Is Your Knee Pain When Kneeling A Sign Of Something Serious?

Knee pain when kneeling often presents as sharp or aching discomfort, which can limit daily activities. It may result from minor injuries or overuse, but sometimes, it signals a more severe or chronic condition like arthritis.

Painkillers are frequently used as an initial approach to address knee pain. However, relying on these medications may not address the underlying issue and can lead to side effects. Additionally, painkillers can mask symptoms, potentially causing delays in diagnosis and treatment. This delay can cause damage to progress, increasing the likelihood of surgery being required.

The Regenexx approach utilizes interventional orthobiologics to address the root causes of pain and promote the body’s natural healing process. This approach provides an alternative path to recovery that reduces the need for medications or surgery.

Understanding Kneeling And Knee Discomfort

When kneeling, the body’s weight places pressure on the knee, stressing the joint. This mechanical pressure compresses knee tissues, including ligaments, cartilage, and nerves. The added pressure can cause pain, especially if the tissues are inflamed, irritated, or damaged by a condition like arthritis.

Knee pain when kneeling can occur at different stages: 

• While kneeling down
• After kneeling for a period
• Upon rising from kneeling
• Later, after having kneeled for an extended period

The pain associated with kneeling can range from a mild or dull ache to a sharp or burning sensation. Continuous or repetitive kneeling can lead to further inflammation and discomfort.

What Triggers Sharp Pain In The Knee When Kneeling?

Pain while kneeling occurs when damaged or inflamed components of the knee become compressed. Damage and inflammation can occur due to:

• Injury. Sudden impacts or twisting movements can damage knee ligaments or cartilage. These injuries are common in sports like soccer or basketball and can cause pain upon kneeling. Acute pain is often felt as a sharp or burning sensation.
• Overuse. Repetitive activities like kneeling or squatting can irritate or inflame joint components. This may lead to knee conditions like bursitis or tendinitis, resulting in knee pain over time. One study also highlights “reasonably good evidence” that physical activities involving kneeling can cause or aggravate knee osteoarthritis. This risk increases in gardening, floor tiling, paving, roofing, and mining.
• Fracture. A direct blow, accident, or fall can fracture knee bones, such as the kneecap. This can lead to severe pain, particularly when pressure is applied while kneeling.
• Dislocation. Dislocations occur when the joint bones slide out of position. This shift can also pull on surrounding structures, leading to cartilage or ligament tears. Dislocations can happen due to direct impact or sudden movements such as swift direction changes. These injuries are common in sports activities like football or soccer.

Underlying Medical Conditions Behind Knee Pain

Knee pain when kneeling can be due to minor or temporary issues. However, sometimes, it can indicate underlying medical conditions. These need to be properly treated to resolve inflammation and pain. These include:

Patellofemoral Syndrome Or Runner’s Knee

Patellofemoral syndrome, or runner’s knee, refers to pain experienced around the kneecap (patella). It happens due to overuse, muscle imbalance, or kneecap misalignment. Causes include activities involving repetitive and forceful knee movements, like running and jumping. 

Over time, these activities irritate joint components, accelerate cartilage wear, and cause inflammation. Kneeling intensifies pain by increasing pressure and friction on the inflamed knee components. 

One study linked extensive kneeling to the worsening of patellofemoral cartilage damage, which can result in patellofemoral osteoarthritis. 

Knee Arthritis

Arthritis is a chronic joint condition that causes inflammation, pain, and reduced mobility. Arthritis diminishes the knee’s cushioning, causing bones to rub together. It also causes inflammation, pain, and swelling. These complications make kneeling or knee bending difficult and painful. 

Over time, arthritis can also lead to significant movement limitations and disability. Osteoarthritis is the most common type of arthritis among aging adults and is one of the leading causes of disability worldwide. 

