Dr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.
Given the complex structure of the knee and many potential causes of knee pain and injury, medical professionals classify injuries based on the location and/or structure of the knee involved. For instance, knee ligament injuries may include an ACL injury, posterolateral corner injury (PLC) or superior tibiofibular joint sprain. In turn, a meniscus tear or discoid meniscus injury is related to the cartilaginous tissue of the meniscus. Yet, a number of sports injuries may be labeled as kneecap pain such as chondromalacia patella, fat pad syndrome, patella dislocation, patellofemoral pain syndrome, Osgood Schlatter’s, and Sinding Larsen Johansson syndrome, which are pediatric knee conditions. Even so, arthritis (osteoarthritis and rheumatoid arthritis), tendonitis and bursitis are common inflammatory conditions of the knee.
While the following muscular knee injuries are often sustained during athletic activities, some can be considered overuse injuries:
- Corked thigh
- Hamstring strain
- Thigh strain
- ITB (iliotibial band) syndrome
- Popliteus syndrome
- DOMS (delayed onset muscle soreness)
Other conditions that correlate with knee pain and injury are:
- Runner’s knee
- Plica syndrome
- Stress fracture
- Repeated use injury
- Restless leg syndrome
Causes and Symptoms of Knee Pain and Injury
Generally speaking, knee pain and injuries occur as a result of an acute, sudden injury, such as a broken bone, torn ligament, strain or meniscus tear. Yet, preexisting conditions such as arthritis or infection may also cause knee pain, as well as chronic conditions including patellar syndrome, tendonitis and bursitis.
Acute Knee Injuries
- Fracture – occurs as a result of direct trauma, accident or sudden event. With noticeable damage to the bony structure of the knee, individuals experience immediate pain and impaired functioning of the knee.
- Ligament injury – as the most common ligament knee injury, a torn anterior cruciate ligament (ACL) ligament is usually the result of a sports-related trauma involving a sudden change in direction or movement.
- Meniscus injury – as a cartilage “shock absorber” located between the bones in the knee, the meniscus often becomes damaged when it is twisted.
- Dislocation injury – mostly occurs due to high velocity impact or trauma during a motor-vehicle accident, and the knee can become dislocated. While this is a very painful injury, it is also a serious injury, as it may impair blood flow to the leg.
Medical Conditions Related to Knee Pain and Injury
- Rheumatoid arthritis – affecting any joint in the body, this autoimmune condition is marked by inflammation and can cause painful swelling and impaired knee function.
- Gout – though present in the big toe, gout is a form of arthritis that can affect the knee.
- Infectious arthritis – also known as septic arthritis, this is an infection in the knee joint, accompanied by pain, swelling and fever.
Overuse Conditions Related to Knee Pain and Injury
- Patellar tendinitis – common in runners and cyclists, this overuse injury occurs when the tendons connecting the patella to the bone of the lower leg become inflamed and cause pain.
- Osteoarthritis – due to age and joint use, osteoarthritis occurs due to a breakdown in cartilage.
Depending on the exact cause of an individual’s knee condition or injury, they can experience a wide range of symptoms. This may include mild to moderate pain and swelling, inability to bend the knee, inability to walk or apply weight to the knee and significant pain.
Treatment and Rehabilitation for Knee Pain and Injuries
Effective treatment and rehabilitation of knee pain and injuries is best accomplished through a multidisciplinary approach, in which multiple body systems and conditions are analyzed. With expertise across many disciplines and conditions, physiatrists are best positioned to identify and develop treatment protocols to relieve pain and restore mobility.
Early treatment of knee pain and injury will likely involve rest, ice therapy, compression (bracing), elevation or even steroid injections, as physiatrists work to manage pain and control inflammation and/or bleeding. Patients should know that early intervention for acute knee pain and injury maximizes healing, improves scar tissue quality, strengthens performance and quickens recovery and return to sports or activities. Even so, physiatrists incorporate a number of conservative, nonsurgical treatment modalities for pain and injuries at every stage.
The following treatment and rehabilitation options provide pain relief, improved mobility and important diagnostic information that is used to further treatment:
- Acupuncture, dry needling
- Ice therapy
- TENS machine
- Electrical stimulation
- Low level laser therapy
- Heat (sub acute, chronic injuries)
- Medication (NSAIDS)
- Supportive taping/bracing
Rehabilitation Exercises for Knee Pain and Injury
- Closed kinetic chain exercises – similar to daily activities, these exercises utilize multiple joints and patients use their own body weight
- Foot posture correction exercises
- Gait analysis and correction
- Balance enhancement exercises – aimed at assessing and restoring core stability, hip and leg muscle control. This is also while including the vestibular and visual systems
- Proprioception exercises – aimed at helping patients generate an awareness of the brain, motor and sensory connection in relation to sports and daily activities
- Sports-specific exercises – aimed at improving agility and response time and will emphasize warm-up, flexibility, posture and positioning
- Strength and stretching exercises
- Yoga and mind-body connection
- Patient education and biomechanics training
At the Howard Liss, M.D. Rehabilitation Institute in Tenafly, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.
To schedule your appointment, contact the Howard Liss, M.D. Rehabilitation Institute today.