Running
Outside
Knee Pain
Two primary causes of inside knee pain
are:
1. Medial ligament Disorders
(MCL)
The medial ligament is regarded as a very serious injury involving
the knee. The ligament's purpose in the knee is to aid in
sideways movement and balance.
The injury can either be a
slight strain (2-3 weeks), a slight tear (4-6 weeks), or a
complete rupture requiring surgery (approx. six months to
full recovery).
The medial ligament when hurt
will normally be associated with other surrounding injuries
to that area. The medial meniscus, the cartilage and surrounding
quadriceps muscles will usually be damaged or hurt also.
Damaging the medial ligament happens in a sudden jerky movement
usually involving a twisting landing motion in which the knee
will collapse inward, eg:falling from a great height and landing
on a straight leg or landing in such a way your body weight
is too large for the inner muscles and ligaments to bear.
The injured can sometimes
feel the tear or hear an audible popping noise at time of
damage.
Swelling quickly follows a sharp pain, which is usually followed
by constant throbbing soreness and a need to limp.
2. Medial cartilage (meniscus)
tear
There are two mensci in the
knee; each rests between the thigh bone (femur) and shin bone
(tibia) and act as ‘shock absorbers’ in the knee
joint. The menisci are made of tough cartilage and conform
to the surfaces of the bones upon which they rest. These menisci
function to distribute your body weight across the knee joint.
Without the meniscus present, the weight of your body would
be unevenly applied to the bones in your legs (the femur and
tibia). This uneven weight distribution would cause excessive
forces in specific areas of bone leading to early damage of
these areas. Therefore, the function of menisci is critical
to the health of your knee.
How do the menisci work?
The joint is made up of three
bones: the femur (thigh bone), the tibia (shin bone), and
the patella (knee cap). The surfaces of these bones at the
knee joint are covered with articular cartilage. This cartilege
allows the bones to slide against each other without causing
damage to the bone. The meniscus sits between the cartilaginous
surfaces to distribute weight and to improve the stability
of the joint.
The menisci are semilunar
shaped and have a wedged profile. The wedged profile maintains
the stability of the joint by keeping the rounded femur surface
from sliding off the flat tibial surface. the blood supply
to the menisci is provided by small blood vessels, but they
also have a large area in the centre of the meniscus that
has no direct blood supply (avascular). This presents a problem
when there is an injury to the meniscus as the avascular areas
tend not to heal. Without the essential nutrients supplied
by blood vessels, healing cannot take place.
The two most common causes
of meniscal tears are due to traumatic injury (often seen
in athletes) and degenerative processes (seen in elderly patients
who have degenerated cartilage). The most common mechanism
of traumatic meniscal tears occurs when the knee joint is
bent (flexed) and the knee is then twisted. It is not uncommon
for this injury to occur along with tears of the anterior
cruciate ligament (ACL) and the medial collateral ligament
(MCL); these three problems occurring together are known as
the "unhappy triad", which is seen in sports such
as football when the player is hit on the outside of the knee.
Individuals who experience a meniscal tear usually experience
pain and swelling as their primary symptoms. Another common
complaint is joint locking, or the inability to completely
straighten the joint. This is due to a piece of the torn meniscus
physically impinging the joint mechanism of the knee.
What treatments are available
for a torn meniscus?
Any knee injury can be treated
acutely with ice and immobilization. This will decrease swelling
and pain in the joint. Your physician can use information
about how the injury occurred and physical examination techniques
to determine the likelihood of a meniscal tear. While x-rays
are invariably normal with an isolated meniscus tear, the
MRI evaluation will often reveal abnormalities of the meniscus.
The next step is to determine whether or not surgery is necessary.
If an individual is not a good surgical candidate or if their
symptoms are not severe, surgery can often be delayed or avoided
altogether.
A severe knee cartilage injury
can radically change an active adult's lifestyle. Symptoms
such as locking, catching localized pain and swelling often
affect your ability to work, play, even perform normal activities.
A cartilage lesion appears
as a hole or divot in the cartilage surface. Since cartilage
has minimal ability to repair itself, even what may seem like
a small lesion (ranging from the size of a dime to a quarter),
if left untreated, can hinder your ability to move free from
pain, and cause deterioration to the joint surface. |
