Knee Pain

Knee Pain

Knee Pain: Understanding Causes & Treatment

This article will help you to identify some of the most common causes of knee pain with tips to help prevent and resolve these potentially disabling conditions.

Knee pain can result a variety of situations:
• Acute trauma – as with a car accident or sports injury
• Gradual onset – chronic low level stress
• Degenerative – as with knee arthritis
• Insidious – systemic conditions

The knee is a complex, hinge joint (discussed below), that has many individual components. Injury to any one of these sensitive structures can result in pain, loss of movement, or even permanent disability. If you have been suffering with knee pain, knee stiffness or other associated symptoms like knee locking, knee clicking, numbness or tingling for more than three days you need to consult your physical therapist or doctor right away.

The team at Forest Hills Rehabilitation have been helping patients just like you, suffering with knee pain related to many different causes for years. Our skilled physical therapists work closely with supervising medical physicians to offer a variety of different treatment options to offer you.

We are easily accessible by public transportation, offer early morning, late evening, and weekend hours, and accept all insurance plans.

Give us a call now to schedule your same-day appointment…

Anatomy of the Knee

knee pain treatment, knee pain physical therapy

The knee is essentially compromised of two major bones: the “femur” or thigh bone, and the “tibia” or shin bone. The ends of these bones are covered with a strong, smooth cartilage in healthy knees, that protects the bones and allows them to slide smoothly over one another. The joint is further cushioned by two small cartilage discs known individually as the “meniscus.”

Inside there are two very strong fibrous bands called the “cruciate ligaments.” These ligaments cross one another as the name would imply, and prevent the knee bones from sliding forward and backward excessively.

Two other fibrous bands called the collateral ligaments attach the bones on the inner and outer sides preventing the knee from bending left or right.

For additional support, large muscles attach to both bones above, below, front and back. The muscles are attached to the bones via bands called tendons. Contracting and relaxing these muscles allow you to move your knee in normal directions.

Bursae, small fluid filled sacs (imagine a balloon holding a small amount of water) are found throughout this system and allow structures in high friction areas to slide past one another.

Injury to any one of these delicate structures can result in profound symptoms. Moreover, it may be difficult for you to determine the source of your knee pain, since symptoms may be closely related. Even though symptoms from one person to the next may be similar, treatment may be very different depending on the source of the injury. This is why it is so important to have an experienced physical therapist and doctor assist in making the diagnosis.

Whether you’re recovering from knee surgery, or suffering with anything from a stiff knee to severe knee pain, we can help. There is no need to live with knee pain or stiffness any longer.

A more in depth discussion of some of the more common conditions associated with knee pain that we treat can be found below…

As you learned in the above-mentioned anatomy discussion, ligaments are tight, inelastic fibrous bands that bind one bone to another. Ligaments have a very poor blood supply, making healing from ligament injuries slow and difficult.

The knee joint is formed essentially by two large bones - the femur, or thigh bone, and the tibia, or shin bone. The two bones are connected by a few very important ligaments. A short discussion of each group follows:

Anterior Cruciate Ligament - ACL

The Anterior Cruciate Ligament or ACL is one of the most common knee injuries the physical therapists at Forest Hills Rehabilitation work with. The ACL prevents the thigh bone (femur) from sliding back (posterior translation.) ACL injuries are usually associated with trauma, and often occur as a result a high velocity sports. If the force is significant enough, the ACL can literally tear from the bone, creating significant knee instability.

ACL sprains generally fair well with appropriate physical therapy. Complete tears of the ACL require orthopedic surgery to reattach the ligaments, and will most definitely require post surgical physical therapy rehabilitation to restore the knee to normal functioning.

Posterior Cruciate Ligament - PCL

The Posterior Cruciate Ligament or PCL is a less common injury, but equally serious. The PCL prevents the femur from sliding forward. Injuries to the PCL usually occur in the same way as ACL injuries, high velocity trauma. Healing times, surgical and physical therapy protocols are also similar.

Collateral Ligaments: Medial and Lateral

The medial collateral ligament attaches the knee bones on the inner side of the knee, and prevents the knee joint from opening on the inner side. The lateral collateral ligament binds the knee bones on the outer side and prevents gapping on the outer side. High velocity forces to the inner or outer side of the knee can damage the collateral ligaments.

The collateral ligaments are not as strong as the ACL and PCL and thus do not require as significant a force to create substantial injury. Complete tears, as with any other ligament, require surgery, and post-surgical physical therapy. Sprains, again will do well with a comprehensive physical therapy program.


Symptoms of knee ligament injuries include knee pain, bruising, stiffness, swelling, and instability.

Since ligaments have a poor blood supply lending these injuries to slower healing, it is imperative that you get examined by one of our trained medical doctors or physical therapists immediately after a knee injury or trauma. Although most knee injuries will require physical therapy from a trained physical therapist, some traumas will lead to the necessity of orthopedic surgery.

The physical therapists and medical doctors at Forest Hills Rehabilitation have been helping patients just like you recover from knee injuries for more than 14 years. Don’t delay… We’re on call seven days a week. If you have an immediate concern, give us a call and talk to one of our trained physical therapists or doctors on the phone right now.

(718) 520-8480

The meniscus (plural: menisci) is a small cartilagenous disc situated in the knee joint. The lateral meniscus is situated on the outer side of the knee joint and the medial meniscus sits on the inner side of the knee joint.

The lateral meniscus and medial meniscus provide a cushion to the bones to slight on and help absorb shock with jumping, running and other such forces. As with ligaments, there is a poor blood supply, leading to slow healing times.

