The body's bones
form a skeletal framework that support the soft tissues. They
protect the internal organs and provide stability for the body and forms
many levers that, when acted on by the muscles, bring out body
movements. For example, your knee joint, a body hinge, is really a
junction of two body levers, the upper thigh bone and the lower leg
bones. Without joints, you couldn't move your hands, legs, arms,
neck, spine or mouth. The job of a chiropractic physician is to
restore and to improve the function of the "deranged" joint.
The Knee, the most
famous joint in sports, is the junction of the upper leg bone (femur) and
the lower leg bone (tibia). These two bones are held together by a series
of tissues called ligaments. The knee is much more than a meeting
place. It is both a hinge and a lever.
There are four large
muscles on the front of the thigh called quadriceps. These muscles
power the extension of the leg. The quadriceps connects to the quadriceps
tendon, which attaches to the kneecap. The kneecap is
attached to the tibia by the kneecap tendon. Thus, when the quadriceps
contracts, the tibia lifts.
Like all joints in the
body, the knee joint is a trade-off between mobility and stability.
For example, the shoulder is extremely mobile but quite unstable. It
is easy to dislocate. The hip is not very mobile, but is very
stable. When compared to the hip and the shoulder for stability, the
knee is somewhere in the middle. The knee is one of the most mobile
joints in the body. You can bend your knee 150 degrees. When
sprinters run full out, maximum bending or flexion of the knee is reached
(this is when the foot, after striding, almost touches the buttocks).
Almost all injuries to
the knee restrict this normal range of motion. When the knee is
fully extended, it is like a stick - it is totally stable. When it
bends, it has play in it -from front to back and side to side. It
can even be slightly rotated. You need this flexibility to change
The bones of the knee
are held together by ligaments. These are gristle like structures
that join the femur and the tibia. They make the knee sturdy and
keep it from wobbling.
The knee has two major
ligament systems. One forms the sleeve-like connection between the
two bones. This is called the knee capsule. Besides the five
capsule ligaments, the knee has two additional ligaments that occupy the
middle of the knee joint. because they cross, they are called
cross or cruciate ligaments. The knee ligaments are what I term the
static knee stabilizers. The muscles and tendons are the dynamic
stabilizers of the knee. They are dynamic because they can quickly spring
into action. The geometric shape of the femur and the tibia add to the knee stability.
The end of the femur has
two knobs called condyles. They are round and smooth. They fit
into the two shallow sockets in the top of the tibia. Because of its
design, there are at least five places where the knee can be injured: the ligaments, the
cartridge, (called menisci), the muscles around the knee,
the kneecap (a bone in front of the knee), and the tendons.
Knee Ligament Sprain
A sprained knee is a rip
or tear of one, or a combination of, the seven knee ligaments. It is
probably the most common of all knee injuries I have seen in my
practice. I have seen knee sprains from football, skiing, tennis,
and simple falls, to name a few.
any injury to the knee
ligaments lead to some instability of the knee. The degree of injury
of the ligaments depends on the amount of the force applied to them.
treatment: When you sprain your knee, you will feel
pain. The degree depends on the severity of the rip or tear.
The immediate treatment is rest, ice, compression and elevation. I
can gain the most valuable diagnostic information if I examine the injured
person within the first 30 minutes following injury. This is the
grace period before swelling sets in.
A grade one sprain is
relatively trivial and usually cost the athlete about 1 week of
idleness. A grade two sprain requires 2-3 weeks to heal. A
grade three sprain requires an operation without surgery, your knee will never
work properly again .
Knee Cartilage Injury
The knee joint
cartilage, called menisci, sit between the ends of the ends of the bones
that make up the joint. They act like knee shock absorber pads.
They are triangular in shape and are wedged between the bone ends. Because
of their shape, they increase the contact area between the two
The covering surface of
the ends of the bone, the joint surface cartridge, is much like a tread on
a tire. This tread will wear down more quickly if there is a great
deal of force applied to it per square inch. Loss of any tread on
the surface of the joint is called arthritis.
Knee cartilage have no
blood supply of their own. They are unique in the human body. Because
of this, a tear or rip cannot heal itself. That is why so many
athletes end up needing surgical treatment for torn knee cartridge.
Treatment: When the meniscus rips, you have the sensation that
something is giving way in the knee. Gradually over the next 6
hours, the knee fills with fluid. With this fluid the knee becomes
stiff and movement is difficult, if not impossible. If the tear is
large enough, the torn piece of cartridge slips into an abnormal position
in the knee. This will cause the joint to lock.
BURSITIS OF THE
KNEE: The knee has 14 bursa sacs that help the joints, tendons,
bones and the skins function. Think of the bursa sac as the body's
ball bearings. For example, if you did not have a knee bursa on your
kneecap, you would split the skin over the cap whenever you fell
down. The most common way to injure a bursa sac is by repeated
trauma to the bursa.