The knee joint is one of the main bearings, it must cope with walking, running, bending, jumping and lifting objects. It also works in conjunction with the joints of the hip and ankle joints, helping in a static upright posture (standing). Thus, not only the knee joint should offer stability and weight support, but it should also offer reasonable mobility. Not surprisingly, this is one of the most common injuries of the joints in the human body.
The joint consists of four main bones: the femur - the large bone in the thigh, is attached by ties to the tibia, the fibula, which runs parallel to the tibia, and the patella (usually called the patella), which "rides" on the joint, like a bend of the knee.
The joint itself has three basic agreements, the main connection of which is the attachment of the femur and tibia, it has an internal (medial) and external (lateral) section, the third compartment is the connection of the patella with the femur, namely the patellofemoral joint. The Patellofemoral connection is unique in that it protects the other joints of the human body, acting as a “shock absorber”.
The knee joint, in good function, is equipped with a large range of movement, strong ties and powerful muscles. The knee, unlike any other joint in the body, depends almost entirely on its surrounding ligaments for stability. The two most important sets of ligaments are the cruciate ligaments located in front of and behind the knee, and the colonial ligaments are located on the sides of the knee. The ligaments are fixed inside and outside the joint (concomitant ligaments), and also intersect at the joint (cruciate ligaments).
The muscles that pass through the knee are quadriceps and hamstrings. The quadriceps are a large group of muscles that make up the front of the thigh. The muscle starts from the hip bone, tapers to the knee to the patella, and attaches to a “stroke” on the knee just below the knee, called the tibial tuberosity. Quadriceps are a very powerful muscle group and straightens the knee in activities such as standing, climbing stairs, or running.
The hamstrings make up the back of the thigh, extending from the pelvis, running along the back of the thigh to attach to the back of the fibula and calf just below the knee. This group of muscles bends the knee and straightens the thigh. The hamstrings are necessary for running and pushing something or someone.
These are the two main muscle groups that control the movement of the knee and are vital for the stability of the joint. There are other muscle groups that affect the movement and stability of the knees, especially the calf muscles, abdominal hips located on the outer thigh, and hip adductors located on the inside of the thigh. Lyolibalnaya band also affects the stability of the knee, like the buttocks (buttocks)).
The knee joint also has a cartilage structure called the meniscus or meniscal cartilage. The meniscus is a C-shaped piece of tissue that fits into the joint between the lower leg and the femur. It helps protect the joint and allows the bones to slide freely over each other, and also absorbs part of the load of the joint. There is also a bursa around the knee joint. A bursa is a small liquid bag that helps muscles and tendons to slide freely as the knee moves.
Below the patella there is a large tendon, the patella tendon, which is attached to the front of the calf.
The knee, which is perfectly aligned, has its bearing axis on the line that runs in the middle of the leg — through the thigh, knee, and ankle. When the knee is not perfectly aligned (also called malalated), it is known as the varus (leg bow) or the valgus alignment (knock-kneed).
The alignment of Varus causes the carrying axis to move inwards, causing more tension and force on the medial (internal) branch of the knee. Persons with a leveling dispersion are very susceptible to arthritis in the knee. Persons who wear legs or knock-kneed are at higher risk for osteoarthritis, that is, they may be prone to knee pain and functional problems at a later age.
Uneven use of muscles is the main cause of joint dysfunction. Dysfunction can manifest as pain or movement restrictions, or both. If these symptoms are ignored, dysfunction can lead to deterioration of the cartilage in the joint. Joint dysfunction can be further exacerbated in the hips and knees due to the constant weight on the legs when standing or walking. Without intervention, the cartilage will eventually become so worn that the result will be “bone”, when there is practically no cartilage in the joint. At the moment, the joint movement is usually strictly limited.
The patella, a small bone in the front of the knee, is embedded in the quadriceps tendon (thigh muscle) and acts to increase the biomechanical shoulder of the quadriceps. The kneecap slides in the groove on the thigh as the knee flexes and expands. Because the patellae of the "floats" within the substance of the quadriceps, proper tracking of this bone in the femoral groove depends on the proper balance of the muscles in order to maintain a central position. Congenital anatomical factors, such as the shape of the patella, also affect this tracking. Because of the location of the patella, it is subject to higher loads than other surfaces of the joint. Thus, despite having a thicker cartilage shell than any other bone, it often begins to wear out in front of other parts of the knee. Lack of patella is a violation of the position or tracking of the patella and can cause pain and / or instability.
Normal patella should be tracked right in the middle of the femoral sulcus. There are varying degrees of abnormal tracking or the slightest deviation of the patella. In mild cases of poor quality, the kneecap is simply tilted into the groove, which leads to an increase in pressure on the side of the patella tilted down. In more severe cases, the patella will actually sweeten or partially slip out of the groove. In the most severe cases of impairment, the patella can actually dislocate completely.
Proper patella tracking depends on many factors. Proper muscle balance is important and is one of the few factors we can control. Usually, the patella wants to sweeten to the outside of the knee (side). By strengthening the inner thigh muscle, the nozzle of the vastus medialis can act to counter this tension.
Tracking is also influenced by the anatomical shape of your patella, femoral sulcus, the angle your knee makes with your thigh (knees beat) and even the position of your leg (pronation). The angle of the hip joint is important because the patella is embedded in the tendon of the quadriceps, which occurs on the thigh and attaches to the knee. The more someone swings, the more angular load occurs on the patella each time the quadricep is compressed.
Increased pronation of the foot (flat feet) can affect tracking of the patella. This is because the rotation of the rest of the leg depends on how the foot contacts the ground. Pronation of the legs can be caused by a number of factors, including an imbalance in strength or intensity between the muscles in the calf (lateral gastronemia and aprons) and comparative weakness in the buttocks and anterior tibialis and posterior tibialis.
