Is Your Knee Pain From Meniscus, Ligament, or Aging?
- 7 hours ago
- 7 min read
This article is a transcribed, edited summary of a video Bob and Brad recorded in December 2024. For the original video, go to https://www.youtube.com/watch?v=83K3EpXCnwI
Brad: All right, if you're having knee pain and you want to find out what the cause really is...
Mike: We're going to help you determine that, because maybe your knee locks up, maybe it grinds, or just feels unstable. So we're going to show you some tests so you can figure out what's going on.
Brad: There you go.
Mike: Let's start talking about the knee, Brad.
Brad: That's right. So we're going to look at Sam, do a brief little anatomy lesson. Let's pull the kneecap away.
Mike: Poor Sam, ripped his kneecap off.
Brad: Yes, Sam, he's tough. He can take it. So we're going to look at typical tissues that can get irritated or damaged and cause pain. See this outside? We've got green on here. And if you look at it, it looks kinda like circles or horseshoes, which is known as a meniscus.
Brad: The meniscus can tear, it can rip, creating pain and other symptoms we'll talk about. The next is that there are four primary supportive ligaments. The MCL, the LCL, ACL, and PCL.
Brad: I'm not going to go through the details of them, but there are four of them. Any of those could possibly get stretched, torn, or actually injured in one way or another. And then of course, old arthritis, where there's cartilage on the joint here and here, and actually on the bottom, when that cartilage has lesions, it becomes rough like sandpaper. It's a problem. Old Arthur. Alright, Sam, we are complete and done with you. Thank you for your help and dedication. Now, let's go on to meniscus injuries, and what are some of the symptoms when you have a meniscus injury? Number one.
Mike: If your knee commonly locks up, so when you're walking or moving around, it locks up on you, and then it takes a little bit of time, but it might eventually unlock. That is a common sign that you have a meniscal tear.
Brad: That's right. I've actually found this to be very common when someone's going up or down the steps, but it can happen other times as well. Number two, it's difficult to fully extend or straighten the knee without pain, as well as if you're going all the way down and putting your weight to a maximum flexion with weight-bearing, it's common that that's painful as well.
Mike: Another common symptom of a meniscal tear is if you are in a full bent knee position, whether you're squatting down or whatever, and then you have some type of turning force going on in there, or catches or hurts, that's another common sign it's a meniscus injury.
Brad: There you go. Two tests that I've used in the clinic, and I've found them very helpful. They're not really hard. The first one is the Thessaly test. This is the knee in question. You bend the knee at five degrees. This is not five degrees; it's just a slight bend all the way through that leg. If it's painful, you stop right there. If it's not, you can rotate slightly. If it's painful, it's positive; if it doesn't hurt at all, it's negative.
Brad: Then you go to the second part, where you bend the knee to 15 degrees, which isn't very much. Five degrees, 15, not five and 15. So a little bit more. Same thing. If it hurts, you stop; if it doesn't hurt, a slight rotation; if it hurts, it's a positive test; if not, it's a negative.
Brad: We're going to talk about how you determine if it is a problem or not in just a little bit. But there's one more test Mike wants to show, which I found really helpful.
Mike: So, this is called the Childress test. Essentially, you're walking like a duck for five to 10 feet. So you're going to get in some sort of squat position, whatever's comfortable for you. Notice my legs are kind of out to the side like this, and then you're just going to kind of walk like a duck. If you're feeling some pain in the knee, it could be a meniscus.
Brad: That's right. Now, when I've used this in the clinic, and it was positive, but they were still functional, I'd work on exercises to improve the problem, and then a week later, I would go through the tests and see if they improved. Now, it's really important that you are not a professional, you do not have a lot of experience with these tests or these symptoms, and you're not going to be able to diagnose yourself positively. If they are positive, don't think you've got a problem right away. You need to go in, and an MRI test is actually the test that's going to give you a definite determination.
Mike: Next, we're going to talk about ligament injuries. So, this is almost always a result of some type of trauma. Typically, this can happen in a sport or maybe a fall. Oftentimes, you have to have a falling and twisting component, or two forces coming at you at once. If we think about basketball or football injuries, these commonly cause this type of ligament injuries.
Brad: That's right. Or it could be where you're standing and something, or a body, falls on the side of your knee. That can really put some stress on your MCL. One thing that is common is that people say, "Boy, I heard a pop, an audible pop," And that is associated with a ligament tear. Again, there are tests, manually, that you can do, but it needs to be done by a professional who's trained at it. You'll need to go to see a doctor, and possibly an MRI will be needed to know for certain what you have.
Mike: I've actually met some people who have torn their ACL. They heard a pop and had no pain right away, but then a few hours later, it really swelled up, and then they felt very unstable. So sometimes, with the ligament injuries, there's actually not always pain right away.
Brad: That's right. And boy, that instability when you walk. I have patients just say, "This knee feels like it's kinda wobbly," and it actually is because it's missing one of the cornerstones that it has. The next thing is usually associated with aging, and that's arthritis.
Mike: So if you have osteoarthritis, what it does is wear down the cartilage like Brad talked about last over time. It just tends to degenerate in most people. So, you're going to just kind of have to deal with it, unfortunately.
Brad: Right. But there are exercises you can do to help with that. And we do have some very good videos on how to exercise with knee arthritis so that you can maybe avoid or eliminate the need for a potential knee replacement.
Mike: Now, typically, some common signs, if you're having pain when, say, you're walking, but then you go into a pool, which has less gravity and forces pulling down, and you have less pain, typically, you have more pain associated with any weight-bearing activities than non-weight-bearing.
Brad: You mean if it's arthritis?
Mike: Yes.
Brad: Right. I just wanted to clarify. Good. Also, family history. If your mother had it, your grandmother had it, sisters, aunts, uncles, it can be related to genetics, but not always.
Mike: And another component is commonly your genetic makeup. Some people are valgus, where their knees come together more. Some people are varus, or they're bow-legged, and their legs go out more. Typically, if you're stuck in these positions for long durations of time, part of your cartilage can start to wear out in certain areas.
Brad: There you go. Alright, so again, hopefully this can give you some indication of what your knee pain is about, but again, get it assessed by a professional before you start treating it as if it is a meniscus or other injuries. So Mike, isn't there something, oh, we got another video that also talks about this to expand your horizons on this.
Mike: Yes, if you want to check out another video, watch "How to Tell if Knee Pain is Meniscus or Ligament Injury."
Brad: Yeah, we just went through that.
Mike: Why'd you pick the same video?
Brad: Actually, it goes through it from a different angle. It's going to give you some helpful information that we did not cover here.
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