Knee muscles hurt: causes, prevention

Anatomy of the lower leg

The leg and ankle are a complex mechanical structure, the correct operation of which ensures full motor activity of the whole organism. There are three bones in the ankle joint. Their interaction must be correct, in combination with the functions of connective tissue elements, ligaments, muscles and tendons.

The foot has 20 bones, 30 joints, 100 muscles, ligaments and tendons. Their work must happen correctly and harmoniously. When at least one function of the general mechanism is disrupted, certain pathological processes begin to develop. They are accompanied by pain in the lower legs.

The shin is the part of the lower limb that connects the knee to the heel. The tibia contains the tibia and fibula, to which the kneecap is attached. Near the heel, these two bones merge into the anterior and posterior malleolus. There are muscles throughout all parts of the lower leg. With their help, the foot bends, extends and rotates. In most cases, the appearance of pain in the lower leg is not associated with serious pathologies. However, the help of a doctor is mandatory.

COMMON CAUSES OF INJURY TO THE KNEE JOINTS

The cause of a knee injury (its connective tissues) is usually associated with one of three factors.

1. Incorrect load distribution. Frequent flexion/extension without preliminary stretching (in sports this is called “cold”) leads to damage to the connecting elements and muscle threads in about a third of cases.
2. Weakened connective structures (age, diabetes, tissue degeneration due to disease progression) also contribute to damage on a regular basis (predisposition to tendon injury in the knee).
3. A mechanical breakdown of the connection becomes the reason for contacting a traumatologist with suspected damage in 20% of cases. This includes an open fracture, injury to the leg in the knee area with sharp objects, crushing of the bone when a heavy load falls from above.

Sports hobbies that can cause damage to the tendon in part of the knee include football, hockey, equestrianism, auto racing, skiing and skating, and jumping. But most often, a wound, sprain, tear or break of a tendon causes a fall on an outstretched leg.

What structures can become inflamed in the lower leg?

Pain in the lower leg and ankle occurs suddenly after an injury - bruise, sprain, fracture, dislocation. It can also be caused by a chronic illness. The following structures can become inflamed in the lower leg:

• Ligaments. They may become inflamed or stretched. When a tendon or muscle is sprained, severe tension occurs. Severe trauma also causes muscle or tendon rupture.
• Joints. Arthritis or arthrosis is a common pathological condition that affects the joints and is accompanied by pain. Ankle pain also often accompanies the development of rheumatoid arthritis.
• Tendons. The most common inflammatory tendon pathology is tendonitis. Also, with constant friction of the tendons and a deficiency of interarticular fluid, bursitis develops. This is accompanied by irritation and discomfort.
• Bones. After an injury, the integrity of the bone is often compromised. This is a fracture or crack. In this case, it is very important to visit a doctor as soon as possible. Only through timely and correct treatment will the bone heal and there will be no consequences of the injury.
• Tarsal tunnel syndrome. It develops when the tarsal tunnel is not pinched. This is a nerve located along the entire length of the lower leg.
• Arch. There are tendons in the leg that work synchronously. This is how the arch is formed. When the tendons are connected correctly, a regular and symmetrical arch is formed. If they are connected asymmetrically, an arch of a small size is formed or it is completely absent. With this condition, discomfort or pain occurs.
• Connective tissue. Connective tissue elements are located on the bottom of the foot. When they become inflamed, it is called plantar fasciitis. This happens when wearing incorrectly selected shoes, too narrow and uncomfortable, or with poor posture.

FUNCTIONS OF MUSCLES AND THEIR CONNECTIONS IN THE KNEE BLOCK

The structure of the knee is represented by 4 muscle groups. The most important block is located under the knee. The tendon, which is located in this part, is responsible for:

• hip straightening;
• keeping your back vertical;
• holding a person’s weight when moving (thanks to this tendon, a person does not fall when walking).

In addition, muscle groups in the knee provide the function of bending the leg at the knee joint and pulling the heel towards the buttocks. These functions are the first to be disrupted when the local tendon is damaged.

Causes of shin pain

After physical effort or minor injury, the pain usually goes away on its own and does not require specialist intervention. If the pain does not go away within 2-3 days, you need to visit an orthopedist or traumatologist who will help establish a diagnosis and prescribe treatment.

One of the causes of pain is flat feet. With this pathology, the shape of the foot is flattened and irregular. Its functioning is impaired, and the shock-absorbing function of the foot is not fulfilled. As a result, muscles and ligaments experience additional stress, and fatigue appears after walking. In this case, you need to use orthopedic shoes or special insoles.

Varicose veins can cause discomfort in the lower leg. This disease is accompanied by stagnation of blood in the vessels. Its microcirculation is disrupted, the walls of blood vessels are greatly stretched. With venous stagnation, discomfort and pain occur.

To reduce the severity of discomfort, it is recommended to wear special compression products. Vein thrombosis and obliterating atherosclerosis are also diseases of the vascular system. Their development is accompanied by circulatory disorders, blood stagnation, and the formation of atherosclerotic plaques.

Other causes of pain in the lower leg include:

• decrease in the concentration of magnesium, calcium, potassium in the blood. Long-term use of diuretics can provoke such conditions;
• improper use of statins, a side effect is deformation of muscle tissue;
• spasms in muscle tissue after prolonged physical activity;
• ruptures or cracks in the tendons after an injury;
• broken bones, cracked joints;
• meniscal deformation, previous trauma;
• blockage of blood vessels;
• inflammatory process in tendons;
• atherosclerotic disease of the circulatory system with the formation of cholesterol plaques, deterioration of blood outflow;
• infectious processes in tissues;
• damage to nerve fibers, ruptures, sprains or trauma to fibers;
• severe injury or muscle strain, which is accompanied by the development of trap syndrome, compression of the lower leg;
• development of muscle contracture under severe tension or loads;
• inflammatory process in the periosteum of the tibia;
• tears of various types in the muscular system of the lower leg;
• tears of the popliteal ligaments;
• inflammatory process in the kneecap, in the tuberous surface;
• neoplasms of a benign or malignant nature in any part of the leg;
• the use of glucocorticosteroid drugs, in this case pain is a side effect;
• compression of muscle tissue or neurons in tissue.

