Knee pain is probably one of the most awful experiences to have. It affects anyone from teenagers to seniors, office workers to professional athletes.

What is the most common cause of knee pain?

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Kingsley Tay, our national beach volleyball athlete, working with chiropractor Jesse Cai. Kingsley suffers from chronic tendinitis in both his knee and ankle.

There are different types of knee pain. Your injury can be briefly classify into the location, when they start (i.e. acute vs. chronic), or how they start (i.e. traumatic vs. non-traumatic).

If you are an athlete, your knee pain is most likely coming from a traumatic sports injury (e.g. tackling another soccer player) or a repetitive overuse injury (e.g. running). For non-athletes, knee pain tend to be chronic without a clear incident to attribute your pain to.

Disorders of the knee cap (patella) that contribute to knee pain include patellofemoral pain syndrome (PFPS) or patellofemoral instability (PFI). If the patellar tendon is involved, patella tendinitis is a likely contribute. Other potential causes of knee pain may include iliotibial band syndrome or IT band dysfunction, ACL injury, torn meniscus, osteoarthritis*, or rheumatoid arthritis.

Some people may experience pain on the inside of the knee while others may have side knee pain. It is good for you to be able to identify knee pain symptoms, however, on its own they are not very useful. We highly don’t recommend you try to self diagnose knee pain.

*Osteoarthritis, also known as degenerative arthritis, was previously mistaken to be a ‘wear and tear’ condition. The latest research shows that osteoarthritis is more likely to be a progressive, natural, age-associated phenomenon that is no different from wrinkles and white hair. Furthermore, studies have also shown osteoarthritic finding on knee MRIs to poorly correlate with pain. In other words, it is common for people who show ‘degenerative’ changes in their knee MRIs to experience NO symptoms.

What are the signs and symptoms of a knee injury?

The most common symptom of knee pain is of course pain itself. Depending on the cause of your knee pain, swelling or warmth to touch may also be observable at the joint. Some knee injuries are accompanied with weakness and instability in the early stages.

For patients experience knee stiffness, it is important to determine if the stiffness is a sensation or a true stiffness (i.e. reduce range of motion or mobility at the knee joint). Most of you will experience a sensation of knee stiffness, without any true loss of knee movement, with your knee pain.

It is also important to note if your knee pain is activity related. For example, some of you may only experience knee pain from running.

What is the first signs of knee ‘problems’?

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Soh Rui Yong: Singapore’s #1 marathon runner and 2x SEA gold medallist doing half squat heel raises under the supervision of chiropractor Jesse Cai. The exercise helps to develop the calf muscles, specifically the soleus.

There are multiple signs that may suggest a potential knee problem. Please note that none of these signs or symptoms should be interpreted in isolation. If you are experiencing knee symptoms, you should consider seeking professional advice. Your chiropractor or physiotherapist will perform an assessment of your knee joint to determine if further investigation or treatment is necessary. If you experience one of the following, we highly recommend you seek professional help:

  • Pain with weight-bearing e.g. unable to stand on one leg
  • Pain during sports or exercise (e.g. hiit class, running, rugby, swimming)
  • Pain with climbing stairs
  • Loss of range of motion e.g. unable to completely straight or bend your knee
  • Loss of function e.g. unable to get into a squat position or unable to stand from a seated position without assistance

Knee pain from running

There are multiple reasons why your knees might be hurting from running but ‘wear and tear’ is not one of the reasons.

Most running injuries or knee pain associated with running are due to poor load management. This will include increasing your mileage too much too soon or increasing your pace too fast too soon. Chronic repetitive overuse can lead to injuries such as patella tendonitis. While most people believe that tight muscles on its own contributes to knee pain, current research does not support that. Latest research has shown that stretching reduces risk of injury by only 4% while strength and conditioning reduces risk of injury by almost 70%.

