Parts Of The Knee

Many readers are interested in the following topic: Anatomy of the Knee. We are happy to note, that our authors have already studied the modern research about the topic you are interested in. Based on the information provided in the latest medical digests, modern research and surveys, we provide extensive answer. Keep reading to find out more.

You don’t usually see me endorse any establishment unless I am sure of it. This is because I believe a lot of you trust me and would take my recommendation. There are Chiropractors out there who would ask you to go for treatment which you don’t need. Darek is an honest Physiotherapist who collaborates with many doctors and surgeons. They trust him and so do I. He upgrades his skills and knowledge by investing in workshops and course overseas every year.
He has a Clinic at Kovan and Marine Parade.

Does Physiotherapy Help Knee Pain?

Knee pain and injury are very common amongst both athletes and normal people. Typically, your body is capable of healing mild knee injuries. However, all injuries should be checked and diagnosed at the start by a physiotherapist. If knee pain persists, physiotherapy can help you recover from the injury through mobilisation techniques, stretches, taping, massage and strengthening exercises.

Before we explain further how you can remedy knee pain, we need to first understand what exactly the knee is, and the types of injuries associated with it. In this article, we will cover:

1. The structure of the knee
2. How the knee functions
3. Common risks that lead to knee pain
4. Tips to prevent knee injuries
5. Symptoms that are categorised under knee pain
6. First aid and immediate steps that should be taken
7. Knee pain diagnosis
8. Types of knee injuries
9. Professional Treatments for knee pain
10. How physiotherapy is used to treat knee pain

The Structure of your Knee

Your knee is a synovial hinge joint connecting the thigh bone (femur) and shin bones (tibia and fibula). It permits the flexion and extension of your lower leg relative to your thigh. In layman terms, your knee enables the bending and straightening of your leg, an essential motion that is required in everyday activities. Simply put, without your knees, you would have trouble walking, running, standing or even sitting.

The most visible component of your knee is the patella, otherwise more commonly known as the kneecap. It sits in a groove connected to the femur and is cushioned by a thick layer of cartilage. Cartilage also surrounds and supports the knee joint on either side. Additionally, ligaments, which are tough bands of connective tissue, hold the bones in place.

The anatomy of your ligaments and bones limit the range of motion of your knee to about 120 degrees of flexion. In addition, the knee is capable of a small degree of lateral and medial rotation when flexed.

How your Knee Functions

Your knee functions based on the contraction of muscles that surround it. When the muscles at the front of your thigh (quadriceps) contracts, your leg straightens. Conversely, when the muscles on the back of the thigh (hamstrings) contract, your leg bends.

The quadriceps and hamstrings work in tandem to allow you to perform any motion that you require your knee to undergo. For most, it is an instinctive process that we spare little thought for.

Common Risks Associated with Knee Injuries

Knee injuries are more prevalent in certain situations. These include:

• Being overweight
• Having weak or tight lower and upper leg muscles
• Playing high impact sports
• Playing sports that rely on knee cushioning impact
• Having previously injured your knees

If you find that these situations apply to you, then you should certainly take active care of your knees.

Tips for Preventing Knee Injuries

If the situations listed above apply to you, then you need to take active care of your knees. We have listed several easy tips to follow:

• Always perform proper warm up of your joints and muscles. This can be done by gently going through the common motions of your sport.
• Wear appropriate footwear and use proper gear
• Avoid abrupt jarring motions
• Perform proper cool down after your sport session by doing light stretches
• Perform incremental increases in physical exertion.

Symptoms of Knee Injuries

Other than knee pain that you are experiencing, you may also observe other symptoms of knee injuries:

• Swelling of your knee
• Increasing redness on the surface
• Heat being trapped in the knee
• Your knee “giving way” or “buckling” when you attempt to put weight on it
• Locking, popping, snapping or clicking sounds when the knee is in motion
• Inability to straighten or bend your knee
• Obvious deformity

First Aid for Knee Injuries

If you are experiencing knee pain, you should apply first aid for the first 48 to 72 hours. This will prevent aggregation of the injury and possibly help to relief some of the pain.

• Stop performing your sport or activity immediately. Do not try to work through or ignore the pain. Instead, rest your knee joint first.
• Apply ice packs to reduce pain, swelling and any internal bleeding. Application can be done for 15 minutes every few hours.
• Bandage the knee to reduce mobility and to provide support for it
• Elevate the injured leg
• Avoid massaging the knee
• Avoid applying heat to the knee

You should also seek the professional opinion of a doctor or physiotherapist regardless of whether the pain remains or subsides.

