Sources of Knee Pain From Bending Over

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Understanding the Bending Knee Pain of Spokane's Workers, Drivers, and First Responders

Many workers in Spokane have jobs that require them to use their bodies a lot. Sometimes they can develop sharp pain in the knee whenever they squat or bend over. Maybe particular sports injuries marked the beginning of knee pain from bending. Regardless, it is one of those weird injuries where someone can appear to function quite normally... until they have to bend down... and then suddenly they seem crippled.

This article will explain why bending hurts your knee joint. It will briefly explain the different parts of the knee before talking about how different failures in the knee can cause different pain. A future post will discuss prevention and home remedies. Since this post is focusing on knee pain from bending in particular, we will not be covering bone fractures. It will also not cover knee pain from diseases, such as rheumatoid arthritis.

What Are the First Signs of Knee Problems?

The first signs that you might have knee problems include pain after you do physical activity, stiffness in the knee joint, and swelling. If you often feel knee pain, it’s a good idea to talk to a healthcare provider you trust.

If you are a worker and your knee hurts

Please call Guardian Occupational Health at 509-402-2880

Or inquire by following this link.

Image is not property of Guardian Occupational Health (image source)

Knee Anatomy and Function

Let's take a look at the amazing knee joint. At the risk of over-simplification, the bones provide the frame, the cartilage the cushioning, the ligaments the reinforced joints, the muscles are the power, and the tendons make everything move and work.

Knee Bones

The knee joint is made up of four main bones: the thigh bone (femur), the shin bone (tibia), the kneecap (patella) and the calfbone (fibula). Among other things, the bones of the knee provide as strong framework for all the other parts of the body to exist; no bones, and the muscles and ligaments just college like raw chicken in a bag. When the knee bones are injured, the pain is extreme and constant, not just when you bend over.

Knee Cartilage

Cartilage is a rubbery, smooth, flexible tissue that sits in between bones. It both absorbs the shock from big movements as well as acts as a cushion and lubricant to keep the hard bones from grating against one another. Without healthy cartilage, the bones would grind against each other. This would cause pain, swelling, and damage to the joint.

There are several kinds of cartilage in the human body, but the cartilage in the knee is mostly made up of something called "hyaline cartilage". It covers the ends of the femur, tibia, and the underside of the patella.

Knee Ligaments

A ligament is a strong, fibrous, elastic tissue that connects bones to one another. There are four main ligaments: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL).

They keep the different knee bones right where they should be in the natural, stabilized formation. They also control the range of motion and prevent your knee from twisting, bending, or extending the wrong ways. Finally, they make sure no bone takes on too much weight during load bearing activities, instead distributing the weight evenly throughout the knee.

Knee Tendons

Tendons are similar to ligaments, but instead of connecting bones to bones, they connect bones to muscles. Like the ligament, each is a collection of dense, cord-like fibers. When you tell your knee to "bend", your brain sends electrical signals to your muscle, which contracts. That contraction causes the tendon to pull or release, causing the entire leg to raise or lower.

There are at least eight major tendons that directly impact the use of the knee: 1) quadriceps tendon, hamstring tendons (3x), popliteal tendon, pes anserinus tendons, and iliotibial band (IT band). Often knee pain from bending can be caused by a single damaged tendon, while the rest of the tendons are perfectly fine.

Knee Muscles

As you can see in the two above diagram, while the majority of the knee is ligaments and tendons, several large leg muscles are connected to the knee. In one sense, everything else in the leg supports the muscles, which are the strength and power of the leg. On the other hand, the muscles are what keep everything upright and protect everything, meaning everything else in the knee relies on them.

The quadriceps, hamstrings, and calf muscle groups are all connected to the knee by ligaments. As a result, an injury or weakness to any of these muscles can result in (or manifest as) knee pain.

If you would like more information on knee tendons and muscles,

and how they can specifically cause injuries, check out this post.

We will be posting our own February 2025.

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Overuse Injuries that Cause Knee Pain from Bending Over

Even when management has reasonable expectations and workers follow safe practices, workers are still at risk of knee injury; the most common causes of knee pain stem from regular, repeated overuse. It's why even though athletes and workers have different activities, the result of an injury is the same.

The same movements over and over can cause inflammation and micro-tears. These are natural responses to effort and are not a significant problem... in small doses. If there is adequate time and an individual works the rest of their body as well, all is good! But years of repeated inflammation and tearing can strain muscles, fatigue tendons, and wear away cartilage.

At first, repetitive strain injuries may not feel very serious, just mild pain and stiffness. But the longer you avoid taking preventative steps, gradually pain will accompany even simple actions, like bending or getting out of a truck. In time, this may lead to severe pain and less ability to move. This change can affect both your work and personal life.

Here are few of the most common sources of knee pain from bending in workers:

Muscle Stiffness

Thankfully this is one of the most common reasons for knee pain from bending. Simply put, when quad muscles get too tight, rather than contracting and releasing, they just stay tight. This puts way more pressure on the tendons than normal.

The solution is simple: LOOSEN THEM UP. Stretch your quads, hit them with a massage gun, toll them out with a rolling pin if you have to. Target the part of the muscle close to the knee. Then do the rest of your stretching, and see if the pain has been relieved.

Patellar Tendonitis (Jumper’s Knee)

This is an overuse injury that causes inflammation of the patellar tendon, which connects the patella (kneecap) to the tibia (shinbone). It would feel like pain just below the kneecap, resulting in stiffness and swelling due to micro-tears in the tendon. In athletes, the tendon tears due to overuse of jumping or heavy squatting. In workers, the overuse is often due to or from weak quad or hamstrings muscles that put excessive pressure on the tendon, causing micro-tears and leading to inflammation and pain.If left untreated, patellar tendonitis can become chronic, potentially leading to more severe tendon damage.

