EP 2: 8 Most Common Knee Problems

EP 2: 8 Most Common Knee Problems 

PART 1: **[Introduction - 1 minute]**

**[Visuals: Splash screen + 10 seconds of background music]**  
Hey everyone, It’s Dr. Jay Bowen. I’m a board-certified physiatrist here at New Jersey Regenerative Institute, or NJRI. I work together with Dr. Thomas Agesen to provide non-surgical solutions to orthopedic problems. Our goal here is to help you release your intrinsic ability to heal yourself. Today I want to take some time to review the 8 most common knee problems we treat here at NJRI. Whether you're an athlete, someone dealing with chronic pain, or just curious about knee health, this video is for you. We’ll be posting new content on the knee every week, so be sure to subscribe and HIT the bell notification so you don’t miss anything. 

**[Outline the video. Text appears on screen as speaking.]**  

We'll cover a range of knee problems, from injuries to conditions like arthritis, and discuss symptoms, causes, and treatment options. Let's get started!
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PART 2: **[Segment 1 - 2 minutes]**

**[Visuals: Illustrations of a healthy knee]**  
First up, let's talk about knee anatomy and function. The knee is a complex joint composed of bones, ligaments, cartilage, and tendons, all working together to provide stability and mobility.

It is a marvel of biomechanical engineering, crucial for both stability and mobility in the human body. It is composed of a junction between the femur (thigh bone), tibia (shinbone), and in front the patella (kneecap), the knee is a complex hinge joint that facilitates movement between the upper and lower leg. Its structure includes cartilage, ligaments, tendons, and synovial fluid, all working in harmony to absorb shock, bear weight, and allow for a wide range of movement—from walking and running to bending and kneeling.  We also need to consider that the knee sits between the hip and foot as these can affect it. 
Beyond its mechanical prowess, the knee plays a central role in everyday activities and sports, making it prone to various injuries and conditions. Understanding its anatomy and function is essential not only for athletes and those recovering from knee problems but for anyone interested in maintaining healthy joint function throughout life. 

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PART 3: **[Segment 2 - 1 minute]**

**[Visuals: Illustrations of a knee injury]**  
Now, one of the most common knee issues we see in our clinic areligament injuries, particularly the anterior cruciate ligament or ACL and medial collateral ligament or MCL. These injuries often occur during sports or activities that involve sudden changes in direction or impact.

The ACL lives inside the joint and treating an ACL tear typically involves both non-surgical and surgical options, depending on the severity of the tear, the individual's activity level, and their overall health. Here at NJRI we advocate for the non-surgical approach whenever it’s possible. If you think you may have an ACL or MCL tear, you likely heard a popping sound at the time of injury and felt immediate intense pain. This is usually followed by noticeable swelling soon after. If you’re currently struggling with instability, swelling, and difficulty walking after an ACL or MCL injury call our office for a consultation.

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PART 4: **[Segment 3 - 1 minute]**

**[Visuals: X-rays or MRIs of knee arthritis]**  
Moving on to knee arthritis, it's a condition where the joint's cartilage deteriorates over time, causing pain, stiffness, and swelling. It's prevalent among older adults but can also affect younger individuals due to injury, prior surgery or genetic factors. Stay tuned for a video next week that will dive more into this issue. In that video you’ll find a longer explanation of the condition as well as our proposed treatment options.

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PART 5: **[Segment 4 - 1 minute]**

**[Visuals: Diagrams of meniscus tears]**  
Next, let's discuss meniscus tears, another common knee problem. These are often caused by twisting or over-flexing the knee, leading to pain, swelling, and sometimes locking of the joint.
Non-surgical treatment options for meniscal tears typically depend on the size, location, and severity of the tear, as well as the individual's symptoms and activity level. Initial treatment often includes the classic RICE protocol. REST, ICE, COMPRESSION and ELEVATION.  Although most people have heard of RICE, MEAT is preferred.  M.E.A.T. is an acronym for movement, exercise, analgesics and treatment. Physical therapy plays a crucial role in non-surgical management by focusing on strengthening the muscles around the knee, improving flexibility, and restoring normal movement patterns that also includes addressing the hip and foot. Therapists may also incorporate modalities to aid in pain relief and promote healing. Additionally, temporarily modifying activities to avoid movements that exacerbate symptoms, such as squatting or twisting, can help facilitate healing of the meniscus tear without the need for surgery. 