Knee Pain Diagnosis

When you visit a physiotherapist or a doctor for the first time for your knee pain, they may perform the following tests:

• Subjective assessment to find out when you first started feeling pain
• Functional movement testing like walking/ stairs/ squatting
• Blood tests (Performed by Doctors only)
• Imaging – X-ray, ultrasound or MRI scans (Performed by Doctors only)
• Knee joint aspirate – a small amount of fluid is drawn from your knee using a needle (Performed by Doctors only)

Based on these tests, the doctor or physiotherapist will be able to diagnose your injury.

Types of Knee Injuries

There are several different types of knee injuries. The most common of which are (1) ligament sprains, (2) tendon tears, (3) cartilage tears and (4) patella-femoral pain syndrome.

Ligament Sprains

Ligament sprains occur when they are stretched beyond their capacity. Common causes of this type of knee injury are sudden twists of your knee, exertion of excessive force, heavy landings and rapid halting when sprinting.

Torn ligaments lead to internal bleeding, swelling, pain and numbness or laxity in the knee. Of all ligaments in the knee joint, the anterior cruciate ligament (ACL) is mostly commonly injured. Unfortunately, your body is incapable of performing self-repair for a ruptured ACL, and thus requires reconstructive surgery.

Tendon Tears

Tendons anchor your muscles to your knee joint. When overstretched, they will tear and bleed. A sudden onset of pain is to be expected, making walking difficult while buckling of knees will occur frequently. Fortunately, most tears can be healed without surgery. Instead, rest coupled with subsequent physiotherapy is enough.

Cartilage Tears

The most common form of cartilage injuries is a torn meniscus. Typically occurring during weight bearing exercises, the cartilage tears due to severe impact or twisting. Subsequent symptoms include swelling, pain and the inability for you to straighten your injured leg. Furthermore, this type of injury is more common amongst older people due to the wear and tear that their legs have accumulated up to this point in their lives.

Patello-femoral Pain Syndrome

Characterised by pain felt behind your knee cap, the patella-femoral pain syndrome is caused by any repeated abnormal movement of the knee when it is bent or straighten. As such, you can expect the pain to come gradually over time.

Additional contributing factors to this injury include:

• Squatting for long periods
• Walking up and down stairs or hills
• Staying still for extended periods of time
• Imbalances in muscle strength
• Tight muscles
• Structural abnormalities

Professional Treatments for Knee Pain

Depending on the exact injury, different types of professional treatments may be recommended for your knee pain. This typically includes:

1. Physiotherapy – pain reduction techniques, taping, exercises and rehabilitation methods
2. Aspiration – drawing of fluid from the knee with a fine needle in order to reduce the amount of swelling
3. Arthroscopic surgery – performed by inserting slender instruments through small incisions. Commonly used to treat cartilage
4. Open surgery – performed when injuries are severe or if the entire joint needs repair

How Physiotherapy Treats Knee Pain

Different physiotherapy techniques are used to treat knee pain depending on the type of injury sustained.

Sprained Ligaments

For sprained ligaments and tendon tears, physiotherapy can be done once the knee’s swelling and pain has subsided. A series of physical exercises will aid you to build up your strength bit by bit without risk of re-tearing the ligament.

Physiotherapy can aid rehabilitation for ACL injuries. For Acute ACL injuries, pain management and gait correction can be performed. As for pre and post-surgery, the following steps will be followed:

1. Pain and swelling management
2. Walking aids
3. Knee movement and muscles control with electrical stimulation kits
4. Eventual return to daily and sporting activities through muscle strengthening routines

Cartilage Tears

For cartilage tears, once surgery has been performed to restore the damaged cartilage, physiotherapy can be conducted to stimulate restorative healing.

If the injury is grade 1 – 2, physiotherapy would include treatments that:

• Release tight and overused muscles
• Correction of gait or posture
• Activation and strengthening of lower limb muscles

The expected time duration for pain relief is about 6 weeks.

If the injury is grade 3 – 4, physiotherapy is aim at pain relief and management:

• Corrective bracing
• Kinesiology taping
• Footwear correction

Trust BMJ to Treat Your Knee Pain

BMJ Therapy is a team of Allied-Health Professionals (Physiotherapists, Occupational therapists) and Massage Therapists with special interests in treating injuries involving our Bones, Muscles and Joints (called musculoskeletal injury). BMJ Therapists have vast clinical experience and base our Physiotherapy Singapore treatment on the latest medical knowledge to deliver the best possible care to our clients.

Contact us today to find out about our knee physiotherapy Singapore service today.

