“Sounds made by moving bones, ligaments, and tendons are not a big problem for knee health… Rather pay attention to silent knee disease”
Due to the COVID-19 pandemic, long-standing social distancing has disappeared, and outdoor activities are gradually increasing as the cold weather has eased recently. However, it is also a time when you suddenly move your shrunken body and get injured here and there. One of the most common injuries is the knee.
If you hear a ‘pop’ sound from your knee when you fall down while enjoying extreme sports such as skiing or tennis, it is likely to be a sign of abnormality. This is because if the knee is swollen and painful, it is possible to suspect an anterior cruciate ligament tear. The cruciate ligament is a tissue that connects the knee joint and controls the forward and backward movement of the knee and maintains the stability of the joint. In particular, the anterior cruciate ligament can be ruptured when enjoying sports such as soccer, basketball, tennis, running, etc., when suddenly stopping, wrong landing or twisting motion.
However, when you get up from a normal sitting, you may hear a ‘popping’ sound from your knee, which is mostly unrelated to knee health. Lee Dong-hoon, director of Dong-hoon Lee Dong-yeon Sejeong Plastic Surgery Clinic, said, “The cause of the sound in the knee is not exactly known, but in most cases, the sound is caused by the movement of bones, ligaments, and tendons. This is not a big problem for knee health. Rather, attention should be paid to knee diseases that do not make a sound. When the doctor feels something strange or when the patient feels pain or a rattling sensation.”
Pain or strange sensations in the knee often go away over time, so many people ignore them and delay treatment. In this case, as the knee becomes unstable, other tissues (knee cartilage or meniscus) may be further damaged. Therefore, it is important to visit a specialist and get a diagnosis if you experience pain or strange sensations in your knee after strenuous activity. Director Lee Dong-hoon said, “Most of the causes of knee cartilage problems occur when the balance between one’s own muscle capacity, weight, and activity is broken. When the muscle capacity remains the same, but the weight or activity increases, or when the weight or activity remains the same, but a lot of muscle is lost.”
Chondromalacia, which causes stiffness and pain
The warning signs of knee health are more pain and feeling than sound. For example, when watching a movie for a long time at the theater or riding a car or airplane in the same position for a long time, there are times when you feel stiffness or pain in your knee. These symptoms disappear with rest, but reappear when kneeling, squatting, going up and down stairs, or performing weight-bearing activities such as running. You may experience a tingling sensation when moving your knee. These are symptoms that may suggest knee chondromalacia.
Knee chondromalacia means that the knee cartilage (cartilage), which should be hard, is weakened or damaged. Knee cartilage absorbs the shock of the patella and helps the bones move without friction. However, trauma such as a severe bump on the knee or a fracture or dislocation can cause chondromalacia. Even if it is not traumatic, it also occurs when the knee is suddenly used excessively. It mainly affects young adults who actively enjoy exercise and women with weak cartilage and low muscle mass around them. According to the Health Insurance Review and Assessment Service, women accounted for 62.5% of the 91,000 patients with knee chondromalacia in 2022. By age group, men aged 20 to 24 had the highest number, followed by women aged 50 to 54 and 25 to 29.
If you feel stiffness or pain and visit a hospital, chondromalacia is diagnosed with an X-ray test or MRI (magnetic resonance imaging) test. Chondromalacia, which does not have severe symptoms, can be improved by strengthening the thigh muscles through stretching, yoga, and strength training while refraining from excessive knee activities for 2 to 3 months. If these conservative treatments do not work and become chronic, surgery is necessary. Yang Ik-hwan, head of the artificial joint center at Seran Hospital, advised, “If you have pain, go to the hospital immediately to find out the degree of cartilage damage.
To prevent chondromalacia of the knee, it is important to avoid straining the knee above all else. Climbing up and down steep roads, extreme running, and weight gain are factors that put a strain on the knees, so it is desirable to avoid them. Your usual posture is also important. It is necessary to refrain from squatting and working or postures that put pressure on the joints, such as with both legs. Regular exercise such as riding a bicycle, walking on flat ground, or swimming helps to prevent knee chondromalacia by strengthening the muscles around the knee.