People who smoke more than two packs of cigarettes a day often experience pain in the lower leg. After quitting the bad habit, the pain of smokers stops on its own. This may be a consequence of stress on the vascular system.

Diagnostic methods

Knee Testing (Photo from Knee Treatment Workshop)
Assessing anterior knee pain is challenging because the pain can be nonspecific and the differential diagnosis is broad. This requires a thorough examination, analysis of symptoms, in-depth knowledge of the associated structures and typical injuries. Assessing the growth and development of young people is also important for making a diagnosis.

Diseases of the hip joint and lumbar spine can provoke knee pain and should be excluded.

Some key factors to consider when making a diagnosis:

• localization of pain, its nature, onset and duration, how it manifests itself during movement and at rest (at night), factors that increase and decrease pain;
• trauma (acute macrotrauma, repetitive microtrauma, recent/remote);
• mechanical symptoms (blocking, instability, worsening during or after physical activity);
• symptoms of inflammation such as morning stiffness, swelling;
• the effectiveness of previous treatment and the patient’s current level of functional activity: is there a history of gout, pseudogout, rheumatoid arthritis or other degenerative joint diseases.

The use of instrumental diagnostic methods, such as ultrasound and magnetic resonance therapy, are excellent ways of differential diagnosis and identification of intra-articular pathologies.

Thus, diagnosis and choice of treatment tactics are quite labor-intensive procedures. The European College of Rehabilitation has developed guidelines that should lead to simplified choice of therapy and, ultimately, improved treatment outcomes.

They offer the following evaluation options:

• Symptoms: (1) pain (location and type) or (2) instability problems.
• Lower extremity configuration: (1) asymmetrical patella, (2) high Q angle, (3) genu valgus, (4) knee recurvation, (5) subtalar joint pronation.
• Patellar position: (1) patellar high, (2) patellar low, (3) patellar displacement, (4) patellar inclination, (5) patellar rotation.
• Muscles and soft tissues: (1) wasting of the vastus medialis, (2) imbalance between the vastus medialis and vastus lateralis, (3) weakness of the knee extensors and hip flexors and abductors, (4) tightness of the medial patellar retinaculum, ( 5) tension in the lateral muscle structures, hamstrings and/or rectus femoris.
• Knee function (pain and/or changes in the trajectory of the patella): during various types of physical activity, such as walking up stairs, exercises on a step platform, and single-leg squats.

The Kujala Anterior Knee Pain Scale (AKPS), which was developed for patients with anterior knee pain, can be used to screen for patellofemoral pain in adolescents and young adults. Ittenbach et al suggest that this questionnaire is highly reliable ( it has shown good test-retest reliability), but it is not without limitations and further research is needed into its use outside the clinical environment and in the general population.

The Lower Extremity Functional Scale (LEFS) is an additional self-assessment test to assess the patient's difficulty in physical activity. This scale is less specific for patients with BPACS than the AKPS questionnaire described above, however, it also has high test-retest reliability.

Treatment of lower leg pain due to various diseases

Depending on the established diagnosis, doctors draw up a treatment algorithm. Often, pain in the lower leg is caused by increased physical activity and prolonged walking. Therefore, in most cases, after rest, all unpleasant symptoms are eliminated.

To restore the full function of muscles, ligaments, tendons, you will need medication and physiotherapeutic treatment followed by recovery - massages, therapeutic exercises, manual therapy.

To reduce the load on the affected limb, it is necessary to wear special devices. To prevent foot pathologies, doctors prescribe orthopedic shoes or insoles. Doctors can also prescribe anti-inflammatory drugs, muscle relaxants, and chondroprotectors. In severe cases, surgical treatment may be necessary.

WHAT TO DO IF THE TENDON TISSUE IN THE KNEE IS DAMAGED?

There is only one key factor in quality treatment of damage in the case of a knee - contact a specialist as early as possible. In most cases, the damaged tendon heals itself (natural reconstruction). From the perspective of traumatology, it requires only favorable conditions for healing after injury:

• fixation of the knee (this can be a special belt used in case of injury, which will distribute the load between the tendon and peritendinous tissues, or plaster);
• tissue nutrition;
• minimizing the load after damage;
• reasonable efforts on the knee (therapeutic gymnastics);
• NSAIDs to prevent inflammation that can be caused by injury of any severity;
• analgesic blockades.

Effective modern methods of therapy for tendon damage in the knee area include iontophoresis and injections of platelet-rich plasma. In case of serious breaks (damage with a violation of the integrity of the fibers), a conservative approach does not give the desired result - surgical intervention is required.

MBST therapy

With the help of magnetic radiation supplied by the MBST device, the following goals can be achieved:

• improve blood circulation and vascular condition;
• get rid of pain;
• prevent further development of the pathological process.

You can sign up for ankle treatment in Moscow at ArthroMedCenter. A completed course of MBST therapy is a good prevention of arthritis, arthrosis, atherosclerosis, and osteoporosis. After the procedure, blood circulation improves and the walls of blood vessels are strengthened. When undergoing MBST therapy, tissues begin to better absorb calcium, and damage and microcracks are restored faster.

Thanks to an integrated approach to treatment and prevention, you can get rid of unpleasant symptoms and prevent further development of diseases.