Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "

Case study ( 11863 views as of April 14, 2024 )

Agnes is a 52-year-old woman develops medial-sided knee pain while kneeling during her usual gardening activity on weekends. The knee pain is progressively becoming worse with her gardening activities and has now affected some of her other activities such as hiking and going up and down stairs. She notes a sense of stiffness on occasion and some pain along the medial joint line. She describes pain at night while in bed, which is worse if she sleeps with her knees together touching.

Agnes could benefit her condition by seeing a physiotherapist to help her with improved joint mobility. A bracing specialist could help her with bracing options to keep her mobile and active. Pilates and massage could also help with her range of motion, swelling and pain. Getting an MRI on her knee could help her physician provide an accurate diagnosis and treatment plan for Agnes' knee pain. Lastly, consultation with an Orthopedic Surgeon and a Rheumatologist for further advice and testing on her condition may also help Agnes resolve this issue and continue her usual hobbies and activities.

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Conversation based on: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "

Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "

  • Leflunomide is a medication commonly used for the treatment of rheumatoid arthritis and other autoimmune conditions. It is important to note that leflunomide is considered an absolute contraindication for pregnancy or for individuals considering pregnancy. If you are of childbearing age, your specialist may advise against starting leflunomide as a precautionary measure. If, for any reason, you are already taking leflunomide and you are planning to become pregnant, it is crucial to inform your specialist well in advance. This is because leflunomide has a long half-life and can remain in the body for months to even years after discontinuation. To ensure the safety of the pregnancy, a washout phase is typically recommended to eliminate leflunomide from the body before attempting to conceive. The specific duration of the washout period may vary depending on individual circumstances and the advice of your healthcare provider. If you have any questions or concerns regarding leflunomide and its potential impact on pregnancy, it is essential to reach out to your healthcare provider or specialist. They will be able to provide you with the most accurate and personalized information based on your specific situation.
  • Fractures lead to morbidity, which really reflects disability but they also lead to mortality. We know that when women and men have fractures they’re more likely to end up not being able to live independently. They’re more likely to end up in a nursing home. In treatment your pharmacist, is the right HCP to make sure it’s the right medication for you.
    • important information about the potential side effects of prednisone, particularly its effects on various aspects of health. Let's break down these points: Blood Sugar Levels: Prednisone can impact blood sugar levels, leading to increased levels in individuals with diabetes or those predisposed to diabetes. Monitoring blood sugar levels more closely is recommended, and adjustments in diabetes medications, including insulin, may be necessary during prednisone treatment. Hypertension (High Blood Pressure): Prednisone can cause or exacerbate hypertension. Individuals with existing high blood pressure may need closer monitoring, and adjustments to blood pressure medications may be required. Eye Health: Prednisone may affect the lens of the eye, leading to the development or acceleration of cataracts. Regular eye check-ups are important, and if there's a decrease in vision, it may be related to cataract development. Cataracts can be surgically removed, and lens implants can be inserted to restore vision. It's crucial for individuals taking prednisone, especially over an extended period, to be aware of these potential side effects and communicate with their healthcare providers. Monitoring and managing blood sugar levels, blood pressure, and eye health are essential aspects of care for those on prednisone therapy. As with any medication, the benefits and risks should be carefully weighed, and healthcare providers may consider alternative treatments or adjust the treatment plan based on individual responses and needs. Regular follow-up appointments with healthcare providers can help address any emerging issues and optimize the overall management of the patient's health.
    • patellofemoral syndrome (also known as patellofemoral pain syndrome or runner's knee) is accurate and provides a good overview of the condition. Patellofemoral syndrome is indeed a common knee issue that can affect a significant portion of the population, particularly active individuals. The patella, or kneecap, plays a crucial role in the proper functioning of the knee joint. Its alignment with the femur influences the movement of the kneecap, and when this alignment is disrupted, it can lead to patellofemoral syndrome. As you mentioned, the back of the kneecap has a V-shaped structure that fits into the trochlea, a groove in the femur. When there's misalignment, especially side-to-side misalignment, during activities that involve bending and straightening the knee (such as walking, running, or climbing stairs), the surfaces of the patella and trochlea may rub against each other in an abnormal way. This can result in friction, irritation, inflammation, and pain around the kneecap. Several factors can contribute to patellofemoral syndrome, including muscle imbalances, weakness or tightness in certain muscle groups, overuse or excessive loading of the knee joint, and anatomical factors. Activities that involve repetitive knee motion, especially those that put stress on the patellofemoral joint, can exacerbate the condition. Management of patellofemoral syndrome often involves physical therapy to address muscle imbalances, strengthen the muscles around the knee, and improve biomechanics. Rest, ice, and anti-inflammatory medications may also be recommended to alleviate pain and inflammation. In some cases, modifications to activities or the use of knee braces may be advised. Individuals experiencing persistent knee pain or symptoms should consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to their specific situation.
