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Physiotherapy

Knee

Ligaments are elastic bands of tissue that connect bones to each other to provide stability and strength to the knee joint. Ligament injuries in the knee are fairly common. There are four main ligaments in the knee that connect the femur or thighbone to the tibia or shin bone:

 

  • Anterior cruciate ligament or ACL – located in the center of the knee, controls the rotation and forward motion of the shin bone

 

  • Posterior cruciate ligament or PCL – located at the back of the knee, controls backward movement of the shin bone

 

  • Medial collateral ligament or MCL – connects the thigh bone to the shin bone on the inside of the knee—MCL stabilizes the inner knee

 

  • Lateral collateral ligament or LCL – connects the thigh bone to the fibula, the smaller bone of the lower leg on the outer side of the knee—LCL stabilizes the outer knee

 

  • Injuries to these ligaments are common in many where the knee may twist with the foot planted, when the knee gets hit, when it is extended too far, when jumping and landing on a flexed knee, stopping suddenly when running, or when suddenly shifting weight from one leg to another. Many people who have tears to the ligaments, particularly ACL tears, opt to have surgical treatment to repair the tear.

 

  • Joint Fluid Analysis is a group of tests that checks for disorders that affect the joints. The tests usually include the following: An exam of physical qualities of the fluid, such as its color and thickness. Chemical tests to check for changes in the fluid's chemicals and are helpful for determining the underlying cause of arthritis, particularly for septic or crystal-induced arthritis. 

  • Meniscus Tear: is a tear of the disc that cushions your knee, most likely due to twisting or turning quickly. The menisci are two fiber cartilage discs that are in between the thigh bone and the leg bone at the knee. They essentially provide shock absorption and cushioning to protect and decrease the load on the other type of cartilage, which is the hyaline cartilage or the articular cartilage that is in the knee. When the meniscus tears, that cushioning or shock absorbing ability is lost, and so there is increased stress on the articular cartilage, and that can lead to osteoarthritis. The meniscus has a poor blood supply- only the peripheral one third of the meniscus is vascularized. The inner two-thirds are not vascularized and so it has a very low capacity of healing. Depending on the severity of the tear, your range of motion, and the amount of pain you’re in, your knee doctor will recommend rest, physical therapy, or surgery.

 

  • ​Causes of a torn meniscus: every step we take, every time we squat down, the meniscus sees an increased pressure, and that can cause very small tears in the meniscus, and they have no ability to repair themselves. Over time, those tears can accumulate and they can get larger, and that’s what leads to something called a degenerative meniscal tear. Another way to get a meniscal tear is by acute trauma, so if we’re walking one day and we step the wrong way, the articular surface at the knee that comes together in the joint can catch the meniscus in between and cause a shearing force on the meniscus if we twist the wrong way, and that can cause an acute meniscal tear.

  • Patellar Tracking Disorder: is when the kneecap shifts out of place because of repetitive stress, an injury, or problems with the knee bone, muscles, tendons or ligaments.

  • Patellofemoral Pain Syndrome: is pain in the front of the knee usually when the knee is bent caused by overuse, injury, excess weight.

  • Osteoarthritis of the Knee: can result from gradual wear and tear on the cartilage in the knee joint that can cause pain, stiffness, and limited range of motion.​

  • Stress Fracture: The most common cause of stress fractures is an abrupt increase in the duration, intensity, or frequency of physical activity without adequate periods of rest.

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