Knee tightness or stiffness in one or both knees is a common issue. Injuries, mechanical problems, or physical stressors on your knees like extra weight can cause tightness in your knee. Lack of flexibility or strength can also be contributing factors. Knee tightness is especially likely if you’ve had a knee injury or if you have a medical condition such as gout, arthritis, or an infection.
Here we talk about different causes of knee stiffness and the basics of what you can do to manage associated symptoms.
First, let’s talk about pain: It’s the body’s way of preventing you from making an injury worse. Since pain may limit movement, it can cause stiffness in the knees, as can any ongoing injury.
Knees become swollen when excess fluid builds up inside the knee due to an injury, overuse, or medical condition. This can cause sensations of tightness as well as pain. Swelling may be subtle, so you may not always notice it unless it’s a severe injury. Since the swelling may not be visible, you may feel this as stiffness in the knee.
Any type of swelling will cause limited movement since there’s less space in the knee. Irritation, internal bleeding, and injuries in the knee can lead to fluid buildup. Arthritis, gout, and tumors or cysts are conditions that can also cause swelling.
Pain and swelling are two mechanisms your body uses to protect itself. Together they can lead to stiffness in your knee. Next, let’s look at possible causes.
Ligament injuries can be caused by trauma or hyperextension of the knee. These injuries often happen in highly active people or while playing sports. If you damage one of the knee ligaments with a sprain, rupture, or tear, there may be internal bleeding. This results in swelling, stiffness, and limited movement.
What you can do for an injured knee ligament:
- Rest with your knee elevated above your heart and do regular ice treatments.
- Take pain relievers.
- Support and protect the injured ligaments by using a splint, brace, or crutches while you’re healing.
- Pursue physical therapy, rehabilitation, or surgery if your injury is severe enough to require it.
A meniscus injury occurs when you damage or tear the cartilage between the bones of the knee joint. This can happen when you put pressure on or rotate the knee, a common occurrence during sports that involve sudden turns and stops. A meniscus tear can also happen while doing something as simple as getting up too fast from a squat or using stairs. Degenerative conditions such as osteoarthritis can also cause meniscal tears.
A meniscus tear can cause pain and swelling. It may be difficult to move your knee over its full range of motion, and your knee may feel locked in a certain position. These restrictions on movement lead to stiffness in the knee.
What you can do for an injured meniscus:
- To treat a meniscus injury, rest with your leg elevated above your heart and do ice treatments several times per day.
- Take nonsteroidal anti-inflammatory drugs.
- Use a compression bandage to reduce inflammation.
- Avoid putting weight on your injured knee and use crutches if necessary.
- Pursue physical therapy or surgery if your situation requires it.
The most common types of knee surgery are:
- ACL Reconstruction
- Knee Arthroscopy
- Knee Ligament Repair
- Lateral Release
- Meniscus Repair or Transplant
- Plica Excision
- Tendon Repair
- Total Knee Replacement
Some knee stiffness is normal after surgery and can be improved with proper care. It’s important that you take the proper steps to fully heal and prevent knee tightness after surgery. Take time to build up the strength, stability, and flexibility of your knee by doing rehabilitation exercises. It may be a few weeks before you can return to your normal activities. It can take three to six months before you can return to physical work and activities.
Use your knee brace and crutches
If you’ve been fitted for a knee brace or had one recommended to you, make sure it fits properly. You should be able to insert two fingers under the strap. If it’s difficult to fit two fingers or if you can fit a third finger, you’ll need to adjust the tightness. Usually, you’ll wear the brace for two to six weeks.
Use crutches if they’ve been given and avoid putting any pressure on your knee until your doctor says it’s okay. Wait at least two weeks or until your doctor gives you the go-ahead before you bathe, swim, or use a hot tub. Follow a healthy diet and drink plenty of fluids. Eat high-fiber foods such as fresh fruits and vegetables to ensure you have regular bowel movements. This will help while you may not have the benefit of moving around as much as usual.
