The Knee Joint
The knee joint is a complex structure that is made up of 3 main bones: the shin bone (tibia), the thigh bone (femur), and the knee cap (patella). The knee joint keeps these bones in place and is vital for movement. It is also one of the most stressed joints in the body, leaving it more vulnerable to injury.
Read on
Each of the ends of the bones in the knees is covered in cartilage to protect the bones and let the joint move smoothly. Between the bones, there are 2 pieces of cartilage called menisci. These are the knee's shock absorbers and help cushion the joint from impact.
The knee joint is held together by ligaments, muscles and their tendons.
There are four main ligaments in the knee:
- The anterior cruciate ligament (ACL)
- The posterior cruciate ligament (PCL)
- The medial collateral ligament (MCL)
- The lateral collateral ligament (LCL)
The cruciate ligaments help limit sideways movement of the joint and support against unusual movement. The collateral ligaments control back-and-forth movement in the joint.
The primary action of the quad muscles at the front of the thigh, is to straighten the leg at the knee. These four strong muscles all connect to the top of the knee cap via a tendon (suprapatellar tendon). Overuse of this tendon – or local trauma – can cause inflammation of the tendon, called tendinitis, plus inflammation of the bursa under the tendon, called bursitis.
Another bursa is located under the tendon connecting the knee cap to the shin bone, the infrapatellar tendon. This area is prone to injury from any biomechanical misalignment. Inflammation of the infrapatellar bursa is also known as ‘clergyman’s knee’, due to excessive kneeling
Common Injuries In The Knee
The knees are frequently injured due to the stress of frequent starts, stops twists and turns applied to the joint during exercise.
Ligament Injuries
The most common injury in the knee is a ligament injury. This normally occurs from an accident, whether a slip, trip or fall. The ligaments’ main role is to stabilise the knee, so if the knee experiences a sudden twisting motion, a rapid change in direction, or an incorrect landing from a jump, this may cause a ligament injury. Sometimes you can hear a pop, or a snap followed by swelling and a loss of range of motion. It is important to see a physiotherapist/ sports therapist who can examine your knee to diagnose which ligament is damaged and how badly, so we can treat it sooner rather than later.
Meniscus damage
Another common injury is to the meniscus (shock absorbers) of the knee. This can happen from general aging where the meniscus has become weak and tears after an awkward turn during normal day to day activities. Or it can happen during sports where the knee twists and pivots. You will normally feel pain, stiffness, locking and a decreased range of motion.
Meniscus damage can take time to heal and can get worse over time if it isn’t treated properly by a physiotherapist/ sports therapist. It is crucial to have a proper assessment to determine the best course of action.
Overuse injuries are also common including ‘runners’ knee’ or osteoarthritis.
Runner’s knee
This injury is common in runners and cyclists. You often have a dull pain around the front of the knee and can feel like a rubbing, grinding, or clicking sound in the knee cap. Your physiotherapist/sports therapist can help treat runners’ knee through a combination of massage and acupuncture. This will help relieve some of the pain and break that viscous cycle.
Osteoarthritis
This is another wear and tear problem for the cartilage in the knee. It causes the cartilage to thin and the surfaces of the joint to become rougher, which means that the knee doesn’t move as smoothly as it should, causing it to feel painful and stiff. It may be aggravated by poor biomechanics, previous injuries, overuse, or the simple effect of years of living. The symptoms can be relieved through orthotics, exercise, and pain-relieving treatments.
Excess Weight
In normal walking the knees are in front of and behind the torso of the body, where most body weight resides. This means that your body weight exerts leverage on the knee, in exactly the same way a spanner does on a nut. That leverage creates four times your body weight on your knees, just from walking.
That leverage increases to a multiple of nine when we squat, so every extra stone puts nine extra stones on the knees.
If we carry excess weight, it will be the knees that will suffer the most
Looking after yourself and keeping healthy will most likely keep your knees healthy too. Getting help sooner rather than later will also help massively with recovery time and getting you back to your day-to-day pain-free activities.
If you are suffering with knee problems, you really need to see a physiotherapist / sports therapist to correctly diagnose and then provide the best treatment possible.