This article is broken down into 6 parts. Feel free to jump straight to any part. The parts are:
- Parts of the knee and the roles they play
- Causes of knee problems
- Who is most likely to have a knee problem
- Common knee problems and conditions
- Treatment of knee injuries
- Do knee braces work?
Parts of the knee and the roles they play
The knee is the largest synovial joint in the body which bears a great deal of body weight and provides extension, flexion, medial rotation, and lateral rotation movements essential for daily activities like standing, lifting, kneeling, and even high impact activities like running and aerobics.
The joint comprises the femur (thigh bone), tibia (shin bone), and patella (kneecap), with tendons that connect the bones to the leg muscles, which allows movement of the knee joint. Ligaments join the bones together, providing stability to the knee.
- There are two pieces of C-shaped cartilage, the medial and lateral menisci, that reinforce the joint and work as shock absorbers between the femur and tibia.
- Both the medial and lateral collateral ligaments stop the femur from sliding side to side.
- The term “meniscus tear” comes from the injury of the menisci.
- The posterior crucial ligament guards against the forward slide of the femur on the tibia and, inversely, the backward slide of the tibia on the femur.
- The anterior crucial ligament guards against the backward slide of the femur on the tibia and, inversely, the forward slide of the tibia on the femur.
The synovial membrane of the knee joint forms numerous bursas or fluid sacs which help reduce wear and tear of the moving structures in the joint. Think of this like lubricating your car engine when you add motor oil.
There are two groups of muscles involved in the movement of the knee:
- The hamstring muscles (located on the back of the thighs), which flex the legs at the knee.
- The quadriceps muscles (located on the front of the thighs) which extend the legs at the knee joint.
Causes of Knee Problems
Knee problems can develop as a result of aging, persistent stress on the knee joint, medical conditions, injury, or sudden movement that strains the knee.
The knees bear the body’s weight and thus absorb a lot of pressure with every step taken. The pressure causes the muscles, ligaments, fibrocartilaginous menisci to weaken and deteriorate as one ages.
Contact sports, accidents, falls, and strenuous activities can cause injuries like bone fractures, torn ligaments, and dislocated kneecaps that result in pain, swelling, instability, and inability to bear weight.
Medical conditions like gout (deposition of uric acid crystals in joints), osteoarthritis, osteoporosis, bacterial infections (e.g. cellulitis), and connective tissue disorders like rheumatoid arthritis can cause damage to the knee joint.
Who is most likely to have a knee problem?
We can categorize the people that can be affected by knee problems into athletes, women, elderly and obese people.
The risk for degenerative joint disorders increases with age and is commonly seen in people who are 40 years above.
Research shows that women that take birth control pills that lessen or stabilize estrogen levels have a lower risk of knee injuries. However there is an increased risk of osteoporosis at menopause because of reduced estrogen which can lead to the development of knee injuries in older women.
Athletes involved in intense sports like football, basketball or races are no exceptions to knee injury. Starting a physical activity without a proper warm-up can result in traumatic injury.
The obese are at high risk of developing knee injuries because the excessive bodyweight can exert too much pressure on the knee and weaken the joint tissues and can result osteoarthritis.
Common knee problems and conditions
- (ACL) Anterior cruciate ligament injuries: Much of the knee’s stability depends on the ACL. An injury to the ACL in the form of a strain or tear due to a blow, hyperextension or hyperflexion. Severe cases may cause the knee to give out, needing surgery to repair.
- (PCL) Posterior cruciate ligament injuries: A strain or tear of the PCL may lead to swelling, pain and instability of the knee. PCL tears don’t occur as often as ACL tears and usually taken care of with physical therapy instead of surgery.
- (MCL) Collateral ligament injuries: These injuries, which can lead to pain, are due to strains on the ligaments which overstretch or tear them and result in loss of stability at the inner knee area.
- Dislocations: This is usually due to high impact injuries to the knee and can result in severe damage to the anatomical structures and immobilization of the knee joint.