Vanessa Goh

Principal Physiotherapist

Vanessa Goh, writes with the patients in her mind. The chatty and bubbly physiotherapist brings not only top notch physio treatment and also lots of laughter to her sessions. Happy patients recover faster, its true!

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BMJ Physiotherapy provides accessible and quality specialist care for your bones, muscles and joints conditions. Our team of highly trained allied health professionals (Physiotherapists, Occupational therapists) and Massage therapists adopt the latest proven treatment methodology and work in alliance to deliver the best possible care to our patients.

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    Yay! We Fixed him! Very kind words from a world class motivation speaker! Thank you Christian Chua.

    “HE FIXED ME!” “I hurt my shoulder several months ago while lifting a heavy suitcase. It felt like a muscle had torn. After resting the shoulder for a few days, the pain subsided but I soon realized that my movement had been restricted. I could not straighten my right arm, could not reach for the remote control behind my pillow, could not do pull-ups and had difficulty putting on my suit.
    I approached Darek Lam from BMJ to help me fix my shoulder. He patiently explained that when the wound healed, a few sets of muscles fused together. It wasn’t going to be a simple one-session treatment. He showed me photographs and videos which allowed me to fully understand my situation. Throughout the 10 over sessions, he put so much effort into fixing my shoulder, and after every session, you could see the improvement.

    You don’t usually see me endorse any establishment unless I am sure of it. This is because I believe a lot of you trust me and would take my recommendation. There are Chiropractors out there who would ask you to go for treatment which you don’t need. Darek is an honest Physiotherapist who collaborates with many doctors and surgeons. They trust him and so do I. He upgrades his skills and knowledge by investing in workshops and course overseas every year.
    He has a Clinic at Kovan and Marine Parade.

    You would spend money to maintain your car, why wouldn’t you spend money to fix your own body?”

    Orthotics Fitting

    Using orthotics in pain relief and movement modification in rehabilitation is widespread. To use an orthotic properly, it needs to be well-fitted to you. Your physiotherapist will first identify modifiable variables in your movement and recommend specific types of supportive orthotics that will help with your pain. Typically used as insoles in shoes, a foot orthotic is meant to retrain your foot muscles to hold your foot arch up whilst performing activities such as walking, running or jumping. Your physiotherapist will fine-tune the support with additional pads if necessary.

    Prehabilitation and post-op rehab

    Rehabilitation can be done before or after surgery! Contrary to popular belief that the physiotherapist’s role will only start after surgery, studies have found that doing pre-operative rehabilitation, a.k.a. Prehab, improves your post-operative outcomes! Your physiotherapist will customise your exercise programme and work with you to strengthen specific groups of muscles that may be affected due to surgery and facilitate the return of your muscle strength.

    Ergonomics assessment

    Ergonomics assessment is a great way to prevent injuries at home or at work. Occupational hazards such as long hours of sitting or repetitive bending down for a particular task can lead to musculoskeletal pain. Your physiotherapist will assess your workplace environment (such as workstation layout, body posture, etc.) and equipment and identify potential factors that may cause injury or discomfort. Based on these findings, recommendations will be made to create a safer environment for you to work in and reduce your risk of injury or pain.

    Running gait analysis

    Running gait analysis is an observational study performed with slow-motion video on a treadmill. Your physiotherapist will analyse your running pattern and identify any issues in your trunk, hip, knee, or foot. These issues may include muscular imbalances, poor posture, or poor foot mechanics. Thereafter, they will tailor specific treatments and exercises to improve your running efficiency and prevent further injury and pain.

    Postural analysis and body reading

    This treatment technique involves your physiotherapist carefully examining and observing your posture and movement patterns. The goal is to achieve symmetry in our body as we perform our tasks and understand the influence of different body parts on a movement. This technique often identifies muscle imbalances and weaknesses, leading to compensatory movements that could lead to pain or discomfort. After identifying the issues, specific treatment plans that incorporate exercises, manual therapy, or taping may be used to guide recovery.

    Taping and Kinesio taping

    Taping is a form of treatment whereby a stretchy or rigid fabric is applied to the skin over the affected body part. This tape serves as a support or feedback mechanism, occasionally applying a force to the body to facilitate movement. There are many different types of tape on the market for various purposes. It is important to note that the tape does not ‘fix’ your problem, and you should get proper treatment for the area.

    Cryotherapy

    Cryotherapy is a treatment technique that involves exposing the treated body part to cold temperatures for a short time.

    typically 10–15 minutes. Many types of cryotherapies are available but are commonly applied at home via an icepack. It is a standard treatment modality typically used for acute injuries, post-operative swelling and pain management, and post-exercise or competition soreness. While generally considered safe, it may cause skin irritation and tissue damage if not applied properly. Please consult your physiotherapist if you need clarification.

