October 13, 2014

Knee pain : Osteopathy asks What, Why and How

Knee pain: What is going on in there?


Knee pain is very commonly seen in osteopathy clinics. Every year around one in four people report pain and discomfort, stiffness and limitations in activity. And that’s only the people who ask for help! Clinic on the Green’s Osteopaths have written this to help you understand what is going on inside the knee, and why you may be experiencing pain there.


The reason the knee is frequently a source of pain is due to its position; the majority of your body weight passes through it! As well as this, the knee is put under strain from activities such as twisting, jumping and running, which stresses every structure in and around the knee joint. Initial ‘niggles’, pain and dysfunction in the knee, lower limb or spine may result in the structure of the knee compensating and exacerbating symptoms.


Your knee is actually made up of three joints: the tibio-femoral joint, the patella-femoral joint and the superior tibio-fibular joint (Fig 1.1). These enable the knee to flex, extend, and importantly give a degree of rotation. Your knee must have a multiple axis of movement so that it can adapt to the stress coming down from the hips and up from the ankles. But this can leave it susceptible to overuse, strain or injury.


The boney joints of the knee are inherently unstable and need support, relying heavily on the muscles, ligaments, fibrous and cartilaginous structures surrounding it. Injury, overuse or degeneration of one or more of these supportive structures can result in knee pain and stiffness. So if you have an occupation involving moderate to high levels of knee stress, or you enjoy sports that involve twisting, repetitive or explosive movements of the knee, you’re at a higher risk of knee injury.



All anatomical structures that form and cross the knee joint can be potential sources of knee pain, which is then made worse by injury or even just bad posture. As a result, our diagnostic approach for knee pain involves four elements:


  1. We gather detailed information regarding the characteristics of the knee pain, onset of pain, local swelling and mechanism of injury, along with any relevant medical history
  2. Assessment of the occupational and/or sporting stress on the knee and whole lower limb to identify possible points of increased stress or overuse
  3. Observational assessment of the functional movement of the knee, lower limb and spine in active and static movements and positions
  4. Physical examination of the lower limb to identify any:


  • Dysfunctional bio-mechanics of the lower limb and spine
  • Muscle imbalances, tightness or weakness
  • Local inflammation and swelling
  • Partial or full dislocations of the three joints of the knee
  • Local anatomical structures during special tests


Combining all the gathered information, our Osteopath will then diagnose the most likely causes of the knee pain. Occasionally it may be necessary to refer you for additional investigations, such as an X-Ray or MRI scan, but this is only in exceptional cases.


Once the cause and contributing factors of knee pain and dysfunction have been identified, our Osteopath can then provide a mixture of hands on treatment and a programme of rehabilitation or re-education for the knee and the entire lower limb.


Although knee pain is common and can be complicated, it doesn’t have to be a constant problem or lifestyle limiting. Through suitable training, conditioning and management, it is possible to overcome knee pain and continue with daily activities, work and sports. This series on ‘Knee Pain: An Osteopathic Perspective’ will provide you with more detailed information on the most common causes, pathologies and dysfunctions of the knee joint.


For further information on how Clinic on the Green can help you, book in for an assessment by phoning 01869 351345 or email



















Core strength, Knees, Muscle and Mind
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