The meniscus can become injured or torn with rotary forces while weight bearing. A common mechanism is with sports injuries (for example when a basketball or tennis player plants the foot and then pivots or rotates rapidly). Other mechanisms of meniscus injury may include car accidents or other such trauma. Additionally the meniscus may tear or fray with degenerative, or wear and tear conditions.

If a portion of the meniscus, as in the case of a torn meniscus, moves out of place it can get caught in the hinge of the knee joint. Imagine putting a pebble in a door hinge - the door would not open or close fully. When the knee joint flexes and extends through its normal movements, the already injured meniscus will get pinched, creating pain, clicking, or locking.

In some cases, a torn meniscus will require orthopedic surgery (arthroscopy.) In most cases however, a skilled physical therapist will be able to move the meniscus out of the hinge by utilizing specific joint mobilization techniques.

If you have sustained a knee injury, or have experience pain, clicking or locking, you should consult a skilled physical therapist right away.

The physical therapists and medical doctors at Forest Hills Rehabilitation have been helping patients just like you recover from knee injuries for more than 14 years. Don’t delay… We’re on call seven days a week. If you have an immediate concern, give us a call and talk to one of our trained physical therapists or doctors on the phone right now.

(718) 520-8480

Imagine what would happen if you gently squeezed the jelly donut. It would bulge on the opposite side. This is analogous to a medically diagnosed “disc bulge.”

Now imagine squeezing it hard enough for the jelly to squirt out. This is similar to a “disc herniation.”

Either spinal disc injury type can be quite serious because that disc material can put pressure on sensitive nerve tissue that a healthy disc is designed to protect.

Resulting symptoms include pain, numbness and tingling, and weakness in the back, legs, or feet.

Because of the seriousness of a disc injury it is important to get evaluated by a trained clinician ASAP. At Forest Hills Rehabilitation, our doctors and physical therapists are specifically trained to diagnose and treat all types of disc injuries, but don’t guess if this condition will get better on its own – because it probably won’t!

The doctors and physical therapists at Forest Hills Rehabilitation have been helping patients just like you recover from serious disc injuries, without surgery for more than 15 years.

If you are experiencing symptoms associated with a spinal disc injury, call our office today to see how our techniques can benefit you.

The medical term for the knee cap is the “patella”. The patella unlike most bones in our bodies is not bound by ligaments to other bones. The patella is embedded in the tendon of the large quadriceps muscle in the thigh.

The back side of the patella is covered with smooth cartilage allowing it to slide freely over the knee bones.

Patients suffering from chronic knee pain are very likely to be suffering from chondromalacia patella as is this is the most common cause of knee pain. Chondromalacia patella (aka patellafemoral syndrome) occurs when the cartilage becomes pitted and roughened. The cartilage degeneration is caused by an abnormal alignment of the knee cap, causing it to track improperly through normal knee movements.

Patients with chondromalacia patella generally complain of knee pain with walking, running, walking down stairs, and rising after sitting for prolonged periods. If left untreated for several weeks a trained physical therapist will likely identify thigh muscle weakness, which will definitely progress, further irritating the condition.

A skilled physical therapist will be likely be able to control and reverse the symptoms of chondromalacia patella, and help you return to normal functional levels relatively quickly. Once the initial inflammatory stages are controlled through specific physical therapy modalities, your physical therapist will aim toward restoring normal tracking movements of the patella. This is accomplished with selective physical therapy strengthening exercises, stretches, and knee joint mobilizations.

The physical therapists and medical doctors at Forest Hills Rehabilitation have been helping patients just like you recover from knee injuries for more than 14 years. If you have been suffering with chronic knee pain, don’t wait another minute. Give us a call now. We’re on call seven days a week. If you have an immediate concern, give us a call and talk to one of our trained physical therapists or doctors on the phone today.

(718) 520-8480

Arthritis literally translates to “inflammation of the joints”. We most commonly use it as a lay term referring to the degeneration of the joints.

The knee joint is formed when the upper leg bone (femur) meets the lower shin bone (tibia). The ends of the bones are covered with a smooth fibrous cartilage. In a healthy knee joint, that cartilage is bathed with a fluid allowing the bones to slide freely over one another through their normal movements.

In an unhealthy knee joint however, the cartilage becomes pitted, the bones become roughened, and the fluid becomes limited. This is what we generally refer to when we mention “knee arthritis.”

It happens from cumulative stress. If you are a professional skier for example, you may have knee arthritis in your thirties. But for most of us arthritis begins in our forties or fifties. The more stress we acquire, the more rapidly and widespread the degeneration. The knee joint is particularly susceptible because it is expected to carry our body weight around for most of our waking hours. Being overweight naturally, adds tremendous stress on the knee joint. The knee joint is also under great stress with walking, running, and jumping.

You may think that nothing can be done for arthritis. This however is not entirely true, and does not tell the whole story.

It’s true that you can’t reverse much of the bone destruction associated with arthritis, but you can make the joint function better with less pain. By addressing the soft-tissues (muscles, tendons, ligaments, etc), as well as the joint motion, proper physical therapy can decrease knee pain, increase joint stability, and ranges of motion.

It is the function and pain level that we're most concerned about anyway, not how our x-rays look!

At our facility, Forest Hills Rehabilitation, we have a unique program that can make you more flexible and stronger by working not only with the joint, but also with the surrounding soft-tissues. The knee joint complex will therefore function better allowing you to function better.

So your x-rays may not change tremendously, but you sure can feel and act differently!

Don't keep putting it off. If you have knee arthritis, our medical doctors and physical therapy team can help! Every day you wait, allows the condition to continue to worsen.

If you are experiencing symptoms associated with knee arthritis, call our office today to see how our techniques can benefit you.

(718) 520-8480

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