It is not uncommon for patients to present complaints of knee pain whilst trekking, climbing, walking or running. The question of “Why do I have knee joint pain?” comes up frequently. The source of your knee joint pain can be from the knee joint (i.e tibio-femoral joint) itself, behind the knee cap (the patella-femoral joint), referred pain from the hip or even referred pain from the lower back.
The knee is a hinge joint consisting of the femur (thigh bone) and the tibia (shin bone) articulating together with the patella (knee cap) sitting in a groove on the front of the femur.
The joint surfaces of these three bones are covered in an extremely hard and extremely smooth substance, called articular cartilage, designed to decrease friction forces.
Between the tibia and femur there are two ‘C’ shaped menisci, which are made of hyaline cartilage. The meniscus sitting on the outside aspect of the joint is referred to as the lateral
meniscus, and the inside one is the medial meniscus. The menisci aid in weight distribution, shock absorption and also play a key role in stabilisation of the knee.
Surrounding the knee joint is a capsule (think of a bag) that holds the lubricating fluid in place. It is made of a double layer, with the outer layer consisting of a thick fibrous
connective tissue that merges with the ligaments and helps to provide stability to the joint (especially when your knee is straight or extended). The inner layer is a thin membrane that
produces synovial fluid, an oily fluid that both lubricates and nourishes the surrounding structures.
In addition to the joint capsule, ligaments (a band of tough connective tissue connecting bone to bone) work to reinforce the knee joint and stop the femur or tibia moving in
unwanted directions especially if we are changing directions, running or climbing. On the front of the knee connecting the patella to the top of the tibia is the patellar ligament, on the
back is the popliteal ligament attaching the femur to tibia. On the inner side is the medial collateral ligament and on the outer side is the lateral collateral ligament, both of these
ligaments act to prevent sideways movements of the tibia or femur. There are two internal ligaments, the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL).
People involved in sports such as netball and football may experience enough trauma to cause the ACL or the PCL to completely tear. In order to appreciate how common knee
injuries are in sport, it is interesting to note the findings of a study of around 500 elite women basketball players. The most common knee injuries were: patellar tendinitis (17.0%
of all players), ACL injury (15.0% of all players), meniscus injury (10.5% of all players), were the most common knee injuries reported. Other sports such as trekking or hiking, especially
when carrying heavy loads or going down hills, can cause different types of injury. Using poles can help decrease the loads your knees experience when trekking downhill.
Many patients with the above types of injuries are very pleasantly surprised to see how much they have improved after receiving physiotherapy. Exercises have a very important role to play in achieving great results.