What you can do for knee stiffness after surgery:
- Do regular ice treatments for 10–20 minutes several times per day.
- Elevate your leg often during the first few days.
- Get enough rest and sleep throughout your recovery.
- Sleep with your knee raised.
- Follow the doctor’s recommendations.
Osteoarthritis and rheumatoid arthritis are two common types of arthritis that can lead to knee tightness. Osteoarthritis causes the cartilage in the knee to erode, leading to malalignment. Rheumatoid arthritis causes damage to the lining of the joints, which leads to inflammation. Both types of arthritis can lead to limited function and range of motion, deformity, and tightness.
Exercises that strengthen the surrounding muscle groups may help your range of motion and knee stability.
What you can do to manage arthritis stiffness:
- Try these exercises designed for knee arthritis mobility.
- Practice low-impact exercises, such as walking, water exercises, or an elliptical trainer, a few times per week.
- Take pain medication (naproxen, ibuprofen) 45 minutes before you exercise.
- Do a heat treatment before starting your workout and/or do an ice treatment when you finish.
Maintaining flexible muscles around your knee that are strong enough to support your body may help to alleviate or prevent tightness in the knee area. Strong legs, hips, and buttocks are thought to reduce knee tightness.
Research surrounding the benefits of strong leg muscles in relation to knee tightness varies. According to a 2010 study that looked at over 2,000 knees of men and women who had or were at risk for osteoarthritis, neither hamstring nor quadriceps strength predicted frequent knee symptoms such as pain, aching, and stiffness.
Still, having strong quadriceps may help to reduce the risk of knee problems, since stronger muscles can help to support the knee joint.
A 2014 study that was conducted over five years with 2,404 participants who also had or were at risk for osteoarthritis, found that weak quadriceps were associated with an increased risk of worsening knee pain in women but not in men. Researchers acknowledged that their longer study built on similar studies of shorter duration (2.5 years), and smaller group sizes, to support the link between leg muscle strength and knee pain. Their study suggests there may also be “sex-specific differences in risk factors for worsening knee pain.”
What you can do for your leg muscles:
- Try exercises designed to support healthy movement in your knees.
- Work on flexibility in your legs with leg stretches.
- Do stretches and yoga poses a few times per week that help to relieve tight hamstrings.
- Do hip abduction exercises to promote good movement patterns and stability.
- Consider regular sessions with a massage therapist.
- Talk to a physical therapist for a treatment plan that takes into account your specific needs.
It’s important that you see a doctor when seeking treatment. A doctor can determine the cause of your knee tightness, and together you can develop a treatment plan to resolve your condition. You may have a physical exam, imaging tests, or lab tests.
You may be referred to a doctor specializing in physical therapy or musculoskeletal and joint problems, or a rheumatologist. If you need surgery, you’ll be referred to an orthopedic surgeon.
When you’re doing knee stretches and exercises it’s important that you follow a few guidelines in order to get the maximum benefits. Here are a few tips:
- Always begin stretching after your muscles are warmed up.
- Instead of bouncing in a stretch, ease into the pose smoothly to prevent muscle tears. Hold the position for 15 to 60 seconds, or 5 to 10 deep breaths, and repeat 3 or 4 times.
- Do stretch a minimum of 2 to 3 times per week for at least 10 minutes per day. It’s better to do a short amount of stretching as often as possible rather than a longer session of stretching less frequently. Stretching often can help to increase your flexibility and range of motion.
- Use proper form and posture. It may help to practice in front of a mirror or have someone look at your alignment.
- Stretch both sides of your body equally.
- Don’t overstretch or force tightened muscles to stretch farther than they’re ready to.
- Go to your own edge or point of sensation without overdoing it or causing pain.
Precision Pain Care and Rehabilitation has two convenient locations in Richmond Hill – Queens and New Hyde Park – Long Island. Call the Richmond Hill office at (718) 215-1888, or (516) 419-4480 for Long Island office, to arrange an appointment with our Interventional Pain Management Specialist, Dr. Jeffrey Chacko.