The knee joint is one of the most complex in the body: it consists of the proximal part, where the bones and cartilage grow together, and the distal part, where the bones meet. In every joint, the articulations with the bones are called joints and the joints themselves are called articulations. The knee consists of four articulations: the proximal femur, the shaft of the femur, the proximal tibia, and the distal tibia. All four of these articulations have a great deal of mobility and are able to move in any direction.
The knee joint is a complicated structure that is made up of many parts. Each part has a specific role, and the connections between the bones and muscles are essential for the knee to function properly. By taking a close look at the knee, we can gain a better understanding of how the joint works and how we can improve it.
It’s amazing how much you can learn about a person from their knees. Whether you’re thinking about getting a job, meeting a potential date or just getting a pedicure, you can learn a lot about a person from their knees. For example, did you know that the front of your knees are the most common place for women to get ingrown toenails? Did you know that the shape of your kneecap can tell a lot about your personality and your age? You may already know the answer to these questions but if not let us tell you all about your knees.
You’ll need the following to maintain your knees healthy:
- Above and below the knee, there are mobile joints.
- Knee joint that is strong
- When it comes to physical movement, proper mechanics are essential.
That pretty about covers it up.
What exactly is a knee?
The knee joint is made up of the femur, tibia, and patella. The knee joint’s breadth enables the construction to withstand heavier weights.
When the quadriceps are contracted, the patella, or “kneecap,” rests inside the quadriceps tendon, giving a mechanical advantage. The rear side of the patella has a smooth hyaline cartilage surface. This is critical for flexion, extension, and rotation of the knee.
The ligaments, capsule, and menisci in your knee serve to hold the joint together.
The importance of exercise
Our bodies react to the pressures we put on them. Regular activity encourages the turnover and development of knee structures (muscles and connective tissue). This is a positive development. Balance exercise loading, frequency, activity type, and rest/recovery to maintain the knee joint healthy.
Loading | Frequency | Activity type & variety | Rest & recovery | Result |
Excessively intense | Too often; unpredictably | There is not enough variety. | Not nearly enough | Inflammation, injury, and overuse injuries |
It’s perfect | Consistent and regular | Diverse and well-balanced | Sufficient; active recovery | Knees that are in good shape |
Too low | Unusual; rare | There is very little activity. | Too much | Ligaments that are weak and prone to damage |
For example, if you keep putting in the hard miles every day while just doing distance running, you’ll most likely get tendinitis. Sitting all day, on the other hand, puts you at risk of knee injury due to weaker knee structures and the pressure of the kneecap on the thighbone in the sitting posture (also known as “movie theater knee”).
Get regular daily exercise, maintain the joint moving through its entire range of motion, and try new activities to keep your knees healthy.
Anatomy of the Knee Ligaments
Anatomy of the Ligaments in the Knee Animation
The knee is stabilized by four major ligaments that prevent excessive mobility.
- The anterior cruciate ligament (ACL) holds the tibia in place and prevents it from sliding forward.
- The posterior cruciate ligament (PCL) holds the tibia in place and prevents it from sliding backward.
- The medial collateral ligament (MCL) protects the knee joint from excessive inward movement. This is the most frequently damaged knee ligament, although it typically heals on its own without the need for surgery.
- The lateral collateral ligament (LCL) is a ligament that prevents the knee joint from moving too far outside.
Knee ligaments are very little. The ACL and PCL have a width of 6-14 millimeters.
Two crescent- shaped rings of cartilage comprise the menisci. The menisci provide knee stability, distribute weight from the femur to the tibia, act as shock absorbers, and spread synovial fluid. Just like other types of cartilage, they can be torn. It’s not just ligaments that keep our knee intact. The quadriceps, hamstrings and calves enhance stability too. When these muscles are strong, we are able to rely less on the passive structures, like ligaments, to resist unwanted movement.
What You Need to Know About Knees
The majority of knee issues develop over time, not on a whim in your basement during a dance-a-thon. This is repeated damage (think wear and tear), and any mechanical device (including the knee) will break down under extreme stress. Knee injuries account for one out of every three sports-related injuries.
Warming up and joint mobility in a dynamic manner
Knee health seems to be dependent on warm-up and dynamic joint mobility. These exercises aid in the management of inflammation, the distribution of joint fluid, the development of structures surrounding the joint, and the improvement of range of motion.
Strengthening your resistance
For healthy knees, resistance training over a complete (and technically correct) range of motion is important. Weight-bearing activities may assist to strengthen and stabilize joints.