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PART 6: **[Segment 5 - 1 minute]**

**[Visuals: Diagrams of patellar tendonitis]**  
Patellar tendonitis or tendinosis is also on our list. This condition involves inflammation of the tendon that connects the kneecap to the shinbone. It's frequently seen in athletes who engage in jumping sports, which is why it is often referred to as Jumper’s knee.

This condition is characterized by pain and tenderness around the lower part of the kneecap (patella), where the patellar tendon attaches to the shinbone (tibia). The pain is often localized and may feel like a dull ache or a sharp, stabbing sensation, especially during activities that involve jumping, running, or kneeling. Usually, the pain worsens with exercise and improves with rest. Swelling and stiffness around the knee may also be present, particularly after periods of activity or prolonged sitting with the knee bent. In some cases, there may be a feeling of weakness in the knee or difficulty fully straightening the leg due to tightness and discomfort in the tendon

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PART 7: **[Segment 6 - 1 minute]**

**[Visuals: Illustrations of bursitis]**  
Bursitis, characterized by inflammation of the bursae (fluid-filled sacs) around the knee joint, can cause pain and swelling. Despite, many people and physicians stating they have bursitis, it is extremely uncommon in our patients who do not have underlying rheumatologic conditions.  The “bursitis” problem is usually from tendon pathology.  It's often linked to repetitive motions or kneeling for extended periods. This condition tends to occur more frequently as people age and is likely due to altered biomechanics - poor flexibility and weakness causing overload. Additionally, rheumatoid arthritis, gout, or diabetes, can increase susceptibility to bursitis due to their impact on joint health and inflammation. Typically we treat this by first evaluating your movements including your hip, ankle and whole kinetic chain then addressing deficits with exercise, stretching, and/or formal physical therapy.  If this fails, further investigation would be considered.  

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PART 8: **[Segment 7 - 1 minute]**

**[Visuals: Picture or MRIs of knee OCD]**  
Osteochondral defects refer to a specific type of injury or damage that affects both the cartilage and the underlying bone within the knee joint. This condition typically occurs in weight-bearing joints such as the knee, ankle, or elbow. Symptoms include severe pain, inability to bear weight, and visible deformity. Diagnosis typically involves a thorough physical examination by a healthcare provider like myself, along with imaging studies such as X-rays, MRI, or CT scans. These tests help to visualize the extent of cartilage and bone damage and determine the appropriate treatment approach

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**[Segment 8 - 1 minute]**

**[Visuals: Illustrations of Osgood-Schlatter disease]**  
Osgood-Schlatter disease is a common cause of knee pain in growing adolescents, especially those involved in sports. It results from inflammation of the growth plate just below the kneecap. Sometimes, a bump at the painful site becomes noticeable.  Typically, the best approach to treatment for these young athletes is to be conservative and first relative rest meaning reducing your activity level until symptoms free with occasional use of ice or Tylenol.  If this does not resolve you should seek a medical evaluation as it may be something different or to obtain other options..



**[Segment 9 - 1 minute]**

**[Visuals: ultrasound of IT Band Syndrome]**  
IT band syndrome, or iliotibial band syndrome, is another common overuse injury that affects the iliotibial band—a thick band of connective tissue that runs along the outside of the thigh, from the hip to the shinbone (tibia) and crosses the outside of the knee It occurs when the IT band becomes tight or inflamed, leading to pain and discomfort, typically on the outside of the knee or hip.  Factors such as poor biomechanics, sudden increases in activity level, inadequate stretching or warm-up, or muscle imbalances can contribute to the development of IT band syndrome.



PART 9: **[Conclusion - 2 minutes]**

**[Visuals: Recap of key points]**  
There you have it, the top 8 most common knee issues explained. Remember, early diagnosis and appropriate treatment are crucial for managing knee problems effectively. If you're experiencing persistent knee pain or have any concerns, don't hesitate to consult with a healthcare professional. I am in Parsippany, NJ and it would be my privilege to see you in person or virtually if you have continued knee issues.  Justcall the office to schedule an appointment

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