Have you ever been exercising and over time your knee starts to develop this achy or even stabbing pain?  Or have you collided with an object or another person and suddenly have trouble standing or moving?  It can be scary to hurt a knee.  Continue reading to learn more about your knees and how to protect them.

The anatomy of the knee:
Understanding the basic anatomy and biomechanics of the knee is the first step to being able to prevent and treat knee pain.  The femur, tibia, fibula, and patella (knee cap) are the bones that come together to create the knee.  The femur is part of the upper leg while the tibia and fibula make up the lower leg.

There are 4 ligaments that hold the bones of the knee together:  ACL, PCL, LCL, & MCL.  These ligaments help keep the femur snug into the meniscus.  The meniscus is a dish-like structure on top of the tibia that the condyles of the femur fit into.  The ligaments, along with the meniscus, provide stability to the knee and guide its back and forth motion.

The last part of the knee anatomy equation involves the muscles.  The muscles that extend the knee are the quadriceps located on the front of your upper leg.  The hamstrings flex the knee and are located on the back of your upper leg.  The calves affect the knee from below the joint.

The knee is a hinge joint.  This means that it moves in one plane of motion (flexion & extension).  Think of it like the hinge on a door.  It is only supposed to move in directions that open or close the door.  Injuries happen when that hinge is forced to move further than normal or in a different direction than flexion & extension.

Traumatic vs. non-traumatic knee injuries:
1. Traumatic
With traumatic knee injuries, you can normally pinpoint the exact time and activity that caused your pain such as a collision while playing sports, a car accident, or an awkward landing.  In these cases, the ligaments &/or meniscus can be torn to a degree.  In addition to sharp pain, you may notice your knee feeling unstable, swollen, and possibly bruised.  Sometimes your knee will click or feel like it is stuck in a position.

If you have a traumatic knee injury it is important to implement the acronym PRICE (Protect, Rest, Ice, Compress, & Elevate).  Protect & Compress can be accomplished with at least a neoprene brace/sleeve or an elastic wrap.  If you want even more protection, you can buy a basic hinge brace from a local drug store or online for about $30.  PRICE is a first aid option you should use to bridge the gap between your injury and an appointment with your doctor.  At that point, your doctor can do an exam and possibly get an MRI to give you answers.

2. Non-traumatic
Unlike traumatic injuries, non-traumatic injuries usually creep in over time.  Many non-traumatic knee injuries can be attributed to overuse or misuse.  Since your quads play such a large role in running, jumping, and many lower body exercises, this muscle group is commonly the main suspect for knee pain caused by muscle spasms, tendonitis, or a strained muscle.  With these injuries, you may notice a progression from general discomfort & tension at first, to achy and sharp stabbing pains if left untreated.

In the early stages of this kind of injury, you can try stretching and rolling out your quads and hamstrings.  This can help relieve the muscle tension that is putting pressure on your knee.  Decreasing the intensity of your workouts can also give your muscles the rest they need in order to recover.  Implementing PRICE can help control your symptoms as well.  These types of injuries are commonly treated by sports chiropractors and physical therapists.  Treatment methods may include sports massage/trigger point therapy, joint manipulations & mobilization, and therapeutic exercises.  Getting treated early can speed up your recovery time and get you back to exercising without pain.

3 ways to avoid a knee injury:

1. The 3:2 ratio
This ratio represents the muscle strength of the quads vs the hamstrings.  Simply put, if you can use the leg extension machine with 30 lbs., then you should be able to do hamstring curls with 20 lbs. (same sets & reps).  Studies have shown that the further you are from that ratio, the more at risk you are for a knee injury.

Keep this ratio in mind when you are creating your lower body workout routine.  Do not sacrifice the muscular balance of your knee by neglecting your hamstrings.  If you begin to notice knee pain developing, the 3:2 ratio may be your answer.

2. Tight-locked position
While you are standing, completely straighten your knees.  You will feel the tension build in your quads while your knee seems to lock into place.  This is the tight-locked position of the knee.  Your range of motion is completely maxed out in this position, making you vulnerable to injury.

If you played sports growing up, you probably remember your coach constantly wanting you to be in a “stance”, or athletic position.  This involves being in a slight squat with your feet a little wider than shoulder-width apart.  This enables you to respond quickly and powerfully in any direction and provides the most stability to your knee.  While it’s obviously not necessary to be in athletic position during daily life and non-athletic activities, by maintaining a slight bend in your knees during training you can avoid an injury.

3. Hip stability
 Walk up a staircase and watch how your knee moves.  Now try skipping a step.  Since it is a hinge joint, there should be no side to side movement.  You may notice that your knee tends to bow in or out as you step up the stairs.  If this is happening by simply walking upstairs, it is probably happening when you do other activities like walking, running, or jumping.

If you continue to do your daily activities and exercises with this occurring, then you will eventually hurt your knee.  Think about what would happen if you hung on the corner of a door while opening and closing it.  The hinge will start squeaking, grinding, and may break entirely.  This is a sign that your hips need to be strengthened.

The abduction and adduction machines at the gym are a good place to start.  You can also do the same exercises with resistance bands or cables.  In addition to that, try joining a Pilates class for an option that thoroughly works out all aspects of your hips.

When you are doing some of the more popular lower body exercises like squats and lunges, make sure you are contracting your glutes as you move through the motions.  This can also be applied when you walk up the stairs to control how much your knee bows in or out.  This will help stabilize your hips and over time, you will notice your glutes naturally contracting when you exercise and do your daily activities.

Conclusion:
Knee injuries and pain are common in the exercise and sports world.  Decrease your odds by improving your exercise techniques, guiding your workouts with the 3:2 ratio, avoiding the tight-locked position, and strengthening your hips.