Poor technique (such as going too heavy in a limited range of motion) and too-heavy or too-frequent resistance training without sufficient recovery may, on the other hand, harm the knee joint. Mix up the exercises and the loading instead than pounding away at those squat one-rep-maxes all the time.
Also, keep in mind that your legs move in several planes. Experiment with asymmetrical and one-legged motions like:
- Lunges or leaps with a “star” (stepping/jumping out to the side or diagonally)
- Squats in a staggered posture, wrestling shots
- Step-ups to platforms on the side/diagonal
- zig-zag leaps and runs, among other things
Knee problems are quite common.
Patellar tendonitis is a condition that affects the patellar tendon.
Prepare to be astounded by the following information: Tendonitis is a condition in which a tendon becomes inflamed. Who’d have guessed? This occurs often as a result of recurrent stress and overload (translation: overuse). Ice, proper recuperation between exercises, and increased mobility may all be beneficial. You may minimize pain by restricting range of motion during workouts, but you should aim to return to a full, healthy range as soon as possible. Static holds and eccentric exercise are other options.
Patellar chondromalacia/kneecap discomfort
Climbing stairs, going down slopes, and sitting are all examples of this. On the backside of the kneecap, this is the gradual loss of hyaline cartilage. When you bend your knee, you may hear snapping, popping, and cracking sounds. Lower-body workouts with perfect technique and a reduced range of motion (with the goal of eventually expanding that ROM) may assist. Women are more likely than males to be affected by this disease.
Meniscus tear/meniscus removal
A catching or grinding feeling in the knee is a common symptom of meniscus issues. Many individuals choose surgery to remove torn pieces because a meniscal injury may cause discomfort, catching, and swelling. Because menisci have no blood flow outside of their outer rim, they recover slowly when ripped. Heavy vertical compressive loads (e.g., crouching, leaping) may obstruct the healing process. While recuperating, use a restricted, gradually increasing range of motion and little resistance.
Ligament issues
ACL injuries are prevalent in sports that require a lot of running and leaping, such as basketball and soccer, as well as activities that require a lot of twisting and lateral pressures on the knee, such as downhill skiing. Women are more likely than males to have ACL injuries due to their looser knee joints; however, understanding and practicing correct running and jumping technique may significantly decrease the risk.
ACL repair is a huge deal since it can’t just be stitched back together once it’s torn (try attaching two mop ends). Rather, ACLs are rebuilt using tendons that have been borrowed.
After an ACL reconstruction, it may take months before you can resume progressive weight training. Partially range of motion exercises and hip/hamstring strengthening are common in ligament rehabilitation. While open chain exercises may be useful in some rehab situations, they should be avoided until post-operative knee function has been evaluated.
When a ligament is overstretched or partly ripped, mild sprains develop, and the only treatment is rest and ice. Workouts may continue as soon as the knee feels better.
Arthritis
While the degradation and inflammation of knee joint cartilage may occur as people become older, this does not always imply that pain and impairment would follow.
In most cases of arthritis, the elephant in the room is body weight. Knee arthritis is significantly linked to a greater body weight. If your BMI is more than 30, your chances of getting arthritis increase by almost fourfold. More plantar flexion and a shorter stride are required when body mass increases. As a result, hamstring dominating knee stability develops. This isn’t good. In those who are overweight, incorrect foot posture while walking and running is also prevalent. Toes may rotate out (duck walk) or in (knock-knee, called valgus), resulting in knee damage and reduced mobility.
What can you do to improve the health of your knees?
Examine your footwear and walking style.
A shoe sole that is non-bouncy and generally flat may help with balance and integrity around the foot and ankle. The idea behind barefoot/minimally shod walking is that the more sensory information received via the soles of the feet, the better the body can detect and rectify positional abnormalities.
Knee problems may be caused by screwed up shoes, feet, and ankles. In fact, too much cushioning in a shoe may be a concern; squishy shoes make it more difficult to balance your feet.
Knee issues may be caused by “duck feet” or the reverse, “knock knees,” and excessive heel strike while walking or jogging.
Examine your squat.
Learn proper squat technique and put it to use. If you want to add additional weight, don’t compromise your technique, particularly if you’re doing it in a partial range of motion.
Squat form that is correct
Sit back into the squat with your hips behind your heels. The higher the strain on the knee joint, the farther forward the knees are positioned. Although Olympic weightlifters prefer to squat with a little higher shin angle, the objective is to maintain shins closer to vertical.
Unweighted squatting with a significant forward shin lean (also known as the “campfire squat”) is safe, but it puts a lot more stress on the knee joint, so don’t attempt it with heavy weight.
