About the condition: Knee joint pain can be related to overuse where small stresses are repeated multiple times without allowing adequate recovery, for example running too much too soon, or excessive jumping. Or injuries can be acute where the injury is caused by an impact or twisting such as an anterior cruciate ligament injury. An overuse injury can also be considered to be acute if it is painful or inflamed.
The knee joint is a complex articulation and there are a number of structures in and around the knee that may be injured. These are:
Bone
The knee joint involves three bones. The thighbone or femur comprises the top portion of the joint. One of the bones in the lower leg (or calf area), the tibia, provides the bottom portion of the joint. The kneecap or patella rides along the front of the femur. The remaining bone in the calf, the fibula, is not involved in the knee joint but is close to the outer portion of the joint.
Ligaments
Ligaments are fibrous bands that connect bones to each other. The knee includes four important ligaments, all of which connect the femur to the tibia: the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) provide front and back (anterior and posterior) and rotational stability to the knee. The medial collateral ligament (MCL) and lateral collateral ligament (LCL) located along the inner (medial) and outer (lateral) sides of the knee provide medial and lateral stability to the knee.
Tendons
Tendons are fibrous bands similar to ligaments however, instead of connecting bones to bones, tendons connect muscles to bones. The two important tendons in the knee are the quadriceps tendon connecting the quadriceps muscle, which lies on the front of the thigh, to the patella and the patella tendon connecting the patella to the tibia.
Cartilage (meniscus)
Cartilaginous structures called menisci line the top of the tibia and lie between the tibia and the femur. Menisci provide both space and cushion for the knee joint. Meniscus tears are common in twisting injuries and commonly occur with an injury to the cruciate ligaments.
Bursae
Bursae are fluid-filled sacs that help to cushion the knee and allow tendons and ligaments to move over each other and bone smoothly. The knee contains three important groups of bursae. The prepatellar bursae lie in front of the patella, the anserine bursae are located on the inner side of the knee and the infrapatellar bursae are located underneath the patella. These bursae can become inflamed or infected and cause pain.
Symptoms: Symptoms vary with the structures that are injured or not functioning correctly. You may experience popping, grinding, locking, the sense of giving way, swelling, pain or a combination of any of these. The onset may be immediate after an injury, a few hours after trauma, or gradually over time.
Treatment: There are a number of options open to treat knee injuries using chiropractic techniques and exercise rehabilitation. These include using the RICE principle in the initial stages of injury to reduce inflammation and ease pain. Various mobilisation, manipulation and soft tissue techniques can be used depending on the cause of the problem, in conjunction with specific exercise rehabilitation.