Injury to the meniscus with a rattling feeling
One of the causes of sudden knee pain is damage to the meniscus. Meniscus, commonly referred to as ‘knee crucible’, is a crescent-shaped cartilage between the articular surfaces of the femur (thigh bone) and tibia (calf bone) in the knee joint. This cartilage plate is a tissue that performs important functions such as weight transfer, external force distribution, joint cartilage protection, and joint stability.
The meniscus is originally soft and has good elasticity, but as it ages, it loses its elasticity and is easily torn. In particular, it is highly likely to occur when the knee is twisted and ruptured in a slightly bent state, so it occurs when exercising excessively. At first, it starts with minor damage, but due to poor lifestyle, the damaged area gradually enlarges and eventually ruptures the meniscus. In addition to aging, meniscal cartilage damage is a disease that occurs in both men and women of all ages because it can be damaged by excessive shock.
If the meniscus is damaged or torn, you may experience pain or a feeling of something stuck when you bend or straighten your knee. Swelling of the knee or restriction of joint motion may occur. You may also feel a sense of instability when going down stairs or going downhill. However, if left untreated, it can lead to degenerative arthritis, so it is desirable to receive treatment from a specialist before that.
Damage to the meniscal cartilage plate can be seen with an MRI scan. If the degree of damage is weak, symptoms improve with drug treatment, injection treatment, and physical therapy. However, surgery is required if there is a locking phenomenon in which the knee cannot be bent or straightened, or if the strength of the leg is loose when walking, or if the pain stops walking due to the pain when changing direction. Choi Jong-hyeok, professor of orthopedic surgery at Gangnam Severance Hospital, said, “If the degree of tear is small and there are no other lesions on the knee, symptomatic improvement can be expected through conservative treatment, such as strengthening the muscles around the knee joint and taking anti-inflammatory painkillers. If there is no response to conservative treatment or if the rupture is severe, surgical treatment using an arthroscopy is required. Specifically, there are partial resection, which removes and trims damaged cartilage, and suture, which stitches damaged cartilage.”
Bursitis, an inflammatory disease of the knee with high recurrence
In addition to cartilage in the knee, there is also a tissue called a bursa. A bursa is a type of oil sac that contains mucus to reduce joint friction. In addition to the knee, there are bursae in the joints such as the elbow, shoulder, hip, and ankle. When this bursa becomes inflammatory (bursitis), pain occurs. Trauma from a fall or bump or repetitive chronic trauma is a major cause of bursitis. It can also be caused by tuberculosis or gout. Sports such as tennis, golf, skiing, kneeling on a hard floor, mopping, or repeated cross-legged postures are also related to the development of bursitis.
The most common symptom of bursitis is pain. In addition to pain, symptoms such as swelling, redness (redness), a feeling of heat, and decreased range of motion may accompany it. Since these symptoms are similar to degenerative arthritis, you should visit a hospital and be diagnosed with knee bursitis by ultrasound or MRI. Treatment for bursitis depends on whether it is simple inflammation or bacterial infection. Conservative treatment of the most common uncomplicated bursitis can reduce pain and restore function. Bacterial infections require antibiotic treatment. Severe swelling or pain can be relieved with anti-inflammatory drugs or cold compresses. Bursitis is easily alleviated if treated early. However, the recurrence rate is high. If the same joint is repeatedly used excessively, it can develop into chronic bursitis, and surgery to remove the bursa may be required.
You can prevent bursitis by avoiding kneeling as much as possible. If it is unavoidable to kneel down to work, it is desirable to wear knee pads. Shoulder bursitis can occur even when working for a long time with the arms raised above shoulder level, so it is recommended to use a footrest to raise the working position or lower the work object. Park Ki-beom, head of orthopedic surgery at Seran Hospital, said, “It is important to avoid stimulation of the inflamed area as much as possible for bursitis. Reduce the amount of time you spend working on your knees or raising your arms above shoulder level. If you have bursitis, you should rest to avoid straining the affected area. If bursitis is left untreated for a long time, it becomes chronic inflammation and the risk of recurrence increases, so early treatment is important,” he emphasized.
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