The squat known as the “campfire.” When lifting large weights, avoid this posture.
Machine squats seem to stimulate muscles surrounding the knee more than free weight squats.
When opposed to the front squat, the back squat produces greater compressive pressures at the knee joint.
Squatting on a decline or with anything under your heels increases patellar tendon stress while reducing glute activation.
When squatting, a wider stance and a wider range of motion may help to activate more hip muscle. If you squat broad, you’ll probably find it most comfortable to turn your toes out somewhat — just make sure your knees follow the same direction as your toes and don’t collapse in.
During weighted squats, going down until where the hamstrings meet the calves (rather than halting and reversing direction at parallel) seems to be the safest posture for knees. The length of the femur, tibia, and torso will need to be modified. You’ve gone too far if your lower back begins to lose its lordotic curvature.
Make sure your muscular balance is correct.
According to several physiotherapists, the knee is the hip’s “outlet valve.” Hip issues may be mistaken for knee problems.
Because most people’s quadriceps are stronger than their hamstrings and glutes, knee stability is imbalanced. Strong hips may help to counteract this. For one group of athletes, strengthening the hips twice a week for six weeks decreased patellofemoral discomfort. The hips may be strengthened by doing the following exercises:
Bridge of the Hips
Step-Up
Weighted Single-Leg Stiff-Leg Deadlift
X-band strolls
Stomping by the band
But don’t forget about your quads. Quadriceps weakness may result in an unstable knee joint. In addition, a shaky knee joint may result in weak quads. It’s a never-ending loop. A major knee stabilizer is the vastus medialis obliquus (VMO).
It’s not easy to turn on the VMO. To begin, try TKEs (terminal knee extensions) and reverse walking (even better on an incline).
Full range of motion squats and single leg workouts may assist build the VMO after you’ve mastered TKEs and reverse walking (well, when proper form is used).
With a broader Q-angle, it may be difficult to activate the muscles that surround the knee. The Q-angle is the angle between the hip and the knee, and it may cause difficulties if it is too big (i.e. the femur has more of a tilt). This is one of the reasons why female athletes with broader pelvises are more prone to have an ACL injury than male competitors.
Examine your flexibility and mobility.
To allow adequate mobility, we require mobile joints and soft tissues surrounding the knee.
Depending on what you do, you’ll develop a personal benchmark for knee flexibility (professional chess player vs. collegiate pole vaulter). You probably have restricted mobility if you can’t perform a complete squat.
Although joint mobility is beneficial, we do not want excessive joint mobility at the knee joint. Limited mobility, on the other hand, may impair appropriate range of motion, altering knee mechanics. As a result, we seek a balance of mobility and stability.
We may increase the range of motion of the knee by doing flexibility exercises and increasing mobility in the surrounding joints. (For further information, see Dynamic Joint Mobility.) Inactivity, on the other hand, limits the range of motion of the knee, particularly if we sit all day, which shortens the front of the hips and “turns off” the muscular contribution from the hips. As a result, hip mobility is altered, and the knees take up the slack.
One of the most important things you can do to enhance knee health is to increase hip mobility. Hip flexor stretches include:
Lunge on a pad with your knee on the pad
Lunge of a warrior with a reach
Leg swings from side to side
Don’t forget about ankle mobility. The kinetic chain may be affected by the feet/ankles, much as the hips. Ankle flexibility exercises include:
Knee taps against the wall
Ankle stretch in an elevated position
Foam rolling for the anterior tibialis (approximately 34% of the way down the page)
Conclusions and suggestions
Knee health requires…
Above and below the knee, there are movable joints.
- Exercises to improve hip and ankle mobility should be done.
…a sturdy knee joint.
- Squat to your entire range of motion.
- Train the quads while ensuring that the VMO is turned on.
…a robust posterior chain.
- Hips, hamstrings, and glutes should all be worked out.
- Include work that requires just one leg.
…as well as appropriate mechanics while moving about.
- Avoid it if it bothers your knee (but work on your underlying biomechanics and solving the fundamental problems).
- Examine your walking style and footwear.
- Proper running, jumping, and exercising form should be learned and practiced.
If your knees are already hurting, the principles of exercise adjustment are to lower the resistance, modify the range of motion, regulate the pace, reduce the amount of activity, and/or switch activities.
Get regular daily exercise, maintain the joint moving through its entire range of motion, and try new activities to keep your knees healthy.
