Bone on bone knee pain is generally caused by excessive pressure on the joint due to the wearing away of cartilage.
The cartilage is here to prevent the bones from being damaged by rubbing together and causing pain and discomfort.
In the anatomy of a healthy knee, between the bones, you have a spongy tissue which is known as cartilage.
There are two different kinds of cartilage, hyline and articular. In the knee joint, the hyline cartilage is what makes up the meniscus.
This tissue is the natural shock absorber within the joint. There are two in each knee, one on the left side and one on the right.
The articular cartilage in comparison is what covers the surface of the bones. It is made up of smooth, viscous cartilage which allows for the joint to slide with minimal friction.
When the cartilage is worn away over time, resulting in degenerative joint disease, then it greatly decreases the shock-absorbing ability of the knee joint. This will result in more friction whenever the joint is utilized.
This is what begins the degenerative joint diseases, osteoarthritis. As the tissue slowly degrades it gets inflamed and more pressure is placed directly onto the bones.
Pain increases over time as the cartilage wears away and everyday activities, such as walking or even standing from a chair, can create extreme discomfort.
Eventually, this bone on bone contact can cause bone spurs, lumps of bony excess in the joint which can result in stiffness and discomfort.
To greater understand the implications of bone on bone knee pain we will look at;
- Exercises for bone on bone knees
- How walking effects bone on bone knees
- How you can minimize pain in bone on bone knees
- What physical therapy can assist with bone on bone knee pain
- What are the effects of bone on bone knee pain longterm
Exercises for Bone on Bone Knee Pain
1. Lying leg raises
Lie flat on your back on the floor or bed with your arms at your sides, toes up. Keep your leg straight while tightening your leg muscles, and slowly lift it several inches.
Tighten your stomach muscles to push your lower back down. Hold and count to 5, then lower your leg as slowly as possible.
Repeat, then switch to the other leg.
2. Lying hamstring stretch
Lie on the floor or bed with both legs bent. Slowly lift one leg, still bent, and bring your knee back toward your chest. Link your hands behind your thigh, not your knee, and straighten your leg.
Pull your straight leg back toward your head until you feel the stretch. Hold for 30 to 60 seconds, then slowly bend your knee and lower your leg back to the floor.
3. Half squat
Stand with your feet shoulder-distance apart and stretch your arms out in front of you. Slowly bend your knees until you’re in a half-sitting position. Hold on to a chair for balance, if necessary.
Keep your back straight and chest lifted, do not lean forward. With your feet flat on the floor, hold the position for 5 seconds, then slowly stand back up.
There should be no pain while performing this exercise.
4. One leg dip
Stand between two chairs and hold on to them for balance. Lift one leg about 12 inches and hold it out in front of you.
Slowly, keeping your back straight, bend the other leg and lower your body a few inches, as if you were about to sit in a chair. Don’t cross the lifted leg in front of the bent leg.
Hold for 5 seconds and straighten back up. Repeat and switch legs.
5. Leg stretch
Sit on the floor with both legs out straight. Stabilize yourself with your hands on either side of your hips, and keep your back straight.
Slowly bend one knee until it feels stretched, but not until it becomes painful.
Hold your leg in that position for 5 seconds, then slowly straighten your leg out as far as you can, again holding for 5 seconds.
Learn more: How to relieve bone-on-bone knee pain without surgery?
Frequently asked questions
Is walking good for bone on bone knees?
Low-impact exercise is great for bone on bone knee pain as it causes less stress on the weight-bearing joints. Walking is one low-impact exercise that you can easily incorporate into your routine!
There are many benefits to walking as a form of exercise if you suffer from osteoarthritis.
Keep cartilage healthy
Low-impact exercise, such as walking, can increase blood flow to the cartilage, helping it to get the nutrients that it needs to stay healthy. This assists to protect the bones in the joints.
The movement will also help to lubricate the joints, decreasing issues such as stiffness and pain, increasing your range of motion at the same time!
Strengthening your muscles surrounding the knee joint will allow the knee to handle more weight. This will help to better support and in turn protect the joints.
Taking some weight off the joint itself will also reduce pain and stiffness in the knee, allowing for easier motion.
Manage your weight
Being overweight or obese can put unnecessary stress on the knee joints, making arthritis much worse.
Walking burns calories and is an easily attainable form of exercise, losing weight at the same time can have a positive impact on your joint health.
What can be done for a knee that is bone on bone?
The treatment of osteoarthritis is to reduce pain and increase mobility in the joint. A combination of the following activities can help to manage joint pain;
Weight loss: Even losing a few pounds can significantly decrease knee pain from osteoarthritis.
Exercise: Strengthening the surrounding muscles will stabilize the joint and in turn reduce pain.
Stretching: Regular stretching will keep the knee mobile and flexible.
OTC anti-inflammatory drugs: For example, ibuprofen and naproxen sodium can help to relieve pain and swelling.
Corticosteroid injections: These injections into the knee can be helpful in severe cases, but assess the risks before attempting this method of treatment and discuss with your doctor. They include hyaluronic acid which acts as a lubricant for the joint and steroids are powerful anti-inflammatory drugs.
Alternative therapies: Topical creams, including capsaicin, are a great treatment for knee pain. You may also choose acupuncture or supplements of glucosamine or chondroitin are also good alternatives.
Braces or similar devices: There are two types of braces that you can use for osteoarthritis. ‘Unloader’ braces take weight away from the sides of the injured knee and ‘support’ braces provide much-needed support for the entire knee.
Physical therapies: This will give you the tools to help increase flexibility and strengthen the surrounding muscles of the joint. It will assist you to undertake daily activities with reduced pain.
Surgery: If all other treatments fail to correct the pain and swelling of bone on bone knee pain then surgery may be the only option, but should be seen as a last resort.
Can physical therapy help bone on bone knee?
Once you have been diagnosed with arthritis in the knee your physical therapist may suggest some exercises which will regain your movement and help you to minimize pain in the joint.
Range of motion exercises will assess your range of motion to ensure that the exercises are not beyond your ability.
It will also assist to increase range of motion over time. If you have poor range of motion then your osteoarthritis will get worse and cause additional stress on the joint.
Your range of motion will be compared with expected range of motion by your physical therapist. It will in time improve your ability to bend and straighten the leg, as well as flexibility.
Muscle-strengthening exercises will focus on the muscles which surround the joint, providing more support for your knee and will take pressure and stress off the joint. It is essential for rehabilitation of bone on bone knee pain.
It has been shown that those osteoarthritis sufferers who take part in strengthening programs have overall less pain in the affected joints and improved quality of life.
The quality of the cartilage that lines the bones, tissue around the joint, and associated muscles all have an impact on the health of the knee.
To preserve joint health, maintaining muscle strength is crucial.
This includes the quadriceps and hamstrings which run along the front and back of the thigh, as they help to control the motion of the knee, they also minimize the force applied to the joint.
What happens if your knee is bone on bone?
We have already learned how bone on bone knee pain begins, but what happens in the longterm when your cartilage has worn away?
When the cartilage is no longer intact to act as a barrier between the knees then ‘potholes’ may form in the bone where the bone is exposed. Here is where the bones rub together. Movement, when this occurs, can cause extreme pain.