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

Case study ( 12403 views as of November 21, 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 "

  • Dr. John Wade MD, FRCPC
    Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 29 June 2023 Artus Health Centre
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
  • Mr. Jackson Sayers BSc.,
    Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 28 April 2023
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Dr. John Wade MD, FRCPC
      Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 15 December 2023 Artus Health Centre
      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.
    • Dr. John Wade MD, FRCPC
      Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 12 December 2023 Artus Health Centre
      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.
  • Mr. Jackson Sayers BSc.,
    Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 13 April 2022
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 03 May 2022
      If a foot or ankle joint is destroyed from an injury it can cause ongoing pain and is called post traumatic arthritis.
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 22 April 2022
      Scoliosis can occur in adolescents and in adults.
  • Mr. Jackson Sayers BSc.,
    Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 13 April 2022
    Rheumatoid Arthritis effects more men than women.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
  • Dr. Daniel Ngui BSc (P.T), MD, CFPC, FCFP
    Dr. Daniel Ngui BSc (P.T), MD, CFPC, FCFP Family Doctor, Vancouver, BC 16 September 2020 Fraser Street Medical | Family Physician Clinic | Vancouver
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 22 April 2022
      Diagnosis of scoliosis in adolescents is important in order to prevent future complications linked to the child's functioning and cosmetic appearance.
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 13 April 2022
      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.
  • Dr. Duncan Miller MD
    Dr. Duncan Miller MD Family Doctor, Vancouver, BC 13 December 2019 Broadway Plaza Family Practice Vancouver
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 22 April 2022
      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.
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 13 April 2022
      Anti-inflammatories such as Ibuprofen or Naproxen only treat the symptoms of RA and do not prevent long term damage to joints.
  • Dr. John Wade MD, FRCPC
    Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 07 December 2019 Artus Health Centre
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
  • Dr. John Wade MD, FRCPC
    Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 14 May 2019 Artus Health Centre
    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
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 13 April 2022
      If first line therapies fail, second line therapies are available and inclue oral medication, subcutaneous injections or IV infused therapies.
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 13 April 2022
      If first line therapies fail, second line therapies are available and inclue oral medication, subcutaneous injections or IV infused therapies.
  • K. Michael
    K. Michael 31 July 2015
    Why would her pain be worse if she slept with her knees touching ?
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
  • Dr. Bertrand Perey MD, FSRC
    Dr. Bertrand Perey MD, FSRC Orthopaedic Surgeon, New Westminster, BC 02 June 2015 Specialist Referral Clinic, Vancouver, BC
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 13 April 2022
      Second line therapies have revolutionized the treatment of Rheumatoid Arthritis.
    • K. Michael
      K. Michael 09 October 2015
      @Karmen MacAngus a physiotherapist can also help you strengthen your knee to reduce pain right ?
    • K. Michael
      K. Michael 11 August 2015
      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
  • T.Brown
    T.Brown 02 April 2015
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • K. Michael
      K. Michael 08 September 2015
      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
    • Dr. Bertrand Perey MD, FSRC
      Dr. Bertrand Perey MD, FSRC Orthopaedic Surgeon, New Westminster, BC 02 June 2015 Specialist Referral Clinic, Vancouver, BC
      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.
  • Joy
    Joy 01 April 2015
    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?
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • T.Brown
      T.Brown 02 April 2015
      I feel like there is a lot than can be done ahead of time to prevent knee pain as we age.
  • Gordon Bohlmann
    Gordon Bohlmann Physiotherapist, Vancouver, BC 10 February 2015 Marpole Physiotherapy Clinic
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Dr. Bertrand Perey MD, FSRC
      Dr. Bertrand Perey MD, FSRC Orthopaedic Surgeon, New Westminster, BC 02 June 2015 Specialist Referral Clinic, Vancouver, BC
      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.
  • Julianne Petersen
    Julianne Petersen Acupuncturist, Vancouver, BC 03 February 2015
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
  • Healthymama
    Healthymama 28 January 2015
    My ankles tend to hurt more than my knees while gardening. I will try adding more stretching to my day.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • T.Brown
      T.Brown 02 April 2015
      I wonder what stretches are good for knee pain, or for ankle pain?
  • Healthymama
    Healthymama 28 January 2015
    My ankles tend to hurt more than my knees while gardening. I will try adding more stretching to my day.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
  • ShirleyG
    ShirleyG 27 January 2015
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
  • Dee
    Dee 17 January 2015
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • ShirleyG
      ShirleyG 27 January 2015
      Knee pads can also reduce the discomfort I feel in my knees when working on the ground. I have found them very helpful.
  • Admin
    Admin 07 January 2015
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Michelle Kaarto, BScK, CSEP CEP
      Michelle Kaarto, BScK, CSEP CEP 08 January 2015
      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!
  • Yuan Lew, MSc MBA
    Yuan Lew, MSc MBA 11 December 2014
    If knee pain from gardening persists, it's best to decrease kneeling and switch to container gardening, where everything will be elevated.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Missy
      Missy 15 April 2015
      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.
  • Chantal Sayers
    Chantal Sayers Vancouver, BC 10 December 2014
    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.
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Michelle Kaarto, BScK, CSEP CEP
      Michelle Kaarto, BScK, CSEP CEP 11 December 2014
      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.
  • Bernadette van der Boom-Bebb
    Bernadette van der Boom-Bebb 06 December 2014
    Would a bracing support for the knee reduce the amount of pain one would experience while gardening?
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Dr. Crysta Serne BSc(Kin), DC
      Dr. Crysta Serne BSc(Kin), DC Chiropractor, Vancouver, BC 08 February 2015 Vitality Clinic, Downtown, Vancouver, BC
      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.
    • K. Michael
      K. Michael 06 December 2014
      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 ?
  • K. Michael
    K. Michael 30 November 2014
    There are cushions available for use while gardening so you are not kneeling on the hard ground
    Reply to: Treatment Options for Knee Pain While Gardening " Agnes a 52-year-old with medial-sided knee pain "
    • Chantal Sayers
      Chantal Sayers Vancouver, BC 10 December 2014
      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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