Bonus points
Closed chain exercises can reduce anterior directed forces on the tibia in relation to the femur, increase compressive forces between the tibia and femur, increase hamstring and quad co-contraction, more closely mimic daily functional activities, and reduce the incidence of patellofemoral complications. (To put it another way, practicing real-life motions like squatting and walking uphill exerts the appropriate pressures on the knee, recruits the right muscles, and keeps your knees happy.)
Proprioception aids in the prevention of injury and joint deterioration in the knee. Proprioception may be improved by performing single-leg lower body exercises, wearing a knee sleeve (for more sensory input), or brushing your teeth and flossing while standing on one leg.
During typical walking, forces on the knee vary from approximately twice your body weight to more than four times your body weight during sprinting and leaping exercises.
Knee wraps and sleeves may offer proprioceptive signals as well as increase warmth and blood flow at the joint. Taping and lightly wrapping the knees, on the other hand, will not offer much support, so don’t count on it.
Pre-workout heat on the knees may help make tissues more elastic.
If you’re overweight or have a knee injury, plyometrics should be avoided.
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References
To see the information sources mentioned in this article, go here.
S. Schwanbeck, P. D. Chilibeck, and G. Binsted. Electromyography was used to compare the free weight squat to the Smith machine squat. 2009;23:2588-2591 in J Strength Cond Res.
A biomechanical comparison of back and front squats in healthy trained people, Gullett JC, et al. 284-292 in J Strength Cond Res, 2009.
The impact of stance width on the electromyographical activity of eight superficial thigh muscles during back squat with various bar weights, Paoli A, Marcolin G, Petrone N. 2009;23:246-250 in J Strength Cond Res.
The impact of back squat depth on the EMG activity of four superficial hip and thigh muscles, Caterisano A, et al. J Strength Cond Res 16:428-432, 2002.
RF Escamilla, RF Escamilla, RF Escamilla, RF Escamilla, RF Escamilla, RF Escamilla, RF Escamilla, RF Escamilla, RF Escamilla, RF Escamilla, RF Escamilla, RF Escamilla,
Senter, C., and Hame, S.L. Tibial torque and knee flexion angle biomechanical analysis: implications for understanding knee injury 2006;36(6):635-641 in Sports Medicine.
Bulletproof Knees, M. Robertson, M. Robertson, M. Robertson, M. Robertson, M. Robert
G. Shankman, G. Shankman, G. Shankman, G. Shankman, G. Shankman, G. Shankman, G. Shankman, G. Shankman NSCA Journal, vol. 11, no. 11, pp. 32-42, 1989.
Treat your own knees, Hunter House Publishers, 2003. Johnson, J.
Obesity and osteoarthritis: disease etiology and nonpharmacologic weight management, Messier SP. 2008;34:713-729 in Rheum Dis Clin North Am.
Knee Surgery: The Essential Guide to Total Knee Recovery, by DF O’Neill. 2008, St. Martin’s Press.
Garrett J & Reznik B. Knee pain: The self-help guide. New Harbinger Publications. 2000.
BC Fleming, H Oksendahl, and BD Beynnon. After anterior cruciate ligament repair, should you do open- or closed-kinetic-chain exercises? Exerc Sport Sci Rev, vol. 33, no. 1, pp. 134-140, 2005.
Visnes H & Bahr R. The evolution of eccentric training as treatment for patellar tendinopathy (jumper’s knee): a critical analysis of exercise programmes. Br J Sports Med 2007;41:217-223.
T. Dierks, 2010 Annual Meeting of the American College of Sports Medicine.
AK Lange, B Banvanseele, MA Fiatarone Singh A comprehensive evaluation of strength training for the treatment of osteoarthritis of the knee. 59:1488-1494 in Arthritis Rheumatoid Arthritis Rheumatoid Arthritis Rheumato
“The knee is the joint between the thigh bone (femur) and the lower leg bone (tibia). In a way, the knee is a “double joint” because the knee is not only on the thigh bone but also the lower leg bone. So, what does that mean? Well, when you bend your knee, your thigh bone moves in the joint, and vice versa: when you move your knee, your thigh bone moves in the joint. The knee is a hinge joint, in that it can move with respect to your thigh bones. According to the ortho textbooks, the knee is a hinge joint, meaning it can bend and straighten.. Read more about ligaments of the knee and let us know what you think.
Frequently Asked Questions
Whats all in your knee?
My knee is a very important part of my body. It is where I stand and it supports me when I walk.
What is the most common knee injury?
The most common knee injury is a torn meniscus.
How important is the knee joint?
The knee joint is an important part of the human body. Its used for balance and stability, as well as to bend the leg.
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