    BFR training

    Blood Flow Restriction (BFR) training uses a specialised pressure cuff secured around the limb to be trained. The purpose of the cuff is to limit the venous return of blood from the limb, resulting in changes in the body’s hormonal composition. This will increase the number of growth factors in the blood, promoting healing and muscle tissue growth in the isolated region. It is generally used to treat weakness in post-surgical cases.

    Exercise testing and therapy

    Exercise testing is an objective measure that physiotherapists use to accurately determine if a patient is suitable for progressing to the next level of rehabilitation. There are a multitude of tests that can be performed, and they will be carefully selected based on your condition. If any issues are spotted during the test or substantial differences need to be corrected, your physiotherapist will curate a specialised exercise programme for you.

    Sports massage

    Sports massage is a type of hands-on treatment that improves an athlete’s ability to return quickly to physical activity after intensive training. This treatment aims to release muscle tightness, improve range of motion, and improve flexibility. Your sports massage therapist will use various techniques, such as deep tissue massage and stretching, in conjunction with warm or cold packs to enhance the effect of the massage. Sports massage is suitable for people of different sporting levels, from amateurs to professionals, and people in physically demanding jobs.

    Clinical Pilates

    Clinical Pilates is a form of exercise therapy adapted from traditional Pilates and targeted at improving posture, balance, and strength. It is typically used as a tool for injured patients suffering from back pain, neck pain, and other joint injuries, such as the shoulder and knee. These exercises are performed on a mat or specialised equipment such as a reformer and are tailored to improve body awareness and the alignment, control, and stability of the injured body part.

    Dry needling

    Dry needling is a treatment technique where thin, sterile needles are inserted into specific points in the body to relieve pain and muscle tension. These points are carefully identified by your physiotherapist and treated to induce a ‘twitch’ response in the tissues. This quick contraction of the muscles results in a reflex relaxation of the tense muscles, allowing blood flow to be restored and the muscle to return to its normal length, resulting in pain relief.

    Radial Shockwave Therapy (RSWT)

    Radial Shockwave Therapy is a non-invasive treatment that uses mechanical waves delivered through a probe through the skin. The waves travel in a “radial’ fashion and can be used to target deep scar tissue. Scarring is part of our body’s healing process and needs to be dealt with for full recovery. Shockwave is ideal for targeting this deeper scar tissue.

    Our physiotherapists usually perform this treatment carefully, which is recommended at 3 to 5 sessions a week.

    Manual Therapy or Mobilisation Therapy

    Manual therapy is a form of hands-on treatment used to diagnose, treat, and improve stiff muscles and joints.

    BMJ physiotherapists use this technique to target tight muscles and fascia, which includes various techniques such as fascia release therapy, trigger point release, pin and stretch release, joint mobilisation, and high-velocity thrust manipulation.

    When used by our experienced physiotherapists, these techniques can help increase joint mobility, improve movement, and help our overall posture alignment. The improvement is often instant, with immediate results. Most importantly, we will teach you similar home techniques to target the tight muscles and fascia at home.

    Anatomy of the Knee

    Knee anatomy involves more than just muscles and bones. Ligaments, tendons, and cartilage work together to connect the thigh bone, shin bone, and knee cap and allow the leg to bend back and forth like a hinge.

    The largest joint in the body, the knee is also one of the most easily injured. Problems with any part of the knee’s anatomy can result in knee pain, stiffness, and difficulty walking.

    This article details knee anatomy. It explains the different parts that make up the knee joint, how the knee works, and common knee problems.

    

    Bones Around the Knee

    Three important bones come together at the knee joint:

    1. The tibia (shin bone)
    2. The femur (thigh bone)
    3. The patella (kneecap)

    A fourth bone, the fibula, is located just next to the tibia and knee joint, and can play an important role in some knee conditions.

    The tibia, femur, and patella all are covered with a smooth layer of cartilage where they contact each other at the knee joint.

    There is also a small bone called a fabella, that is often located behind the knee joint. The fabella is a type of bone called a sesamoid bone (meaning it sits within a tendon). It’s of little consequence to the function of the knee joint and is only found in about 25% of the population.

    

    Cartilage of the Knee

    There are two types of cartilage in the knee joint:

    1. Articular cartilage is the smooth lining that covers the end of the bone. When the smooth articular cartilage is worn away, knee arthritis is the result. Cartilage is generally a resilient structure that resists damage, but when injured, it has a difficult time healing. It can also wear down over time with age.
    2. The other type of cartilage in the knee joint is called the meniscus. The meniscus is a shock absorber that sits between the end of the thigh bone and the top of the shin bone.