Osteoarthritis (Wear-and-Tear Arthritis)

Also known as knee arthritis, osteoarthritis is when the cartilage in the knee degenerates to the point that bones start to come into contact with one another. In the early stages of osteoarthritis, the cartilage loses moisture and flexibility, making it more vulnerable to taking damage and less effective in absorbing shock. This, in turn, makes in inflamed, except hte enzymes the body releases that usually repair inflamed tissue actually accelerate the degenerative process.

The rubbing of bone against bone is quite painful, particularly if the cartilage if further impacted by bone spurs. Patients describe the feeling as a creaking or grinding in the knee that causes soreness, swelling, stiffness, and eventually significant pain and full immobility if untreated. OA is a progressive condition, meaning symptoms tend to worsen over time, but early intervention can help manage symptoms and maintain joint function.

Patellofemoral Pain Syndrome (PFPS)

More commonly known as "runner's knee" or "patellofemoral syndrom", is the notorious pain in the front of the knee, specifically where the kneecap (patella) meets the thighbone (femur). The pain occurs when the mechanics are out of wack: the bones are not aligned right and when they move they aren't moving along the body's natural tracks. This misalignment can prevent the bones and soft tissues from moving smoothly along their natural paths.

When PFPS is found in workers, several factors may contribute to the condition, often exacerbating one another:

• Alignment Issues: Poor alignment of the lower limbs (such as flat feet, overpronation, or knock knees) causes improper load distribution across the knee joint, leading to muscle overcompensation.

• Weak Quad and Lateral Muscles: Overtime this weakness results in imbalances in the muscles around the knees.

• Tightness: This causes overuse of the hip flexors and IT band (iliotibial band), which tightens them up, putting further strain on the patella.

• Improper Patellar Tracking: The patella now is way overworking, and begins to get out of the groove at the end of the femer, which wears down bone, ligament, and cartilage.

The result? Repeated movements lead to pain, irritation that eventually makes simple activities feel impossible... hell even SITTING for while will cause pain! on the knee joint. Thankfully, the pain and discomfort of PFPS can usually be managed effectively with appropriate treatment and preventive measures,

If you are a worker experiencing chronic knee pain from bending,

Please call Guardian Occupational Health at 509-402-2880

Or inquire by following this link.

Image is not property of Guardian Occupational Health (image source)

Knee Pain from Bending Due to Acute Injuries

Acute injuries are injuries happen suddenly from events like a fall, a direct hit, or not lifting correctly. These injuries can be mild, like a sprain, or severe, like a torn ligament or broken bone.In the workplace, not using the right lifting methods can cause acute knee injuries. If you lift with your back instead of your legs, twist while lifting, or try to carry something too heavy, you might stress your knee joints.

Signs of an acute knee injury include a sudden pop or tearing feeling in your knee. You may also feel strong pain, swelling, and find it hard to put weight on that leg. If you suddenly began to experienced pain bending your knees, then one of these conditions are the most likely cause:

Meniscus Tear

The meniscus is a C-shaped cartilage structure that cushions the femur (thigh bone_ and tibia (shinbone). It distributes weight across the joint, stabilizes movement, and absorbs shock. However, with repeated movement that causes irritation, the meniscus can degenerate, exposing it to sudden injury when the individual performs some rapid movement with their knee.

While meniscus degeneration can be managed, a full tear requires surgical intervention. So if you feel any pain, swelling, stiffness, weakness, or locking in joint line (bottom front of your knee), you need to find an occupational health facility to arrange for you to take an MRI to determine the extent of the damage.

Ligament Tear

This general term covers the the two knee ligaments most likely to tear: the Anterior Cruciate Ligament (ACL) and the posterior cruciate ligament (PCL). These injuries have been made famous by football and basketball and are caused by twisting or pivoting the knee unnaturally, or by taking direct, heavy, awkward blows to the knee.

Ligament tears often come with a notorious "popping sound" followed by severe pain and extreme swelling... so it is difficult to ignore and just work through it. But sometimes the knee pain from bending is paired with radiating pain from behind the knee as well, and the pain would intensify if you bent your knee.

Other Knee Injuries

The following knee injuries halt use of the knee, and are thus not covered in this blog post:

• Tendon rupture (Patellar Tendon and Quadriceps Tendon)

• Broken Knee Bones (Patella of Tibial Plateau Fracture)

• Full meniscus tear

• Dislocation (Patellar Dislocation)

• Arthritis

If you are a worker needing treatment options for a previous knee injury

Please call Guardian Occupational Health at 509-402-2880

Or inquire by following this link

Conclusion: Solutions for Knee Pain from Bending

Spokane's workers often do jobs that are hard on the body, like construction, manufacturing, and farming. Even if they do everything right, years on the site doing the same thing over and over can little by little reduce your knee's strength and capability. And even then, accidents happen; slipping, falling, or ramming can cause sudden tears and breaks to bones and ligaments.

Soon we will be posting about solutions to knee pain, but for now here is a quick rundown of home treatments you can begin right away:

• Manage your body weight... the less weight, the less stress on your knee.

• Go to physical therapy... lots of knee pain can be fixed with massaging out a tight knee, followed by loading in controlled movements.

• Strengthening exercises... don't do this until AFTER you go to physical therapy. But once you start, be diligent!

• Vary your exercise... even if you work on your feet, be sure to incorporate daily activities that work out your whole body.