The knee is one of the most complex joints in the human body. It is based between the ankle and the hip and it allows your leg to bend so there’s a lot going on around the knee which can make it susceptible to injury. At All Out Physiotherapy we are experts in knee pain and have been treating all kinds of knee pain for years at this point. To understand and diagnose knee injuries firstly we need to know the anatomy of the knee joint.
Anatomy
The thigh bone (femur), the shin bone (tibia) and the kneecap (patella) articulate through tibiofemoral ( shin and thigh bone meeting together) and patellofemoral joints (the kneecap and the thigh and shin bone meeting together). These three bones are covered in articular cartilage which is an extremely hard, smooth substance designed to decrease the friction forces (cartilage). The medial and lateral condyles of the femur articulate with the tibia to form tibiofemoral joint. Similarly, the anterior and distal part of the femur articulate with the patella to form patellofemoral joint. The tibiofemoral joint is the weight bearing joint of the knee. The patella lies in an indentation of the femur known as the intercondylar groove. This is basically just a fancy way of saying the knee is complex.
Meniscus
There are two menisci in the space between the femoral and tibial condyles. They are crescent-shaped lamellae, each with anterior and posterior horn, and are triangular in cross-section. The medial meniscus is larger than the lateral one due to the fact that the medial aspect of the knee is weight bearing more than the lateral which does mean it is more prone to injury.
Bursa
A bursa is synovial fluid filled sac, found between moving structures in a joint with the aim of reducing wear and tear on those structures. There are four bursae found in the knee joint.
- Suprapatellar bursa
- Prepatellar bursa
- Infrapatellar bursa
- Semimembranosus bursa
All of these can cause pain and discomfort.
Ligaments
There are 4 main ligaments which help to provide stability over the knee. The four are called:
- Anterior cruciate ligament
- Posterior cruciate ligament
- Medial collateral ligament
- Lateral collateral ligament
They join the knee from bone to bone and prevent it from moving.
Muscles
There are also 9 different muscles which cross the knee as well which include 3 from the hamstrings, the quads going through the patella tendon. Popliteus, sartorius, gracilis, tensor fascia latae and gastrocnemius (calf muscle). All of these muscles crossing the knee joint mean that an injury can cause significant pain and disability.
Different types of injuries
When it comes to injuries around the knee it is easier to start with the most common which is muscle sprains and ligament injuries. We can get something called popliteal cyst, better known as Baker’s cyst, is a fluid-filled swelling that is developed at the back of the knee which usually occurs when the knee is inflamed or swollen.
We can get bursitis which is just inflammation of the bursae around the knee.
Tendonitis which is just pathology involving the tendons around the knee which can cause damage and pain also .
Sinding Larsen and Osgood schlatters disease where the tendon which attaches into the bone of the quads or patella tendon start to pull on the bone causing bony growth and pain.
We can get osteoarthritis of the knee as well which is where the joint starts to wear causing pain and inflammation.
How can physio help?
So how does a physiotherapist look at the knee or more importantly how do we at All Out Physiotherapy look at the knee?
Well we don’t look at the knee in isolation we tend to see the knee as part of a chain with the hip and ankle. Usually there is something going on there as well which causes knee pain also.
We take a full and detailed assessment and listen to your concerns asking about how it happened, how long it has been and whether there have been previous injuries to the affected area or elsewhere. It is important that we know all the details about you and what is happening as this provides us with the ability to diagnose accurately and help you feel better about your knee.
Once we speak to you we assess the knee and the hip and ankle as well as seeing how you are moving around. This tells us where there are any weaknesses and from there using the All Out Method we are then able to treat and help you achieve your goals.
If you or anyone you know (could be your brother, sister, mum, dad, uncle, friends or extended family) have knee pain or have been struggling with knee pain then do not hesitate to get in contact with me through the website or if you want to discover how we can help you then book a free discovery session with us here and see how we can help your knee pain first hand.
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