Medical Musings, Health Hypotheses & Therapeutic Thoughts
So, we have discussed how the poor 'design' of the knee joint means it is prone to various injuries and dysfunctions, but what does that mean in your everyday life?
Here we will consider the anatomy of the knee a bit further, and discuss some of the ways our knees can give us grief.
It is important to remember that, like most of the other joints in the body, the knee requires its neighbours to be doing a relatively good job in order to perform its own.
So the knee joint consists of the tibiofemoral articulation, between the shin bone and thigh bone, and the patellofemoral joint, between the kneecap and thigh bone.
Because the quadriceps is a big, strong, muscle group, there is a lot of force focusing on the attachments to the patella, as well as the articulation between the patella and rest of the knee joint, and the patellar tendon that runs from the kneecap to the shin bone.
Both of these will tend to cause pain around or behind the kneecap, at the front of the knee.
So what about pain on the sides, or back, of the knee?
Posterior knee pain (behind the knee) is actually probably the least common area, compared to the front or sides. However, given how poorly-designed the knee is, it is still a pretty common patient complaint.
Other sources of posterior knee pain include the nerves in the area, whether from local insult or irritation in the lumbar (low) spine; the posterior cruciate ligament, or PCL, or the blood vessels in the area (e.g. DVT or deep vein thrombosis, or aneurysms). Interestingly, the patella may also refer pain to the posterior knee.
Note: Another source of pain (in all aspects of the knee) could also be bursitis.
In the next blog, we will consider pain on the sides of the knee - in medical-speak, the medial (inside) and lateral (outside) aspects.
LAPRADE R. et al, (2010) Analysis of the static function of the popliteus tendon in evaluation of an anatomic reconstruction: “the fifth ligament of the knee”, Am J Sports Med., 38:543