Your knees take a lot of stress from regular movements like walking, squatting, and going up and down stairs. The muscles surrounding the knee are also used for motion in joints like the hip or ankle.
Knee problems can be caused by overuse, traumatic injury, and/or naturally occurring changes. Suffering from knee pain? Contact us to learn about treatment options.
How Your Knee Works
The knee consists of four bones – the kneecap (patella), the upper leg thigh bone (femur), the shin bone (tibia), and an outer lower-leg bone (fibula) – the joints between them, the ligaments that keep it stable, and the muscles that generate strength and motion.
The thigh bone stacks on top of the shin bone, creating the true knee joint. The outer bone runs parallel with the shin bone of the lower leg, forming the tibiofibular joint. The kneecap contacts the thigh bone in the front of the knee to form the patellofemoral joint.
The meniscus, a flexible rim of soft tissue, fills the space between the thigh bone and shin bone. The meniscus is comprised of two C-shaped pieces, which help increase the knee’s stability and provide shock absorption.
The four main ligaments in the knee that help provide stability are commonly injured in sports or by trauma. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) wrap around each other deep within the knee, attaching the thigh bone to the shin bone. This helps prevent excessive pivoting of the knee and keeps the shin bone from moving forward or backward under the thigh bone.
The medial collateral ligament (MCL) and the lateral collateral ligament (LCL) help keep the knee stable side-to-side. The MCL runs vertically along the inside of the knee, while the LCL runs vertically on the outside of the knee.
Three main muscle groups surround the knee joint and help power the knee for walking. The quadriceps muscles on the front of the thigh bone cross the knee over the kneecap, attaching to the shin bone via the patellar tendon. On the backside of the thigh, the hamstring muscles cross the knee. Hamstring tendons attach on the fibula and on various places on the shin bone.
In the back of the shin bone, the calf muscles (gastrocnemius) attach to the heel and run up the back of the lower leg, connecting again behind the knee on the backside of the thigh bone.
Many other muscles play a role in the knee’s function and tracking of the kneecap, including the IT band and gluteal muscles. The bones, joints, ligaments, and muscles must work in unison for the knee to function properly.
Evaluating Knee Pain
Knee-pain evaluation starts with you telling us when and how your knee pain started, how it feels, and treatments you’ve tried. We also ask about other medical conditions that may contribute to your knee pain. We do a physical exam and test your knee’s structures, range of motion and strength, looking for specific problems. Sometimes we check hip strength and range of motion, as these can play a role in knee pain.
Based on the findings, we may use a cortisone injection with a numbing medicine to simultaneously relieve your pain and determine its source. Sometimes we order X-rays, to show fractures, spurs, and changes from arthritis, or MRIs, to show more bone detail and soft-tissue damage like ligament or meniscus tears.
Causes of Knee Pain
- Less common causes: infection, tumors, or nerve problems
Treating Knee Pain
Treatment of knee pain is very specific to the diagnosis and severity of your symptoms.