The knee is the most frequently injured joint in athletes. Most injuries occur due to the extreme stress during twisting activities such as football, skiing, squash and any other sport that requires a large amount of body movement. Fortunately, the muscles surrounding the knee generally do a very good job of protecting the joint and most injuries are not too serious. However, as there are a multitude of things that can go wrong with the knee joint, any prolonged or acute pain,along with restricted movement should be checked out.
The Knee Joint:
The Knee Joint is made up of four bones: the thigh bone or femur, the two long bones of the lower leg: tibia and fibula, and patella, or knee-cap. The knee joint is a hinge joint, and although it may look like quite simple, it is one of the most complex joints in the body. It is also the largest joint in the body and more likely to be injured than any other.
As well as flexing and extending, the knee also has a small degree of rotation. This is perhaps one of the reasons why there are so many injuries to the knee. It is also one of the main joints to be affected by arthritis as we age. Taking care of our knees in the younger years may possibly help prevent future complications in our more mature years.
The Menisci (meniscus) are you shock absorbers. They sit between the femur and tibia to provide cushioning, lubrication, stability and load transmission. A meniscal tear can often occur whilst twisting the knee, leading to pain, swelling, locking or giving way. Operations are often performed to remove, or partially remove the damaged area of these structures. Surgeons often try to removal as little as possible as removing a complete meniscus can significantly reduce the shock absorbing ability of the knee.
The Cruciate Ligaments are found in the centre of the knee and are the major stabilising ligaments of the joint. You may have heard of these ligaments: the Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament (PCL). These ligaments prevent the femur and tibia sliding in opposite directions against each other. ACL tears are usually dramatic with immediate symptoms, whilst PCL tears are often less dramatic, but still result in problems.
A rupture of one of these ligaments often leads to significant swelling and instability, along with pain, discomfort and other complications. Surgery is often be performed to repair theses ligaments, but is not needed in every case. Suitable and persistent rehabilitation can have very beneficial effects in regaining stability and mobility over time.
There are four main ligaments that stabilise the knee joint; the cruciate ligaments, which we have spoken about, and the two collateral ligaments, which sit either side of the knee joint. The collateral ligaments stabilise the knee in a sideways direction, and you can probably guess, a sideways force is often the mechanism of injury. Most injuries occur to the inside (medial) ligament through direct trauma and include pain to the touch and stiffness. Fortunately, the majority of injuries to this ligament are not serious and heal quickly.
Osteoarthritis (OA) is a disease that causes the hyaline cartilage within a joint to break down; and the surrounding bone to thicken and restrict movement. OA commonly affects the hips, lower back, neck and knee joints. OA in the knee affects over 70,000 people each year in the UK; and most physicians believe a combination of factors including muscle weakness, obesity, injury and aging are responsible. Symptoms of OA include pain, stiffness and thickening around the joint, as well as reduced range of motion. Pain is commonly worse in the morning and during weight bearing activity.
Other problems which cause knee pain include: OA under the kneecap (patella), rheumatoid arthritis, muscle strains, bursitis, tendonitis, Osgood Schlatter’s disease, thrombosis, fracture and dislocation. Other areas that can refer pain to the knee include: OA of the hip joint and lower back, along with problems around the foot or ankle, such as overpronation (flat footed).
Stay Injury Free:
As the knee joint sits between two long levers, the upper and lower leg, it is extremely reliant upon the surrounding muscles and ligaments. The muscles at the front of the knee are the quadriceps and the muscles behind are the hamstrings. As well as aiding smooth movement, these muscles also help to support and protect the knee from damage. Therefore, exercise will help maintain the strength and condition of these muscles, whilst movement will lubricate the joint and the structures within it. Overall, regular exercise which will help maintain the integrity and longevity of the joint and hopefully minimise problems later on. Be kind to your knees.
How an Osteopath can help:
Osteopaths can often identify the cause of knee pain or discomfort and can help to reduce this discomfort. Your osteopath should also provide information on exercises to help with your condition, or possibly activities to avoid. Osteopathy is predominantly a ‘hands on’ treatment, although it may also involve ultrasound, acupuncture or TENS therapy. Should your condition require further investigation, an osteopath can write to your GP asking for further investigation.
“The weight of the world may be on your shoulders; but think what that’s doing to your knees!” JH.
For more information please contact Jason at: firstname.lastname@example.org or visit: www.jhoughtonosteopath.co.uk Tel: 01603 291925. M: 07736 449603. Thank you for reading.
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