The knee is the largest and one of the most complex joints of the body. It is designed for mobility and stability. And because the joint has great functional demands imposed on it by weight-bearing stress, such as walking, running and jumping, the knee suffers derangement of its function and stability more frequently than any other joint.
Q: What are the main components of the knee joint?
A: There are 4 bones which make up the knee joint: the long bone of the thigh, the femur; the knee cap, the patella; the lower leg bones, the tibia (inside) and the fibula (outside). There are also soft tissue structures that go between the femur and the tibia which are called menisci. These are crescent shaped cartilage that help to keep the bones together as a joint as well as acting as shock absorbers for the knee. Ligaments also connect the bones together like ropes anchoring a boat to a dock, some motion is available but there is a limit. The muscles surround the knee joint and are responsible for moving the bones and provide additional stability to this basically unstable joint.
Q: I have a sandpaper-like noise coming from my knee when I bend or straighten my knee. Is there anything I can do to decrease the noise?
A: Joints should be noise-less so having noise coming from the joint usually means there is some wear and tear in the surfaces of the bones. This type of noise usually comes from wearing away of the surface of the kneecap that rubs along the thigh bone. In physical therapy, we have found that the muscles on the front of the thigh do not contract in the normal coordinated fashion, causing the kneecap to move out of its normal groove. This causes a wearing away of the undersurface of the kneecap and after a while sounds like sandpaper scraping with movement. Oftentimes, this noise can be decreased or eliminated with re-educating the muscles so that the movement occurring at the kneecap is back in the groove.
Q: My knee sometimes buckles or locks. What is causing this?
A: If this problem is occurring, you should see your physician as this could be due to a variety of causes. Oftentimes, this is associated with a mechanical problem or a –loose body” in the knee (there’s something in the joint interfering with normal function).
Q: What does swelling indicate?
A: Swelling usually follows an injury. It usually means that an inflammatory process has started as this is the body’s way to heal. Sometimes swelling indicates that there is bleeding inside the joint.
Q: What is tendonitis?
A: Tendonitis means there is inflammation at the tendon. This is usually a sign of overusing a muscle as the tendon is the tough, fibrous attachment of the muscle onto the bone. Usually, the recommendation for this type of condition is rest and gradual resumption of activity. Sometimes scarring occurs in the tendon as it heals so certain forms of massage or soft tissue work is necessary to improve the movement of the tendon. Also since the tendon does not have as good a blood supply as the muscle fibers themselves, healing may be slower as nutrients take longer to get to the tendon. It is also wise to look at the activity and see if it can be done in a more efficient manner so as not to stress the tendon unduly.
Q: If I tear my anterior cruciate ligament is surgery my only option?
A: This is something to discuss with your orthopedist. The anterior cruciate ligament is very important in knee stability and a tear in this ligament can cause lots of problems in the knee joint. Some patients I have seen have opted to avoid surgery and do exercises instead. The muscles can be strengthened to provide stability at the knee and braces can be worn to provide an external stability. Your options will depend on the severity of the tear, your level of physical activity and the condition of your joints and muscles.
Q: How do I get my knees in better shape?
A: The body is very specific in conditioning. That means that is you are a runner, your muscles and joints are conditioned to running. It may not be in the best of shape to do mountain climbing or swimming. The best way to get in shape is to do the activity that you want to do. So, if you want to get your knees in shape to do lifting activities, you would be best to do an exercise program that gradiently got you to do more challenging lifting activities. Like-wise, if you wanted to get your knees in shape to do skiing, you would do exercises and activities that would best do the movements you do in skiing, including skiing itself.
Like with other entries I have written, you should use common sense when doing activities and listen to your body when you are getting fatigued or straining. Aim for prevention whenever possible and seek out help when appropriate. Your body does communicate to you a lot, you just need to listen.