If your knee hurts gradually overtime and you think running (or any sports for that matter) is the cause, look into your exercise routine and your knee function/health. Are your knees conditioned to support your current training?

Read more: How to Prevent Running Injuries: From a Sports Chiropractor Perspective

How to alleviate painful knees?

Believe it or not, we use exercise for knee pain relief at Square One. Most people think rest is the solution for painful knees. While it is true resting does help reduce knee pain, it is not actually beneficial in the long term. The alleviation of symptoms as a result of rest should not be confused with recovery. If your pain has subsided due to pain alone, it will most likely return once you resume usual activities.

Also, there is no research to support icing as a strategy for pain or injury. Pain medications should also be avoided unless absolutely necessary.

Read more: Everything You Need To Know About Pain: Elite Athlete Edition

What is the best way to treat knee injury?

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Our office setup at Bukit Pasoh Road. We are the only exercise chiropractor in Singapore and we utilise movements and exercises to help you achieve pain-free living. Our equipment include weights and kettlebells from Again Faster. We believe movement is medicine!

Exercise. It might be true that your current workout routine is making your pain worse but exercise for fitness and exercise therapy for pain are completely different ball games. We have wonderful success rates at Square One using exercise programming to help our clients get back to pain-free living. Research has also shown that rehabilitative exercises that are painful have a significant benefit over pain-free ones.

Virtually all clinical guidelines do not recommend passive therapy such as chiropractic adjustments, soft tissue therapy (IASTM, cross friction massage), dry needling, or even ultrasound/laser therapy as first choice treatment for knee pain. There is no reason why you should choose those treatments over exercise to achieve pain-free living.

How long does it take to recover from a knee injury?

Most soft tissues will take at longest three to six months to heal. If your pain is lasting for more than three to six months after the initial injury, there might be other factors that you will need to address to achieve full recovery. Most of our clients take four to seven visits across a three month period to achieve full recovery – that is to be pain-free AND to return to sport if applicable.

You may be surprise to hear that ACL tears respond just as well to exercise rehabilitation as compared to surgery. Your knees are more robust than you think. Sure, they may be hurting now but don’t the pain beat you down. With the right care, you can overcome your injury.

How to Prevent Knee Pain?

There is no 100% prevention that we know of but there are a few things you can do to keep knee pain at bay.

  • Maintain a healthy weight: This is probably one of the biggest risk factors when it comes to knee pain. Overweight/obesity is associated with many health issues including pain at other parts of your body. If you are diagnosed with osteoarthritis and could do with losing a few pounds, this is 100% the first place to start.
  • Be conditioned for your lifestyle: Doesn’t matter if you work in an office or play professional sports, keeping active and fit is a prerequisite to pain-free living. If you are getting knee pain as a sedentary individual, consider exercising more to keep your body and joints strong. If you are getting knee pain as an athlete, consider your training load: You can either cut back on the training or make sure your knees are adequately conditioned for the load you are putting them through.
  • Be discerning and educate yourself: There are a lot of false information about knee pain being circulated on the internet. Advice such as running is bad for your knees or painful knees is an indication of damage are not based on the latest evidence. Such misconceptions often reduce sense of well-being and lead to negative health beliefs, which in turn increases susceptibility to pain. It’s a lose-lose situation!

What does a chiropractor do?

A chiropractor is a musculoskeletal health care expert. We are trained to diagnose, treat, and manage conditions pertaining to your muscles and joints health. While many chiropractors in Singapore only provides chiropractic adjustments, Square One offers customised pain solutions.

Our approach to recovery is exercise-based and we aim to get you discharge from our care within four to seven visits. We believe in empowering you.

For further information, check out our knee pain page.

Are you looking to visit us? Our office is at Bukit Pasoh Road – a two-minute walk from Outram Park MRT (Exit H, Dorsett Hotel) and Pinnacles at Duxton. If you are coming from Tanjong Pagar, a stroll through Duxton Plains Park will bring you to us.

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