CNY Orthopedic Sports Medicine, PC: Bodyzone: Knee

Body Zone: Knee

Overview
To judge by the number of professions and activities that have knee complaints named after them - housemaid's knee, runner's knee, clergyman's knee - this large weight-bearing joint can be a pain. (Note for trivia buffs: Latin for knee is genu, hence the verb to genuflect or bend the knees as in worship or prayer). Although the knee has the range of motion of a rotating hinge, it can also lock into a rigid structure, allowing us to form a straight leg.

This ability to walk upright (bipedalism) led to a dramatic shift of gravitational forces and extra loading on the knee. Even simple, everyday activities like walking downstairs and gardening (gardener's knee?) can be a potential source of injury. During high intensity athletic activity - like lifting weights from a bent position - the load can reach six times the body weight. And in fast motion sports like football, where sudden changes of direction are common, the rotational forces may be more than a knee can bear.


Injuries
Because the knee is so often jarred during running and jumping movements, the cartilage and menisci are very prone to wear and tear. Tendons are also susceptible to repetitive motion injuries. With overuse, they can stretch and become inflamed (tendinitis).

The ligaments of the knee are possibly the most under-reinforced elements of the body. These structures, particularly the anterior cruciate ligament (ACL) are frequently injured during sports activities. Twisting motions, in which the upper leg rotates while the lower leg is fixed or planted, can result in torn ligaments.

Anterior Cruciate Ligament Tear
Chondromalacia Patella
Cartilage Defects
Bursitis
Medial Collateral Ligament Injury
Total Knee Replacement
Patella Malalignment/Dislocation
Lateral Collateral Ligament Injury
Posterior Cruciate Ligament Tear
Patellar Tendonitis
Meniscal Tear


Harmful Behaviors
  • Recurring microtrauma. These small but cumulative injuries can cause serious damage to the knee.
  • Tackles in football, impacts against hard surfaces, minor twists from skiing, all add up to larger problems over time.
  • Poor technique. Whether walking, standing, bending, or weightlifting, unnatural movements of the knee can cause wear problems on the joint.
  • Over-work. Some people are more prone to degenerative conditions that wear away cartilage and other protective structures.


  • Good Practices
  • Keep strong. Well-developed and conditioned muscles ease stress on the joint, help the knee cap track properly, and add protective mass.
  • Keep flexible. Good flexibility in the knee allows ligaments to move without tearing or rupturing.
  • Don't over-extend. Work within your limits and listen to those sounds and sensations in the knee. Often, they're just the harmless movement of tendons over bones, but repeated snaps, pops, or grinding sensations may mean harm is being done. And persistent pain is usually a reliable indicator that the knee is injured.


  • General Conditioning
    More so than most joints in the body, the condition of the knee is affected by the surrounding muscles and ligaments. A strong and long-lasting knee is usually the result of thorough conditioning and physical activity; the best routines will target the entire region of the knee, including the front quadriceps, the rear hamstrings, and the calf muscles in the lower leg.

    Training and exercise routines should recognize some of the inherent weaknesses of the knee. The intensity or duration of training should increase gradually, building-up by no more than 10% per week. Activities or exercises that place extreme pressure on the underside of the kneecap (deep knee bends for example) should be carefully employed. Appropriate shoes that help stabilize and cushion the knee, proper stretching and warm-up routines are easy ways to reduce injuries while exercising.



    Anatomy
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    The basic problem with the knee is this: how to sit the femur (or thigh) bone on top of the tibia (shinbone), maintain flexibility, yet create stability and endurance. It's a bit like trying to balance one chopstick on top of another. Obviously, you need some kind of cushion between the chopsticks, and strings or tapes to bind them together. This is essentially what Mother Nature has created. Between the femur and tibia are two pads of shock-absorbing tissue called menisci (plural of meniscus), which protect the surfaces and add stability and shock absorption. The ends of the bones are covered with a smooth, resilient surface called articular cartilage that allows for fluid movement. Strong vertical bands of elastic tissue called ligaments lash the bones together. The final touch is the patella (or kneecap).

    On the front of the femur, there is a slight groove (the patellofemoral groove) that guides the movement of the kneecap. The kneecap is not only positioned by this groove, but also by the surrounding quadriceps muscles, and the patellar and quadriceps tendons. As the quadriceps contract, they pull the attached tendon, sliding the kneecap, and extending the lower leg. Fluid filled sacs (bursae) decrease the friction between two surfaces that move in relationship to one another, such as bones, tendons and muscles.

    The Body in Motion
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    Product Considerations
    Knee: Compression Sleeves
    Knee compression sleeves give added support, increasing stability and helping to reduce swelling in an injured knee. Patients that have light sprains may be directed to use a compression sleeve during the early stages of rehabilitation. Other patients that have ongoing knee problems or chronic conditions may be recommended to use a sleeve on a daily basis. These sleeves are less restricting than most other knee supports and can be worn under loose fitting clothing.

    Knee compression sleeves can be used to treat:

  • Light swelling.
  • Light knee strains.
  • Chronic inflammation.
  • Degenerative joint disease.

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