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Why does my knee keep giving way?

I regularly treat people with knee injuries in my practice.

One of the common ailments people present with when complaining of their knee is that “my knee keeps giving way for no reason!” It often occurs unexpectedly and can result in a fall which can lead to injures such as fractured ribs or hips. One patient recently reported that his knee gave way whilst carrying two cups of tea upstairs. He fell backwards down the stairs. Thankfully, he didn’t break anything.


Causes for Knee buckling.

Ligament injury: Ligaments are bands of tough elastic tissue, which bind joints together and offer support to joints. An injury to a ligament of the knee, through a sport injury or fall and lead to instability within the joint and make your knee buckle

Cartilage tear: A cartilage tear can occur if you land heavily on your knee and twist as often seen in football players. Cartilage tears can also develop as we get older. This is probably due to the elasticity of the cartilage reducing with age.

Osteoarthritis: Oosteoarthritis is the natural aging process. In your knee the cartilage can become so thin that it no longer covers the ends of your bones. They start to rub against each other and eventually wear away. This can alter the shape of your joint, forcing your bones out of their normal position. In addition, the muscles that move your knee gradually weaken and become thin or wasted. This can make your knee unstable so that it gives way when you put weight on it.

Back problems: If you have a back problem, particularly with nerve pain down the leg, this can alter the nerve transmission to the muscles. If the muscles that move the knee don’t receive the signal clearly, there can be some misfiring resulting in your leg giving way or buckling.

What is the knee pain I get when I run?

It’s called Ilio-Tibial-Band Friction Syndrome (ITBFS) and it is quite common.

The knee is the most commonly injured body part in runners, making up 25% of all running injuries. That is quite a lot, considering around 50% of all runners can expect to sustain a running injury over a 12-month period.

Various structures around the knee can be affected; quite frequently, runners develop pain on the outside of the knee which can be caused by an irritation of the Ilio-Tibial-Band (ITB), a band of connective tissue that runs from the pelvis to the outside of the knee.  The injury is called Ilio-Tibial-Band Friction Syndrome (ITBFS).

So what exactly is ITBFS?

ITBFS is an overuse injury that generally builds up gradually, so it is not an acute strain or tear.  Repetitive friction of the tissue of the ITB rubbing over a bony prominence along the outer thigh can result in pain and localised inflammation at the friction site.

Initially, the pain may only occur during a run but it can quickly progress with each run, to the point where the pain may linger after a run and even basic activities such as bending and straightening of the knee or lying on the affected side at night can be sore.

What are the causes?

A range of factors can contribute to the development of ITBFS, for example:

  • Training errors, such as a sudden increase in training intensity
  • Hip muscle deficiencies, e.g. weak gluteal muscles and reduced core strength
  • Poor ankle and foot mechanics
  • Running inefficiencies, such as a reduced cadence (running too slow), which often results in overstriding. This can put an increased load on the knee, causing ITBFS over time, especially when running long distances.
  • Poor footwear

Identifying And Treating Pain From Nerve Tension

Do I have a trapped nerve?

We all know that your joints move and your muscles contract and stretch. But did you know that your nerve tissue also needs to move freely and unimpeded?

If your neural tissue is impeded then pain or restriction of your nerve movement is a common result.  The adverse neural tension can result in nerve pain and limited motion. This is what is commonly referred to as a trapped nerve.

Nerve tension is pain that occurs because a nerve is being compressed or stuck in its surrounding tissue which prevents it from moving within its tract like it normally does. This can happen for a variety of reasons.

Common examples of structures that can impede a nerve’s movement include:

  • Back Pain e.g. bulging disc
  • Piriformis Syndrome
  • Sciatica
  • Neck Pain
  • Shoulder Pain
  • Carpal Tunnel Syndrome
  • Tennis or Golfer’s Elbow
  • Pinched Nerve

Depending on the severity of the damage that is causing nerve tension, surgery may be necessary. However, in most cases nerve tension can be relieved through physical therapy such as osteopathy or physiotherapy, and prescribed stretching exercises.

Effective Therapy for Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness, and tingling, in the thumb, index finger, middle finger, and the thumb side of the ring fingers.

In severe cases, this can lead to pain travelling up to the neck and shoulder, often misleading health care professionals into thinking the radiating arm pain is actually coming from the neck rather than the wrist.

Your osteopath should be able to diagnose if you have this and recommend that you consult with your doctor for an appropriate onward referral if the symptoms are severe.