    Ligaments of the Knee

    Ligaments are structures that connect two bones together. There are four major ligaments that surround the knee joint.

    Two of these ligaments are in the center of the joint, and they cross each other. These are called the cruciate ligaments and consist of the anterior cruciate ligament and the posterior cruciate ligament.

    One ligament is on each side of the knee joint—the medial collateral ligament on the inner side and the lateral collateral ligament on the outer side. Ligament injuries typically result in complaints of instability of the knee joint.

    Muscles and Tendons

    Muscles propel the knee joint back and forth. A tendon connects the muscle to the bone. When the muscle contracts, the tendons are pulled, and the bone is moved.

    The knee joint is most significantly affected by two major muscle groups:

    1. The quadriceps muscles provide strength and power with knee extension (straightening).
    2. The hamstring muscles allow for strength and power in flexion (bending).

    The patellar tendon on the front of the knee is part of the quadriceps mechanism. Other smaller muscles and tendons surround the knee joint as well.

    Joint Capsule and Lining

    The synovium is the lining of the joint space. The synovium is a layer of tissue that defines the joint space.

    The synovial cells produce a slippery, viscous fluid called synovial fluid within the joint. In conditions that cause inflammation of the joint, there can be an abundance of synovial fluid produced, which leads to swelling of the knee joint.

    Joint Bursa

    A bursa is a structure in your body that is placed between two moving parts. In your knee, there is a prominent bursa just in front of your knee and underneath the skin.

    The bursa functions as a means to allow for smooth movement between these two structures (skin and bone). There are actually hundreds of bursae spread throughout your body.

    The bursa in front of the kneecap is prone to swelling, especially when people injure their knees or perform activities that involve kneeling on hard surfaces. Inflammation of the bursa, called prepatellar bursitis, is common in people who do flooring work or cleaning work and have to spend a lot of time kneeling.

    Knee Joint Function

    Knee function is determined in large part by the anatomy of the joint. The primary function of the knee is to hinge at the lower extremity.

    However, the knee does not only bend back and forth. There are also rotational movements at the knee joint.

    In order for the knee joint to function properly, there needs to be good stability of the joint throughout its range of motion. If there are restrictions in mobility or instability of the knee joint, the function will not be normal.

    A normally functioning knee joint will allow the following:

    • Lower extremity support when standing
    • Strength and power with movements such as standing up, squatting, or climbing
    • Efficient movement when walking or running
    • Power to propel your body more when you move
    • Shock absorption when walking or landing from a jumping position

    These are just some of the important functions that the knee joint allows. In order for any one of these functions to behave normally, all of the aforementioned structures need to be working together—and functioning normally.

    Common Knee Conditions

    Knee pain, decreased range of motion, and functional problems can be due to a number of conditions, including:

    • Arthritis:Arthritis occurs when there are inflammation and damage to the cartilage of the knee joint. Arthritis can lead to swelling, pain, and difficulties with activities.
    • Ligament injuries: Some of the most common sports-related injuries to the knee joint are ligament injuries. The most commonly injured ligaments are the anterior cruciate and the medial collateral ligaments.
    • Meniscus tears: Tears of the meniscus, the cushion between the bones, can occur as the result of an injury, or as a result of wear and tear. Not all tears cause pain or functional problems.
    • Tendonitis: Inflammation to the tendons that surround the joint can lead to a common condition known as tendonitis. Some of the tendons around for more prone to developing inflammation.

    A Word From Verywell

    The knee joint is a complex structure that involves bones, tendons, ligaments, muscles, and other structures for normal function. When there is damage to one of the structures that surround the knee joint, this can lead to discomfort and disability. Understanding the normal function of the knee joint can help you address some of these common conditions.

    Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

    1. American Academy of Orthopaedic Surgeons: OrthoInfo. Common knee injuries.
    2. U.S. National Library of Medicine: MedlinePlus. Meniscus tears–aftercare.
    3. American Academy of Orthpaedic Surgeons: Ortho Info. Synovial Chondromatosis.
    4. National Institute of Health: News in Health. Beating Bursitis: Take Care of Your Joint Cushions.
    5. U.S. National Library of Medicine: MedlinePlus. Knee Injuries.
    • Bronstein RD, Schaffer JC. Physical Examination of the Knee: Meniscus, Cartilage, and Patellofemoral Conditions. J Am Acad Orthop Surg. 2017;25(5):365-374. doi:10.5435/JAAOS-D-15-00464

    By Jonathan Cluett, MD
    Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men’s and women’s national soccer teams.

    

    

    

    

    

    

    

    

    

    

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