Written for YOU Massage & Therapy Centre Southampton by Physiotherapist Phil Coleman
The knee joint is a modified hinge joint, meaning that it flexes (bends) and extends (straightens) but also has a small degree of rotation. Its stability is largely provided by ligaments such as the anterior and posterior cruciate ligaments (ACL and PCL) and the medial and lateral ligaments. The knee’s movements are provided mainly by the quadriceps at the front of the thigh (knee extensors) and the hamstrings and calf complex behind (knee flexors). The knees also have soft cartilage pads (the menisci) shaped like moon crescents on the medial and lateral aspect. These act as shock absorbs and give knees greater stability.
Knees tend to be happy in straight line activities such as running but are often injured in rapid rotational movements when the foot is fixed on the ground. Hence the all too common incidences of ACL ruptures and meniscus tears in football. These often require surgery and rehabilitation – ACL ruptures usually lead to 9 months out of sport. Contrary to popular belief, running does not wear out the knee joints but appears to thicken and strengthen the cartilage, hence runners tend to have less risk of osteoarthritis than non-runners.
A common knee problem seen in physiotherapy clinics is patellofemoral pain syndrome (PFPS) – pain around and behind the patella (knee cap). There may also be crackling and grating noises (crepitus) which can be alarming but is rarely serious. Pain is often elicited walking downstairs, squatting or sitting too long. There is usually an insidious onset and the cause may be from relative weakness in the hips or knee muscles or alignment issues which the physiotherapist would address.
Another common injury is iliotibial band (ITB) syndrome where pain is felt on the outside of the knee with activities such as running or cycling. The ITB is a band of connective tissue (fascia) which attaches to the lateral hip muscles and finishes below the knee. Its functions are to stabilise the knee and aid extension. It can often be tight but cannot be stretched so focus is usually spent around the hip muscles which can be stretched and strengthened. Running technique and training programmes may also be addressed.
For a Physiotherapy appointment in Southampton with Phil Coleman call us on 02380639747