2005-04-22 / Columnists

Eye On Physical Therapy

By Dr. Tim Rohrs

If there were a joint that should deserve to win a lifetime achievement award for service to our bodies, it would be the knee joint. Although many think of the knee joint as a simple hinge joint, it is much more complex than that and requires proper functioning of all its parts. The patella or knee cap must glide up and down as we straighten and bend our knee. The tibia must glide anteriorly as we straighten our knee while the fibula glides posteriorly. As the knee approaches the fully straightened position, the tibia and fibula start to externally rotate, or rotate away from the midline.

Our knees must deal with many stresses placed upon them. Runners pound those joints unmercifully while running on concrete. Those who must climb subway steps every day deal with incredible compression forces on the knee cap. For instance, climbing up stairs there are compressive forces of 2.5 times a person’s body weight. A person weighing 150 pounds have 375 pounds of pressure on their knee cap. Descending stairs is 3.5 times the person’s body weight or 525 pounds of pressure. Those that squat frequently have the worst, 7 times their own body weight or 1050 pounds of pressure for a 150 pound person.

For years our knees do the job and allow us to function pain free. As we get older muscle strength becomes less and flexibility decreases, and any abnormal movement of the knee cap or knee joint itself can cause early degenerative changes and osteo arthritis. Pain medication may mask the pain, but does not correct the underlying problem.

A full biomechanical evaluation of the knee joint by a licensed physical therapist, at the onset of pain, may go a long way to prevent progression of the pain and degeneration. As always consult your physician regarding any joint or muscle pain.

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