A 2020 research paper shows that some of the movements in which people with OA experienced “complete difficulty” most often include:

• Kneeling
• Maintaining kneeling
• Squatting 
• Maintaining squatting

Baker’s Cyst

A Baker’s cyst is a fluid-filled bump that develops behind the knee, often due to other knee problems like arthritis and cartilage tear. Symptoms include sharp pain behind the knee that worsens when bending or straightening the joint.

Kneeling can also squeeze the fluid and compress nearby tissues, causing sharp pain. 

PCL Tear

A PCL tear affects the posterior cruciate ligament. This ligament is located at the back of the knee and controls backward movements of the shin. PCL tears often result from direct impacts, such as car accidents or falling on a bent knee.

Kneeling with a PCL tear is painful because this position places direct pressure on the ligament. The knee can also feel unstable or give out, adding to the pain and making kneeling difficult.

Recognizing Factors That Increase Risks Of Knee Conditions

Risk factors that increase the likelihood of experiencing knee pain when kneeling include:

• Age. With aging, the cartilage in the knees wears away. This increases the risk of arthritis and joint pain, with symptoms intensifying when kneeling. 
• Previous Injuries. Old injuries, such as fractures or ligament tears, can alter knee movement. These changes can cause residual pain and affect load distribution during movement. This may irritate knee components like surrounding ligaments, cartilage, and nerves. It also increases the risk of recurring injuries.
• Obesity. Extra weight puts more pressure on the knees. This leads to pain and potential damage. It also raises the risk of osteoarthritis and other chronic knee issues linked to chronic knee pain. 
• Activities that predispose the knee to pain. Certain sports, daily activities, and jobs can stress the knee. These include gardening and sports that involve sudden changes of direction, like soccer. One study found a higher risk of knee pain among professions like floor layers, painters, parquet layers, roofers, and tilers.
  
• Lack of conditioning and weak muscles: When the muscles around the knee are not well-conditioned, they are less capable of supporting and stabilizing the knee joint. This weakness makes the knee more prone to injuries, especially during activities that stress the joint. Weak muscles also fail to absorb shock during movement. This adds extra stress on the knee, leading to faster wear and tear of the cartilage.

• Poor posture: Posture affects how your body distributes weight and pressure. Poor posture can alter the alignment and movement of the knee. Over time, this misalignment can strain the knee and speed up the loss of cushioning cartilage, leading to pain.

• Improper footwear: Wearing shoes that do not provide proper support can change the gait, or how a person walks and stands. This can cause misalignments in the knee, leading to uneven pressure on the joint and increasing the risk of cartilage degeneration and pain. 

• Congenital features: Some people are born with traits like thinner cartilage or a different knee structure, which can make their knees more vulnerable to damage. These congenital features can increase the risk of developing arthritis or other degenerative knee conditions, leading to pain when the knee is under stress, such as during kneeling.

When To Seek Medical Attention

Knee pain after a minor injury or impact may resolve on its own with at-home care and rest. However, medical attention may be needed if discomfort when kneeling persists, worsens, or significantly limits daily activities. 

Persistent or worsening pain could indicate underlying chronic conditions or severe injury. Early diagnosis and treatment are crucial to prevent long-term damage.

How Are Knee Problems Diagnosed?

Physicians use a combination of methods to diagnose knee problems accurately:

• Medical history. A physician reviews your symptoms, activities, professional history, and medical conditions. This helps identify or rule out possible causes.
• Physical examination. Physicians use various tests to identify pain points and assess the range of motion. 
• Imaging tests. X-rays, MRI, or ultrasound tests help view internal structures. They help identify fractures, ligament tears, or the presence and extent of arthritis. 
• Arthroscopy. This surgical intervention involves inserting a small camera into the knee through an incision. It helps visualize internal structures and enables the surgeon to perform minor interventions, like removing inflamed tissue debris. 

