There is a lot of myth, rumor, misconception and just plain bad information available on the topic of knee pain. Everyone has a story to share or opinion to give on what caused, cured or eases their particular knee pain. There's also a lot of scare mongering and doom and gloom surrounding long-standing degenerative knee problems with many people of the opinion that nothing can be done barring joint replacement surgery.

I am going to attempt to lay to bed some of this misinformation and give knee pain sufferers some more accurate and up-to-date information — and hopefully the knowledge that there is something they can do to help themselves.

Cartilage tears always require surgery: False

Cartilage tears are a common knee injury, usually caused by a twisting force applied to the joint while weight bearing. The degree of a cartilage tear can vary massively, from a minor "nick" to a full rupture and floating fragment.

Obviously, the severity of the tear has a big implication on the treatment options, but so too does the location of the tear. The menisci (two rings of cartilage in the knee) have a blood supply that is better on the outer peripherals, than it is in the middle. A tear to the outside of the ring, therefore has a better chance of healing, than a tear in the center.

The other factor to consider is the use of the knee. For a young active individual, especially someone who play sports, an arthroscopy may be a better option, than for someone older and more sedentary.

On the whole, this is a decision for the patient and the consultant to make together, once in possession of all of the information. Cartilage tears can heal themselves in time, so surgery may not always be necessary. It is also worth knowing that a surprisingly high proportion of people with no knee pain or history of injury display some degree of cartilage damage when their knees are scanned.

Arthritic knees are inherited and inevitable for some: False

While there is evidence in the form of family groups suffering with knee osteoarthritis (OA) which would suggest a genetic predisposition to developing OA, this is not entirely the case.

OA is a degenerative condition with a mechanical cause. The cartilage becomes worn due to a repeated loading or friction force placed upon it. Hypothetically, if an individual never put any weight or stress through their knees, they could not develop OA. This is regardless of their family history.

The reason OA appears to have a family link is more likely due to factors such as movement patterns, muscle imbalances and lifestyle or activity aspects, than it is something "in your genes" that directly causes the condition. For example, movement patterns such as overpronation at the foot and "knock knees" (increased knee adduction) can be passed through genetics and are common factors in OA development.

So, even if your parents, grandparents and everyone else in your family has suffered with OA, it does not mean that developing the condition is inevitable. Identification and correction of any contributing factors as early as possible will significantly reduce the likelihood of repeating the pattern.

Degenerative knee pain only occurs in older people: False

When we talk about degenerative knee pain, most people will instinctively think "arthritis" and "older people." However, what the term degenerative really means is a gradual wearing and breaking down of tissues within the joint. When talking about the knee, this usually means the cartilage (both hyaline and meniscus).

Degeneration can in fact occur in young people — as young as teenagers. While this is uncommon, it can develop after a traumatic injury and also as a result of biomechanical deviations that cause increased stress or friction on certain parts of the joint. The most common example of this is a condition called patellofemoral pain — also sometimes known as chondromalacia patellae where the cartilage lining the back of the knee cap is damaged due to repeated friction.

Women are more likely to suffer knee pain: True

Unfortunately, women are more prone to degenerative, gradual onset knee pain than men. The reason for this sits with the pelvis.

Women naturally have a wider pelvis to allow for childbirth. This means that when standing with the knees together, there is a larger angle from the hip down to the knee and so an increased pressure on certain areas of the joint. This is often compounded by common patterns of muscle imbalance that women often suffer after pregnancy and also when carrying young children on one hip.

All of these factors can result in the knee joint "falling inward" when walking, an increased stress on the medial joint and altered patella tracking.

Nothing can be done to help arthritic knees until surgery: False

Most definitely false! Knee joint replacement is a major surgery that should be a last resort. While results are usually good, they are not always a total success. A replacement joint will also only last 10-15 years and so having one too early may result in the need for a second replacement joint later in life.

Exercise programs can have a massive effect on pain from arthritic knee joints. I've seen this for myself. Strengthening the muscles surrounding the knee joints and the hips can be achieved with a simple exercise program performed at least three times a week.

Exercises such as clams, hip hikes, wall squats and VMO setting are my recommendations. A biomechanical assessment is also suggested to determine if the use of orthotic shoe inserts may also be of benefit in improving knee joint alignment.

Other treatments such as electrotherapies and heat treatments, soft tissues treatments and joint supports may also help to reduce symptoms.

Impacts from running are bad for the knee joints: False

Knee pain and injury is a common complaint among runners, so it is easy to see how this myth has developed. However, several studies are available that show no link between runners and an increased development of osteoarthritis or any other degenerative knee condition.

When runners do suffer knee injuries, they tend to be soft tissue related (e.g. IT band syndrome; patella tendinopathy; patellofemoral pain; pes anserine bursitis) and a result of faulty biomechanics from the feet or hips, rather than damage from the impact involved in running.

In fact, weight-bearing exercises actually strengthen the cartilage. Cells known as chondrocytes (found within the cartilage) sense an increased load and in turn increase the production of components required to repair and remodel the tissue.

So, running can cause knee injuries when abnormal joint stresses occur in a healthily functioning knee joint, but runners are at no greater risk of developing degenerative injury that anyone else — and in fact their cartilage may even be stronger.

Hopefully, this little piece will help dispel some of the widely-believed myths surrounding knee joint pain. The most important thing to take away from this is that knee pain is by no means the end of the line. There are many options available to those with knee pain, so no one should have to just grin and bear it.