Knees - The Good and The Bad

By Cameron Allshorn

Following on from Foot Health Week By Alayne I wanted to touch on knees. Like feet, we have two of them and they do a fair bit in helping us stay upright and like the feet they are crucially important for doing a lot of the things that we love doing. 

The knee itself has 3 prominent bone structures involved (Femur, Tibia, Patella)  plus the additional involvement of the tibia/fibula joint. There are a number of soft tissues that are involved including hamstrings, ITB (illiotibial band), menisci, and quadriceps. 

Knee complaints vary from acute to chronic and a lot in between. One thing is common though, almost everyone refers to one knee as the ‘bad one’. I’m here to say that doesn’t have to be where the story ends! With treatment, management and overall a plan of progression that ‘bad’ knee can become a better one.   

Knee injuries can arise from a number of things such as; 

• Mechanical involvement (i.e twisting/hyper extension), 

• Rapid loading (i.e landing, change of direction)

• Repetitive strain (i.e running, kneeling, etc). 

• Gait dynamics and patterns (ankle instability, over pronation of feet, increased valgus/varus forces)

Chronic Knee injuries are often linked to previous instances of knee pain and usually stem from underlying degenerative changes such as osteoarthritis or cartilage loss. Chronic knee pain is often associated with a previous knee trauma however it can occur without notice from age 30+. As with other joint based pain the risk of chronic knee pain increases with obesity. 

For acute knee injuries we often find that soft tissue treatment along with articulation and mobilisation of the joint can provide solid improvement of symptoms, this is then best accompanied by structured exercises to improve strength and stability of the knee. In a lot of cases we will recommend isometric and eccentric exercises that involve the knee and other aspects of the lower extremity. 

In both cases (acute or chronic) symptoms can be influenced by or the result of adaption from other regions of the body such as the feet, ankle, hips and lower back and vice versa. As osteopaths we will always assess the whole body and that is no different regarding knee pain.

In more severe injuries (often where stability is compromised) we may recommend further investigation (i.e x-ray or MRI) as this can help establish if there has been any partial or complete rupture of structures like the ACL, PCL or patella tendon, this imaging is also helpful for assessing possible degenerative changes, bone bruising, swelling or bursitis.

In any case, early management is often the key regardless of if it is considered acute or chronic and the sooner the process can get started the quicker that bad knee can move towards being a good one. If you have knee pain or any questions about your knees we’re happy to answer them.