Knee Problems

 

  • Knee pain is common, with the most common cause being the cartilage (meniscus).
  • Other common causes are referral from the lumbar spine, tracking issue of the kneecap (often a result of misalignment of the spine due to a low back disc problem), or ligament injuries.
  • Many apparent knee problems are actually low back problems, where the disc in the back squashes the nerve that runs behind it. These nerve roots join together and form a huge nerve (called the Sciatic Nerve) that runs down the leg, supplying the muscles around the knee.  
  •  When a lumbar disc (disc in the back) squashes these nerves, frequently the muscles supplied by this nerve tighten and produce pain and or weakness, and can even affect the tracking of the kneecap giving rise to Patello-Femoral joint pain.  A lumbar disc problem can also cause a twist in the pelvis, loading one knee more than usual creating or contributing to the local knee pain.
  • This can occur in the absence of low pain! (Hiding the clue the problem is the back).
  • A thorough Knee Assessment should include testing of the low back to exclude this possibility. It may be that your specific knee problem has both low back and local knee components.

 

What structures in the Knee are locally affected?

  • Many structures within the Knee can be injured and cause pain.
  • The most commonly injured structure inside the Knee is the cartilage that sits between the joint where the Femur (thigh bone) and Tibia (shin bone) join. This cartilage is called the Meniscus, and is most commonly injured with a twisting movement.
  • Certain movements of the Knee (most commonly repeated bending of the knee, as in prolonged sitting or kneeling) cause a flap of this cartilage to protrude into the joint space.
  • Loading the knee to walk, run or squat pinches this cartilage, causing knee pain and inhibits power of the quadriceps.
  • Frequently this is the cause of the restriction and pain, and the loss of power. If this is the cause of your problem, certain exercises can be identified during your McKenzie Assessment that essentially push the flap of cartilage back into place, which gives a relief of pain and restores strength and movement within minutes.
  • Injuries to the ligaments usually involve someone sliding across your leg (as in a tackle in soccer) or landing and pivoting (like after mark at Football in a pack).
  • Ligament injuries usually present with a large degree of swelling as these ligaments have a strong blood supply. iStock_000004834717Small14