“And on the last day, God took all the excess parts of the body that were left…and created the knee.” That was how our anatomy teacher introduced the knee to us as wee young Pilates Instructor trainees. This image and idea has stuck with me these past twenty years as I’ve navigated many clients with knee issues. What is it about the knee? Why is it the crux for so many? Is it really that complicated? Does its structure not make sense?
The knee is actually a fairly simple joint. A (modified) hinge joint, similar to the elbow. Unlike the elbow, however, it is subject to many stresses, being the joint that holds together the two longest bones in the body, the femur and tibia. The way I see it the knee joint is akin to the middle child. The older sibling being the hip joint with its ball and socket joint giving it so many varied movements and the younger being the ankle joint with it’s complex hinge joint qualities. Often times, what evolves as a knee issue is an issue with the ankle or hip joint. Therefore, during Knee-vember here at SolPop Pilates, we will be working the knee, hip and ankle joint - the three siblings as it were, to make sure they are working together in a coordinated manner.
The knee joint also has some really exciting properties to it. The menisci are two c-shaped pieces of cartilage that together look like a sideways figure eight. If you like football, tennis or basketball, you’ve heard this term thrown around a lot in regards to injured players. The meniscus act like little cushions between the two large bones of the leg, the femur and tibia. When there is a fall or forceful twist, these cushions can get torn.
There are also four major ligaments of the knee - also commonly heard on ESPN in regards to injured players. These are: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). All this to say your knee basically has the equivalent of packing tape surrounding it to help stabilize it.
The patella (“small plate”, your knee cap) is one of my favorite structures of the knee. When we are born the patella is simply cartilage and does not ossify (become bone) until we are 3-6 years old. Isn’t that cool? The patella acts as a pulley, helping the quadricep muscles generate force on the knee. Without it, we couldn’t move as well as we do (standing, sitting, walking, running, skipping!). It is a sesamoid bone (does not contact another bone) housed inside the quadriceps tendon and it’s really important that it moves within that tendon like a train on a track.
The muscles surrounding the knee joint are your quadriceps, most commonly referred to as “quads.” There are four of them: rectus femoris, vastus lateralis, vastus medialis, vastus intermedius. All four of them unite and attach to the patella. These are the muscles that help guide our train (patella, aka kneecap) in the track. At the back of the knee are the popliteus (one of my favorite muscle names), the hamstrings, and the gastrocnemius.
This month at SolPop Pilates, we’ll be tracking your patella, strengthening your quadriceps (yes, all four of them), and working those muscles around the hip and ankles. Because, really, all siblings should work together and get along : )