Conventional Treatment Options

Common treatment options for knee pain while kneeling include: 

• R.I.C.E Method. The RICE method helps reduce pain and swelling after an injury. It includes resting to prevent further injury, icing, compression to reduce swelling, and elevation for fluid drainage. One of the main downsides of the RICE method lies in the fact that this approach reduces blood flow to the injured area. One study shows that this can slow down healing and increase recovery times. 
• Medications. Common medications include:
  • Nonsteroidal anti-inflammatory drugs. NSAIDs temporarily ease pain and improve mobility by blocking inflammatory chemicals. Despite their effectiveness for short-term relief, NSAIDs don’t address the root cause of inflammation. Prolonged use also causes side effects like increased risks of stroke, heart attack, kidney disease, and stomach ulcers. 
  • Corticosteroid injections. These are the synthetic versions of the cortisol hormone. They help reduce inflammation and pain more effectively. However, prolonged use may lead to cartilage loss and disrupt normal cortisol production.
• Surgery. Surgical interventions depend on what causes pain upon kneeling. They may include:
  • Partial knee replacement surgery. This surgery involves replacing only the damaged part of the knee. This is usually either the inner, outer, or kneecap portion. Removed parts are replaced with prosthetics. 
  • Total knee replacement. This surgery involves replacing the entire knee joint with artificial components made of metal and plastic. 
  • Arthroscopic Surgery. This procedure uses a small camera to diagnose and treat joint issues. Surgeons insert an arthroscope into the knee, guiding repairs of damaged tissues. 

Every surgical intervention carries risks, including blood clots, infections, and damage to nearby joint components. Additionally, outcomes don’t always meet expectations. 

One study found that up to 95% of patients expect to be able to kneel after total knee replacement. However, another research paper shows that 40-68% of patients experience difficulty kneeling or cannot kneel after surgery. Additionally, a 2017 study shows 15 to 30% of patients don’t return to work after undergoing total knee replacement surgery. 

A Unique Approach To Interpreting Pain Signals

Diagnosing the real causes of knee pain when kneeling can be challenging because this symptom can point to several conditions. 

To improve diagnostic accuracy and guide informed treatment decisions, physicians in the licensed Regenexx network may use SANS evaluation to provide an analysis of joint health. 

During evaluation, the physician will review existing MRIs and scans and examine your body in motion. This specialized evaluation method may also use advanced diagnostic tools such as ultrasound to determine the causes of pain. 

The Regenexx Approach To Combat Debilitating Knee Pain

The body has a natural ability to heal its own tissues, but this ability can diminish due to injury or aging. The Regenexx approach utilizes interventional orthobiologics to support the body’s natural healing process, reducing the need for prescription medication and surgery.

After a thorough evaluation, physicians in the licensed Regenexx network create personalized treatment plans around your condition. These plans may include one or more of the orthobiologics below. 

Regenexx-SD Injectate

Procedures using Regenexx-SD injectate include a patented protocol that utilizes Bone Marrow Concentrate (BMC) which contains the patient’s own mesenchymal stem cells. The cell processing for a Regenexx-SD injectate routinely achieves 20x concentration— far above what non-Regenexx cell processing can achieve.

Regenexx-SCP Injectate

Procedures using Regenexx-SCP injectate represent a supercharged version of platelet-rich plasma (PRP). In this process, blood is drawn, then processed to isolate the platelets and growth factors. The growth factors are then purified, concentrated, and injected into the knee area using imaging guidance for precision. Regenexx-SCP injectate provides a higher concentration of growth factors compared to typical PRP procedures.

Regenexx-PL Injectate

Procedures using Regenexx-PL injectate are a highly specialized derivative of platelet-rich plasma (PRP) with a faster and more concentrated release of growth factors compared to typical PRP.  The PL injectate is often combined with other orthobiologics such as PRP and bone marrow concentrate.

Address Knee Pain And Discomfort When Kneeling

Regenexx’s proprietary methods help reduce pain and improve mobility by supporting the body’s natural ability to heal, reducing the need for surgery or prescription drugs. Consult with a physician in the licensed Regenexx network to determine if this approach is right for managing your knee pain. A physician can provide personalized treatment plans for your condition.