Exploring the Knee Joint

One of the largest and most complex joints in the body, for medics and movement professionals the knee can be one of the often most complained about parts of the body. Yoga can often see knee issues from strains in standing poses and Pilates observes many with knee injuries seeking support. This prompted us to provide a further explanation about the wonders of this important joint. This post is for information purposes only and does not substitute speaking to a professional if there is a pain in the knee.


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Anatomy of the Knee

The knee joint is comprised of:

  1. Three bones that form the joint - femur, tibia and patella,

  2. Tendons from muscles in the upper and lower leg cross-over and contribute to its movement,

  3. Four ligaments - medial (inside), lateral (outside), posterior (back) and anterior (front),

  4. Two menisci - lateral and media, and

  5. several sacs and bursae that help the knee move smoothly.

The more component parts the more chance there is of something to go wrong and pain to arise.

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Movement of the Knee

Principally the knee is a hinge joint, so it moves in one plane of motion - sagittal (forwards and back of the central axis). However, there is some slight give in the joint when bent that can permit a rotation.

It is often this slight rotation when undertaking high-impact or weight bearing movements that can lead to injuries or wearing out the joint unevenly.


Fascia of the knee

The knee tracks along two fascial meridians and impacts a third. Often the knee is a sight of pain when the issue may be the hip or foot. A whole body approach of fascia is very supportive to knee stability.

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Spiral Line (SPL) tracking

The SPL is responsible for tracking the knee forward and backward, like walking. Consider the entire leg a spiral from big toe to outer hip and the knee should be the centre point that tracks forwards for healthy balance of the lower limbs.

Common to modern movement patterns is that the outer thigh is tight and inner ankle too weak, which leaves the knee dropping inwards when bent. The knee takes the strain in daily simple movements.

Loosen the iliotibial (IT) band with foam roller is often recommended, but the reality is some neuromuscular reactivation training is required. The outer hip muscles need to draw the knee laterally whilst the ankle (SBL) and arches of the feet press down for the inner knee and thigh to connect into the DFL. Finally, the ‘external hip rotators’ have to be active even when the feet are in parallel. If the toes have to turn out for balance it is a clear sign that these muscles cannot work in parallel and retraining of the side and back glutes is a priority.

Tom Myers ‘Anatomy Trains’ Book

Tom Myers ‘Anatomy Trains’ Book

DEEP FRONT LINE (DFL)

Raynor massage calls this the ‘inner line’ and it is the track that helps find the deep core muscle connection for stability. It tracks from the inner arches and ankle of the feet, through the middle of the knee capsule (popliteus) and into the inner thigh bone. From this crosses into the pelvic floor and abdominal muscles.

This is important to understand as strengthening the arches of the feet can often help stabilise the knee from dropping inwards. When activated it prevents the knees ‘bowing’ outwards and knee cap rolling inwards.

Tom Myers ‘Anatomy Trains’ Book

Tom Myers ‘Anatomy Trains’ Book

Superficial Back Line (SBL)

The fascia tracks into the lateral aspect of the knee that provides counterbalance for the DFL. However, when the knee is bent it separates the fascial line from the lower leg to the remainder of the body. This is why bending the knees to pick something up from the floor is easier than with straight legs - it is not just the hamstrings alone that restrict the movement.

If this line becomes restricted with sitting a great deal it can lead to strain into the outer knee and this can lead to pain. The connection here is to open the front of the pelvis and activate the glute in the back body.


Metaphysics of the Knee Joint

In the chakra energy system the knees are part of the root chakra system. This is the sense of belonging to the earth and community. Consider the archetypal images of when people are on their knees and the energy of this joint becomes very apparent - pride. The ability to bend the knees with ease and stability reflects the inner approach to responding to life’s challenges. Being grounded in strength yet soft and fluid through the knee is a healthy approach.

When there are times in life that the knees give way then strength is required. When the knee becomes rigid there is a lack of openness and flexibility in approach. As the body ages the knees often show the signs of restriction and this can reflect the belief that we become set in our ways with age. An open perspective will keep the knees bouncing with ease.


Holistic Training of the Knee

  1. Track the knee when bending in squats - check that it is going over the second and third toes as the knee bends and keep that rotation as the leg straightens.

  2. Lift the heels and take a balancing plie - this can help find the arches of the feet and control the thighs. Use this to help improve the muscles when the foot is flat on the floor.

  3. External rotation in sumo squats - squeeze the knees back towards the pinkie toe to keep the knee tracking on the middle of the ankle.

  4. Knee always stays over the foot - keep the knee over the centre or heel of the foot to prevent over flexing in the joint and straining it when weight bearing in lunges and squats.

  5. Twisting the spine - often the knee opposite to the rotation will want to drop inwards as the torso rotates. Keep focusing on pressing in the opposite direction to the shoulders to keep stable.

  6. Squat to stand from glutes - take the strain out of the knee. Sit on a chair with wheels that rolls easily. Stand up without rolling the chair back at all. This uses the glutes and pours less weight into the knees to lift the body-weight up.

  7. Train the quadriceps to pull up the kneecap in extension whilst keeping space in the back of the knee joint. Ramming the knees straight is overpowering and forceful on the knee joint.

SQUATS - KEEP KNEE OF MIDDLE TOES

SQUATS - KEEP KNEE OF MIDDLE TOES

IN TWISTS PUSH THE KNEE TOWARDS PINKIE TOE

IN TWISTS PUSH THE KNEE TOWARDS PINKIE TOE

If you have concerns about your knees, then get in touch. Our team of high quality yoga and pilates teachers will guide you to discover your knee joint balance.


ACKNOWLEDGEMENTS

Fascia information from ‘Anatomy Trains’ by Tom Myers; Functional Fascia by

Energy from ‘Energy Medicine’ by Donna Eden