  • If you aren’t responding to first-line rheumatoid arthritis therapies, then your rheumatologist may be looking at offering you a second-line therapy. Second-line therapies are a major advance to the treatment of rheumatoid arthritis, and may be pills, injections under the skin or intravenous infusions.
    • If a foot or ankle joint is destroyed from an injury it can cause ongoing pain and is called post traumatic arthritis.
    • Scoliosis can occur in adolescents and in adults.
  • Rheumatoid Arthritis effects more men than women.
  • Patellofemoral syndrome is a very common knee injury. It’s said that it may affect up to one-third of the population. The reason is that the patella, which is the kneecap, sits on the front of the knee, and its alignment with the femur - which is the large bone on the top of the leg - dictates whether or not the kneecap’s movement is correct. When these two bones are not aligned well together, this causes friction or irritation around the area of the kneecap, and that can lead to inflammation and pain. The back of the kneecap is shaped like a V, which fits into a little groove in the femur called the trochlea.
    • Diagnosis of scoliosis in adolescents is important in order to prevent future complications linked to the child's functioning and cosmetic appearance.
    • In addition to medications for rheumatoid arthritis, canes, crutches and walkers can help people stay mobile. You may also need to make lifestyle changes to manage your condition and reduce your risk of heart disease.
  • Physiotherapists may suggest that you place both feet on the ground when sitting. If you can’t reach the ground, use a phonebook or textbook to place your feet on. Also, have your knees be in line with your hips and have your backside pushed into the back of the chair. If you have questions about managing Neck Pain, seeing a Physiotherapist could help.
    • The vast majority of adults diagnosed with scoliosis do not need treatment, however in some cases it can be caused by tumors, the growth of a mass or a neurological problem which if left untreated can be life threatening.
    • Anti-inflammatories such as Ibuprofen or Naproxen only treat the symptoms of RA and do not prevent long term damage to joints.
  • Physiotherapists may suggest that you place both feet on the ground when sitting. If you can’t reach the ground, use a phonebook or textbook to place your feet on. Also, have your knees be in line with your hips and have your backside pushed into the back of the chair. If you have questions about managing Neck Pain, seeing a Physiotherapist could help.
  • Ankylosing spondylitus affects about one in a thousand people. It runs in families, and it is associated with certain genes, such as HLAB27, which is the most common gene in ankylosing spondylitus. It typically occurs in men between the ages of 20 to 30, but also occurs in women and children. Ankylosing spondylitis symptoms include pain and stiffness in the joints in the lower back, spine, hips, knees, shoulders, ligaments and tendons. It can be worse in the morning, causing 30 to 60 minutes of stiffness in the spine. Some people experience inflammation of the tendons of the heels, feet or eyes. Over time, the inflammation can cause permanent damage to the joints
    • If first line therapies fail, second line therapies are available and inclue oral medication, subcutaneous injections or IV infused therapies.
    • If first line therapies fail, second line therapies are available and inclue oral medication, subcutaneous injections or IV infused therapies.
  • Why would her pain be worse if she slept with her knees touching ?
  • Knee pain caused by gardening can be caused by a sudden injury like what has happened to this 52 year old women, or an overuse injury, or by an underlying condition, such as arthritis. Treatment will vary depending on the cause as in this case by gardening. Symptoms of knee injury can include pain, swelling, and stiffness which is apparent in this women from gardening.
    • Second line therapies have revolutionized the treatment of Rheumatoid Arthritis.
    • @Karmen MacAngus a physiotherapist can also help you strengthen your knee to reduce pain right ?
    • With gardening you tend to do it all at once. It's a good idea to pace yourself so you don't overuse the joint by spending too much time in one position
  • At 52 it's likely late to start, but one thing I am conscious of is squatting more, and one time it often is appropriate is during gardening. I've read that squatting is a more natural position but in our culture of sitting in chairs for everything, we lose the flexibility. It doesn't look very ladylike! but it can be comfortable if your body is used to being in the position.
    • I do find that squatting is easier than kneeling but it's easy to get stuck if you aren't used to staying in that position. It's best to ease in to doing it in place of kneeling
    • Squatting is great way to take the pressure of the knee joint and put it into the large quadricep muscles. Always make sure that your knee never goes beyond you toe when you squat.
  • Would using assistive devices like knee pads, gardening mats, etc. prevent knee pain or simply ease the symptom of knee pain? For instance, if I use assistive devices when I garden at 35, will I not have knee pain at 75?
    • I feel like there is a lot than can be done ahead of time to prevent knee pain as we age.
