The Knee Joint
The knee joint is made up of the shin bone and the hip bone that are held together by 4 main ligaments – the medial collateral ligament (MCL - on the inside of the knee), the lateral collateral ligament (LCL -the outside of the knee) and the two cruciate ligaments (ACL, PCL) on the inside of the knee. The ligaments are assisted with a joint capsule that surrounds the knee joint and helps keep it lubricated with a substance called synovial fluid.
At the ends of these two bones we have a cartilage structure to help with all the shock we put through the knee throughout our lives.
One of the most interesting parts of the knee is how the muscles cross over the joint. The hamstrings act like reigns for a horse, helping to steer and control the knee during movements. The calf muscles grab hold of the hip point and provide stability at the back of the knee and the quadriceps use the patella as a fulcrum to propel us forward during walking.
Some of the common conditions of the knee are meniscal tears (cartilage tears), ligament tears (ACL, PCL, MCL, LCL) or sprains, muscle tendon inflammation and arthritis.
I purposefully separated the patella from discussions around the knee. Although we discuss it within knee pain it is commonly misunderstood. The patella sits within a grove of the hip bone which acts as the patella’s tracks. The patella is like a train it rides up and down along the track and helps to produce the fulcrum for the quadricep muscles to do their job.
Sometimes the hip bone is not moving in synchrony and is either too slow or too fast. This means the tracks for the patella begin to change in angle throwing the train off course. It is known as patella maltracking and can lead to a patella dislocation or chondromalacia patellae.
The general solution has been to always look at the muscles that control the patella and try to change the way in which they are used and angle in which they pull. However this is trying to deal with the train i.e. the patella. But if the tracks for this train are always out of sync are we ever going to get back to the train riding over the tracks smoothly again? The answer is definitely a NO. We need to understand why the hip bone i.e. the tracks are not in line. This can be a structural problem or it could be do with your bio-mechanics and movement patterns.