Common Conditions of the Knee
The knee is made up of two joints:
The Tibiofemoral Joint (where the shin meets the femur): This is known as a hinge joint and allows for flexion and extension.
Patellofemoral joint (where the patella meets the femur): The patella sits inside the quadriceps muscle and moves superiorly with knee extension and inferiorly with flexion.
1) Patellar Tracking/Malalignment Problems:
The patella should normally slide straight up and down a dip in the femur called the femoral groove. Minor tracking is normal to varying degrees but even a subtle shift in position can cause wearing of the tissue around the joint and of the patella itself.
Causes of tracking:
- Increased Q angle: the angle of the femur, from the patella to the outside of the hip
- Tight Glute Max and IT band
- Weak hip abductors and VMO
- Structural Issues: genu valgum (knock-kneed) or varum (bowlegged). Pes planus (flat feet) or Pes cavus (high arch).
2) Chondromalacia Patella:
This condition refers to a breaking down of the cartilage in the knee joint. It is most common in runners and jumpers and can predispose these athlete’s to osteoarthritis.
3) Iliotibial Band Syndrome: Not to be confused with Iliotibial Band Friction Syndrome.
IT Band Syndrome: A contracture or thickening of the iliotibial band, leading to pain anywhere from the outside of the hip down to the outside of the knee.
IT Band Friction Syndrome: Irritation of the IT band as it passes over the outside of the thigh, just above the knee.
These conditions have very similar presentations, both seen most often in runners and cyclists who do repeated flexion and extension exercises.
- Tight TFL and Rectus Femoris: will pull the pelvis anteriorly
- Weak Glute Med: will pull the pelvis anteriorly
- Short Glute Max: will increase tension on IT band from the side of the hip
This condition is an inflammation of the patellar ligament where it attaches just below the knee. On the shin bone below the patella is a protrusion of bone known as the tibial tuberocity (where the patellar ligament attaches).
Due to repetitive strain (jumping) or being over weight, there is often bony overgrowth on the tibial tuberocity.
A bursa is a fluid-filled sac that allows tissues to glide upon one another and avoid friction or irritation. All the main joints of the body contain multiple bursae. Bursitis is when one of these sacs gets inflamed. There are 24 bursae in the knee joint.
6) Miniscus Injuries
The menisci are two round-shaped discs made of cartilaginous tissue that sit between the femur and the tibia. They act as shock absorption and distribute weight through the knee joint.
MInisci tears are very common, most often occurring when the knee is bent and then twisted. The first symptoms associated with a torn meniscus are pain and swelling of the knee.
Catherine Taman is a Registered Massage Therapist practicing in Toronto, Canada. She has a special interest in treating chronic pain, headaches, sports injuries and pregnancy related pain. To book an appointment with Catherine, visit rmtmassagetherapytoronto