- I am getting old so it’s probably arthritis. (We’re all older than what we used to be but arthritis and advancing age alone doesn’t cause pain nearly as often as what people think)
- I’ve been rough on my knees, so I’ve torn the meniscus. (Using our joints result in conditioning, not abuse, and believe it or not, meniscal image findings are often incidental, pain-free discoveries)
- I fell badly / trained hard / injured the knee on Sunday (You’ll be surprised how resilient these structures can be and while a bona fide injury / tissue damage is possible resting a non-injury will be futile and frustrating)
- I’ve suddenly and enthusiastically started a new activity, so I probably just have tendonitis (The updated term is tendinopathy but considering the immense patient dedication required to correct this mismatch in load, I would suggest removing ‘just’ from each patient’s sentence when this discussion comes up)
- My pain was diagnosed on x-ray / ultrasound scan / MRI (in the absence of a recent, sudden onset of pain from a traumatic event, research says that while x-rays may on occasion be correct, we can’t reliably establish the cause from such imaging)
- I need a knee replacement (with the mixed feedback from patients worldwide, we only support this drastic measure if all other causes for pain and dysfunction have reliably been ruled out)
- I haven’t been as active as what I’m supposed to be, so my knees are probably weak. (But does weakness cause pain? Really??)
It’s important to know that you could simultaneously have more than 1 of the conditions mentioned above, or may not have any one of those. Pain and musculoskeletal dysfunction is a complex environment and in the interest of efficiency or wanting to show competence and confidence, health professionals, your family, friends and even Google may easily lead you on any incorrect path. Taking one or 2 elements into account and overlooking the others brews incorrect assumptions, poor responses to treatment and persisting symptoms!
So, consider the following:
- How did your symptoms come about? (traumatic and instantaneous onset, or over time)
- Does your pain intensity fluctuate from day to day or based on the time of the day?
- Does the pain location change / move around / spread or become more localised?
- Did the current pain migrate from elsewhere?
- Do you have other medical conditions which may impact your knee?
- Do you have symptoms on the other side, or pain anywhere else ranging anywhere from your lower back to the tips of your toes?
- Has your pain changed from one side to the other, be that over weeks and months or potentially daily.
As professionals specialised in the health and functional capacity of the neuromusculoskeletal system we need to investigate all the above and far more before we can consider any possible diagnosis and even then, there are likely still 3 or 4 possibilities we need to rule out as we work to get to the bottom of it all.
If you’ve allowed anyone’s momentary judgement of your symptoms to determine your diagnosis and the required treatment, especially if such treatment fell short of providing an impactful and lasting answer, perhaps your real diagnosis is still out there! Treatment of most conditions (excluding e.g., autoimmune conditions and recovering trauma) should show obvious and progressive restoration of normal comfort and function, or the diagnostic mark has been missed.
Your health and physical wellbeing should be a priority deserving of quality care. Make sure to discuss any concerns you may have directly with your preferred physiotherapist, so that you can receive the appropriate guidance for your unique situation.