Knee Pain -

Knee pain is a common presentation for clients of any range of age and gender.

Table of Contents

Knee pain indeed is a vast topic.

So in this post, we are going to go through how to identify the reason why we can experience knee pain.

For doing so we are going to look at some special testing, that we use for the knee joints.

Next, in a further post, we may analyse individual conditions.

What about the Knee Joint?

The knee is the strongest joint in the body.

It takes a lot of pressure from the upper body and still has to handle the shock coming from the lower leg session, shock as walking, running and jumping.

Indeed, whenever we do one of these actions, the knee plays a big role.

Knee Anatomy

Bond:

Above: Femur
Below: Medially the Tibia, laterally the Fibula.
Patellar is the front “floating bond”

Ligaments:

Anterior Crucial Ligament
Posterior Crucial Ligament
Posterior Menisco-Femoral Ligament
Fibular Collateral Ligament
Tibial Collateral Ligament
Transverse Ligament (this one is visible only from the front side of the knee, below the patella).

In between the bonds we have:

Medial Meniscus
Lateral Meniscus

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So, the knee joint can be divided into two parts:

Tibiofemoral joint
Connects through the collateral ligaments, cruciate ligaments and menisci;
Patellofemoral joint
Gives stability to the medial and lateral retinaculum and allows the extension mechanism through the tendons of the quadriceps f..

Now that we have a better idea of what the knee anatomy is, we can look into his functionality.

Knee ROM are:

Extension: 0°
Flexion: 140°
Internal Rotation: 30°
External Rotation: 40°
Abduction/Adduction: 15°

Said so, we can see that the major movement that the knee can accomplish is, flexion.

Even if the Internal and External rotation since to be a big move for the knee, in the reality, that’s not always the case.

The older we get, easily this motion actively gets tighter.

Indeed, one of the main reason for meniscus injury is the twisting of the knee, when the feet is holding the ground and the body rotates.

But as previously mentioned in this post we would look into the knee special test.

What knee functional test have to tell us?

As we already mentioned in another post, a generic active, passive or resisted ROM tell us about muscle functionality.

On the other hand, a special test for the knee can show us if a ligament or a meniscus is loose, in the case of ligament or injured.

Furthermore, special tests, on the knee are essential to prevent further injury and reduce joint degeneration.

To start with we have the drawer test: Anterior Draw test and Posterior Draw test.

The Anterior one is to test the anterior crucial ligament, and the posterior, obviously, is for the crucial posterior ligament.

Both these tests are done with the client lying supine on the table, with a hip and knee flexed, and foot on the table.

The therapist will ensure that the foot doesn’t move and will place its hands around the knee, with the fingers (except the thumb) seating at the top of the calf and the thumbs seating on the patella.

For the A.D. test, the therapist will lightly pull the knee joint away from the patient body.

On the other hand, for the P.D. test, the therapist will push the knee towards the patient’s body.

These tests are positive if there is a loose movement within the knee, in the direction of pull or push.

If the client has a history of injuries, to the ACL or PCL the therapist wants to make sure not to push or pull with great effort, or injury could occur.