- Meniscal tears: The menisci can be torn during forceful rotations or twisting of the knee and it results in difficulty extending the knee (knee loc), pain, and stiffness.
- Gout: This is a type of arthritis that results from the buildup of uric acid crystals inside a joint. It can affect the knees and cause swelling and severe pain episodes.
- Bursitis: The inflammation of the bursas or fluid sacs that help reduce friction between the moving structures of the joint can result in a painful swelling around the affected joint.
- Baker’s cyst: This is when fluid collects in the back of the knee. This usually occurs from conditions like arthritis.
- Tendonitis: Inflammation of the tendon can occur as a result of overuse of a tendon during sports. For example, in basketball, the force of hitting the ground after a jump can strain the tendon. Tendonitis can occur in other activities like running, soccer, football, jumping, etc.
- Osteoarthritis: This is a degenerative joint condition that affects the knee and is the most common type of arthritis. Symptoms of osteoarthritis are stiffness, swelling and knee pain. Wear and tear of the cartilage and aging are the chief cause of osteoarthritis. It can also occur due to excessive stress on the joint caused by repeated injury or obesity. It affects older people more.
- Septic arthritis: This is an infection from a virus, or fungus or bacteria inside the knee. It can lead to swelling, inflammation and pain, resulting in difficulty of movement of the knee. While not so common, septic arthritis is a serious and usually worsens quickly if untreated.
- Rheumatoid arthritis: It is the inflammation of joint tissue caused by autoimmune attacks on the joint tissues. It can affect the knee by destroying the knee cartilage, resulting in swollen and painful knees. It mostly affects those aged 40 and above and is more common in women. It also affects people at an earlier age than osteoarthritis.
- Chondromalacia patella: Known also as the patellofemoral syndrome, this occurs when the cartilage under the kneecap (patella) becomes irritated, which results in pain. The pain from this condition occurs more with young people (as opposed to arthritis that affects older people).
Treatment of Knee injuries
Treatment for knee injuries depends on the cause and severity of the knee injury, but it is advisable to visit the nearest healthcare facility.
Treatment may involve managing pain and inflammation with medications like corticosteroids, ibuprofen. Injuries due to trauma or tears may require bracing (using a knee brace), realignment of knee back to place, or surgery (arthroscopy).
Severe cases like ACL, MCL, or meniscus tears may require arthroscopic surgery. Knee braces are also prescribed by physicians for patients with ACL or meniscus tears and knee sprains. After surgery, or even if surgery isn’t an option, physical therapy may be also required to strengthen the knee and regain movement.
Self-care measures for a minor knee injury are:
- Rest by taking a break from normal daily activities to reduce persistent strain on the knee and to also allow time for healing.
- Make use of ice bags on the injured knee can help reduce both pain and swelling
- Use a compression bandage to help prevent fluid build-up in the damaged tissues and also maintain knee alignment and stability.
- Elevate the injured leg on pillows can help reduce swelling.
- Use a knee braces to provide compression as needed and help hold the knee joints together to prevent buckling or sliding.
Do knee braces work?
Knee braces provide support and stability to the knees and they can help reduce pain by shifting the bodyweight off the injured portion of the knee, allowing the injured portion to heal. Knee braces have been said to provide added support during the recovery process of knee injuries such as ACL tear and also provide pain relief in osteoarthritis. There are also prophylactic braces are used by athletes to prevent knee injuries. Braces can only work if they are used the right way. Therefore it is necessary to consult your physician on which knee brace is right for you.
A brace can be much helpful for adding stability while the knee is recovering but it should not be used as a long-term solution to fix the injured portion of the knee. The stability of the knee is gotten through the muscles, tendons, and ligaments of the upper leg and any damage to these structures will make the knee unstable. If a brace is worn for a very long period, the knee weakens and begins to depend on the braces for stability instead of its natural stabilizes- the ligaments, tendons, and muscles. It is necessary to first treat the knee injury before wearing a brace.