The Knee

By Senior Physiotherapist Rob Barker.

Knee’s can be very tricky, in that when they are sore and irritable it is hard not to notice your discomfort! Knee pain can develop over time or it can be acute. Lets learn more about the structures in the knee.

Ligaments

There are four main ligaments in the knee – the famous anterior cruciate ligament (ACL), lesser known posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). These structure act like anchors for the bone and stop movements they are very strong rope like structures which can take great forces.

Meniscus

The menisci of the knee have an important role in:

• load-bearing
• shock absorption within the joint.
• function as secondary stabilisers,
• have a proprioceptive role
• aid the lubrication and nutrition of the articular cartilage.

Meniscal tears are the most common injury of the knee. They may occur in acute knee injuries in younger patients, or as part of a degenerative process in older individuals. Medial meniscal tears occur more frequently than tears of the lateral meniscus. This is because on the lateral side, the meniscus carries 70% of the load in the lateral compartment, whereas the medial meniscus carries only 50% of that of its compartment.

Articular Cartilage – (Boney)

A common type of knee injury is damage to the articular cartilage, the smooth substance that covers the ends of the bones and keeps them from rubbing together as you move. Cartilage, or chondral, damage is known as a lesion and can range from a soft spot on the cartilage (Grade I lesion) or a small tear in the top layer to an extensive tear that extends all the way to the bone (Grade IV or “full-thickness” lesion).

Knees can suffer from “wear and tear” problems or traumatic (caused by an injury such as falling on the knee, jumping down, or rapidly changing direction while playing a sport).

These change  the normal joint function and lead to pain, inflammation and limited mobility.

Patellofemoral pain

Patellofemoral pain typically presents as pain on or around the knee cap, it can also be sharp and hurt with activities like lunges or steps. This can be due to some kind of dysfunction in how the knee cap is sliding within the trochlear groove during certain movements and how the muscles are working together.

The wonderful thing about knee pain is that Physiotherapy can provide lots of different management techniques with excellent effect such as:

• muscle release
• dry needling and hands on treatment
• taping for temporary relief of pain
• home exercises
• clinical pilates
• strength based work

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