Knee pain

Osgood-Schlatter disease causes swelling and discomfort below the knee. Other symptoms of the condition include:

• Pain when straightening the knee or squatting to a deep position.
• Pain when running or travelling up or down stairs.
• Pain that improves after resting.
• A swollen tibial tuberosity and irritated skin over the area (the bony bump at the top of the tibia bone in the lower leg).
• Weakened or smaller quadriceps muscles.

The most common causes of Osgood-Schlatter disease are:

• Growth spurts.
• Periods of increased physical activity involving kicking, running or jumping and sports that involve vigorous use of the quadriceps.
• A prior knee injury before the knee has finished growing.

Dan Everson Podiatry can diagnose Osgood-Schlatter disease through history taking, a physical examination of the foot and ankle and a biomechanical assessment to study your range of movement, look for swelling in the joint and assess pain experienced through movement. An X-ray, MRI or CT scan may also be recommended to evaluate the stage of the condition.

Osgood-Schlatter disease usually resolves itself with activity modification, a stretching program, knee pad wearing during exercise and pain relief. Dan Everson Podiatry can create a tailored recovery program for you.

Kinetic Orthotics can also be prescribed to correct abnormalities or imbalances in the feet and legs. This is a range recommended by Dan Everson Podiatry, designed using patent-protected technology to optimise the way force is transferred as you move.

In rare cases where people don’t respond to non-surgical treatments, surgery may be advised.

Regular stretching before and after exercise is advised as a precaution measure for this condition.

• Pain or discomfort in the front of the knee most likely to occur when you run, jump, kneel, squat, use stairs or perform any other activity that involves repeated bending of the knee.
• Swelling of the knee
• Unusual sounds or feeling in the knee during movement such as popping, grating or grinding. It may feel like the kneecap is catching on something during movement.
• Feeling like your knee might be about to suddenly give way or collapse underneath your weight.
• Pain at the front of the knee that gets worse during extended periods of sitting or standing.

The cause of pain is a result of cartilage under the kneecap becoming abnormally softened due to poor alignment of the kneecap. As the kneecap slides over the femoral bone, it grates over the bone due to the kneecap’s misalignment, causing irritation, swelling and pain. Common causes include:

• Overuse and repetitive strain (especially twisting motions) in the knees through increased running distance or training intensity.
• Muscular imbalances between the muscles on the thighs (adductors and abductors) and weak hamstrings and quadriceps. This is common in young people and adolescents during growth spurts.
• Running or jumping on uneven and hard surfaces such as concrete and bitumen. This is a particularly high risk activity for people who are overweight.
• A genetic abnormality that affects the way the kneecap moves.
• Previous injuries to the kneecap such as a dislocation.
• Direct trauma to the kneecap that pushes it to either side of the leg. This could be from a fall or car accident.

Dan Everson Podiatry can diagnose chondromalacia patella by assessing your health and exercise history and conducting a thorough physical examination of the affected knee, combined with further testing to assess damage to the cartilage under the knee. A blood test and X-ray can be used to rule out arthritis and inflammation. MRI scans will provide a more complete picture of the knee joint. A referral from the GP to an orthopaedic surgeon may be required.

The aim in treating this condition is to provide or create a straight pathway for the kneecap to travel during movement. This will help prevent pain and discomfort and rehabilitate the knee. With proper rest and rehabilitation, a patient can expect to fully recover and return to normal function.

Dan Everson Podiatry would typically suggest one or more of the following treatment methods:

• A period of rest from exercise or activity causing pain in the knee.
• Anti-inflammatory medication to reduce swelling.
• Applying ice to the area after exercise or movement that causes pain.
• Taping the kneecap to help guide the way it moves.
• A knee brace can be useful if it is designed to re-align the kneecap during movement.
• Kinetic Orthotics can be prescribed to correct abnormalities or imbalances in the subtalar joint of the foot and rotation of the tibia bone of the leg. This is a range recommended by Dan Everson Podiatry, designed using patent-protected technology to optimise the way force is transferred as you move.

Dan Everson Podiatry recommends the following activities to help prevent an onset or recurrence of chrondomalacia patella:

• Carefully monitor and reduce any activity that involves squats, especially with weights.
• Ensure your shoes or joggers are not damaged or worn out, and distribute your weight evenly across the foot. Schedule an appointment with your podiatrist to ensure you have appropriate footwear for your needs and lifestyle.
• Stretch and strengthen the quadriceps and hamstrings to rehabilitate the knee and kneecap.
• Orthotics may be prescribed to help prevent an occurrence of chrondomalacia patella for those at risk.

The symptoms most often associated with rheumatoid arthritis of the knee are:

• Pain, swelling, stiffness and difficulties bending or straightening the knee.
• Cracking or popping sounds coming from the knee when you move, or experiencing a grinding sensation.
• Fever, fatigue and appetite loss.
• Changes to the appearance of the knee – either a sunken appearance or knees pointing towards each other.

The causes of rheumatoid arthritis are presently unknown.

Dan Everson Podiatry can assess for rheumatoid arthritis through history taking, a physical examination of the foot and ankle and a biomechanical assessment to study your range of movement, look for swelling in the joint and pain experienced through movement. An X-ray, MRI or CT scan may also be recommended to evaluate the stage of the disease. A blood test through the doctor and consultation with a rheumatologist may also be required to diagnosis and manage in condition, in conjunction with podiatric care.

Dan Everson Podiatry would typically suggest one or more of the following treatment methods:

• Anti-inflammatory, pain relief and prescription medication can help slow the spread of the illness.
• Rest and applying ice to the area.
• Your podiatrist can recommend certain exercises to improve your range of movement and strengthen the knee.
• Surgery may be recommended in some cases. Dan Everson Podiatry can provide guidance on the ideal procedure and costings.

There is no known way to prevent rheumatoid arthritis, as the causes are presently unknown. There are several ways to reduce your risk of major joint damage after a diagnosis of this condition:

• Consult with your doctor as soon as you have any symptoms to be properly diagnosed, so you can be managed by your podiatrist appropriately.
• Speak with your podiatrist about a program of gentle stretches and strength movements to reduce pain and strengthen the bones.
• Rest from exercise during the periods you are experiencing the most pain.
• Avoid smoking.