Another common imbalance in the quadriceps muscle group in the front of the thigh is between the outer quadriceps muscle (vastus lateralis) and the inner quadriceps muscle (vastus medialis), which can also cause problems with the patella. These two muscles run on either side of the front of the thigh and attach to the patella. Part of their role is to stabilize the patella. When one side is stronger than the other, the kneecap can be lowered to one side. Runners often have relatively stronger, denser external muscles of the quadriceps than internal muscles of the quadriceps, the kneecap can be dropped to the outside. This mechanism is a common cause of paltemoferal pain syndrome, a common complaint of runners.
Another factor that can pull the knee out of alignment is the density in the tensor fascia of the latae and, more specifically, the iliotibial band (thick tendon-like part of the tensor fascia latae). This band runs outside the thigh and inserts just below the knee. Density in this area can cause the tendon to pull the knee joint out of order and rub it out, resulting in inflammation and pain. This tightness is known as the iliotibial band syndrome.
There are two main causes of knee pain associated with the iliotibial band syndrome. The first is “overload”, and the second is “biomechanical errors”.
Overload is common with a sport that requires a lot of work or weight. This is why ITBS is usually a runner injury. When the tensor fascia latae muscles and the iliotibial band become tired and overwhelmed, they lose the ability to adequately stabilize the entire leg. This, in turn, causes stress on the knee joint, leading to pain and damage to the structures that make up the knee joint. Biomechanical errors can be associated with muscle imbalance, compensatory or postural dysfunction, torsion of the hip joint, pronation of the legs or difference in leg length.
During certain loads, the knees may fall towards the center of the body (adduct). This may not be due to any knee problems, but relative to the relative imbalance between the tightness of the adductors and the ITB (iliotibial band), as well as weakness or inhibition of the buttocks. Conversely, when the knees fall out (abduction), this may be due to the comparative tightness of the biceps of the femur, iliopsoas & piriformis in relation to the gluteal group.
Another injury-prone area is the anterior cruciate ligament (ACL), a vital stabilizing ligament in the knee. It is located deep inside the knee joint and provides almost all resistance to direct stress on the joint. Injuries to this ligament are very common in aggressive sports and usually occur when a sudden hyperextension or rotational force for the connection, i .e. Twisting quickly, etc.
When ACL is ruptured, reinforcement in the joint increases, preventing shearing forces on the surface of the cartilage and leading to progressive rupture of the cartilaginous discs (menisci) and destruction of the surface of the joint. Over time, this breakthrough leads to degenerative arthritis.
Another important factor that can cause dysfunction in the knee is a restriction in movement in the hip or ankle area. If you lack movement in a joint with a high degree of ability to move (hips or ankle), then another connection that has a lower degree of translocability, in this case, the Knesse, is forced to compensate.
Indeed, this is the nature of the relationship between the hip and the knee, pain in the knee is often just a manifestation of poor motor control or range in the hip, be it bending, stretching or rotating. Strengthening hip stabilizers is the right way to avoid common knee injuries.
Restricting the movement of the hip may cause pain in the knee. The normal range of internal and external rotation of the hip joint is 35-50 degrees inside and 50 degrees outside in the healthy thigh. The knee can perform only this internal and external rotation is minimal. When the whole leg rotates, most of the movement must come from the hip joint, so as not to impose too much torsion on the knee joint. If the hips are tight and the range of motion is limited, excessive movement from the knee may be required and may cause pain felt in the knee joint.
Similarly, limiting movement in the knee can lead to pain in the hip joint. The normal range of movement of the knee during flexion is 150 degrees and 180 degrees when stretched. Although the thigh can flex to 135 degrees, it can stretch only 30 degrees in a normal thigh. Thus, a compromised movement in the knee may require that the hip extend beyond the normal range of movement and manifest as pain in the hip.
Balanced movement in the hip and knee joints, as well as between the hip and the knee is the best prevention of wear and pain in these joints. In addition, moderate to moderate deterioration can also be helped by restoring the range of motion and balancing the actions of the muscles around the joint.
Menical tears occur when excessive movement of the knee joint increases on these pads between the femur and lower leg. This may be forced expansion, bending, side by side or rotational motions. The hearing may be insignificant and does not have a mechanical effect on the normal knee slip, or it may be large and cause a trap, popping out and even blocking the knee so that it does not fully stretch.
Unusable movement ranges within the knee in flexing and / or stretching are common knee dysfunctions and can create significant problems in the kinetic chain. Inadequate bending of the knee reduces the quality of the "depreciation" of the limbs. This may affect the individual walk. Insufficient knee flexion may actually be a secondary symptom of insufficient hip flexion. These dysfunctions can affect the tote.
Weak quadriceps are a common cause of insufficient knee flexion or excessive expansion of the knee. Excessive flexion of the ankle is the most common cause of knee joint hyperextension. Excessive flexion of the knee joint and insufficient elongation of the knee joint can be caused by a number of factors, including weakness of the stool and gastrocnemius muscle or weakness of the quadriceps.
Some people stand and move when they “lock” the knee straight, even pushing it backwards. This position is sometimes called “washer-legs”, and makes the leg more crescent than straight. It applies body weight to the joint, while at the same time pushing the compound slowly, causing damage to the cartilage. Many people push their knees to hyperextension while standing and walking. Others “strike” the joint in a straight position during exercise.
Any of these factors can cause varying degrees of pain, as well as short and long-term damage, it is important to look at the knee not just as a separate part of the anatomy, but also as an integral part of the kinetic chain.