  • Assistance devices such as mats, knee pads, stools and braces are certainly options for individuals struggling with knee pain from gardening. The causes with gardening are usually either from prolonged compression of the structures in the knee such as the menisci, patella-femoral joint, medial and lateral articular surfaces; prolonged stretch of the knee ligaments depending on the position of the knee joint; or repeated movements that can cause a repetitive strain injury. Advise for the first set of causes would be to ensure that no single posture is sustained for too long - in other words try to modify the gardening activity so that you do not spend too much time in one static position. If the cause is due to repetitive strain, then its very important to address the biomechanics to ensure that the knee is working in the right way. Obviously having good mobility in the knee is also important as others have already addressed.
    • A physiotherapist is a great option for looking at getting help with exercise and alignment issue of the patella tracking wrong which can cause an over amount of knee pain when bending down a lot like in gardening.
  • While kneeling or crouching for long periods of time during the gardening, the blood circulation from the quadriceps and hamstring muscles are restrained (stagnated). Cupping therapy and Acupuncture can improve circulation through the knee by detoxing these muscles and restore fresh blood to these large muscles that feed the knee joint.
  • My ankles tend to hurt more than my knees while gardening. I will try adding more stretching to my day.
    • I wonder what stretches are good for knee pain, or for ankle pain?
  • My ankles tend to hurt more than my knees while gardening. I will try adding more stretching to my day.
  • It is important to find out if it is joint pain or muscle pain you are experiencing. A friend kept thinking that she was experiencing muscle pain in her knees, so she took anti inflammatory medication. Since the issue was persistent she visited her doctor and was sent for an MRI. It was determined to be a injury to her joint and she was sent to a physiotherapist to help her with improved joint mobility. It is important that a doctor is seen to determine what is wrong and to ensure you are being treated properly for your injury.
  • I have a wonderful mat that I use when gardening that really helps reduce knee discomfort. I find I get more knee pain at the beginning of the gardening season but that once my body gets used to the position and movement again it adapts and the pain goes away. I also find that Tylenol helps with the pain.
    • Knee pads can also reduce the discomfort I feel in my knees when working on the ground. I have found them very helpful.
  • I started stretching when I was 15. Being over 40 now, I have tried to maintain a level of flexibility that will allow my muscles to work more and my joints to work less as I get older. In my experience too many people view stretching as a winter thing that they do before or after an activity or at the gym. I have always tried to view stretching as a thing I like to do wherever I am. Stretching has so many good attributes and accompanied by a good strength program, should really be looked at as a year round activity.
    • Stretching has so many benefits. People often skip or rush through stretching because it doesn't feel like much work for the most part, and many of us are looking for that quick workout and don't want to spend time stretching afterward. It is amazing how quickly your flexibility can decrease over time - good for you @John for maintaining a regular stretching program!
  • If knee pain from gardening persists, it's best to decrease kneeling and switch to container gardening, where everything will be elevated.
    • I was going to say this...I've been bugging my husband for a few years as I would like him to build me some containers for gardening. For me the problem isn't so much my knees but my back. Costco is also now selling some plastic raised bins.
  • It is my understanding that most of us over time as we age will experience a certain amount of joint pain from Osteoarthritis, but if the pain starts to interfere with normal activities and is constantly there, I would definitely eek out professional help from various professionals for for sure. I would start with my family doctor but would likely also see a physiotherapist on my own.
    • I have self-referred to physiotherapists before, and they really helped me understand the nature and cause of my knee pain. I think visiting your family doctor is important to rule out any other issues, and physiotherapy is key to understanding and managing knee pain.
  • Would a bracing support for the knee reduce the amount of pain one would experience while gardening?
    • My suggestion is to stretch your leg adequately prior to initiating gardening, and take several breaks to stand up and move around. I would also consider using knee pads or a gardening mat so help alleviate the pressure placed directly on the knee. Further, make sure the foot is flat against the ground versus having your toes curled under creating n inappropriate fulcrum at the base of the toes. The last piece of home care advice is if you experience back, knee, or ankle pain consistently when gardening (or doing any activity for that matter), seek out a Chiropractor to obtain a diagnosis of the underlying cause.
    • I would think finding a proper brace that would allow you to kneel for any length of time would be difficult. And uncomfortable. But perhaps one that is similar to a tensor bandage would help ?
  • There are cushions available for use while gardening so you are not kneeling on the hard ground
    • I've seen some nice knee pads that can be used specifically for gardening. In fact, my mother has one that she uses. They are typically made out of strong foam and can be purchased at garden stores I believe.
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