What My Colleague George (Dr. Russell) Taught Me About the Knee

I was feel­ing a lit­tle twist­ed in my right knee so I got a treat­ment from my col­league George (Dr. George Rus­sell.)

He was able to help me a lot – he iden­ti­fied a prob­lem with the way my knee was rotat­ing.

It’s a sub­tle thing.  That’s because rota­tion isn’t the main motion that occurs at the knee. Most­ly the knee bends (flex­es, in med­ical par­lance) and straight­ens (extends).

But noth­ing in the realm of anato­my is ever that sim­ple or one-dimen­sion­al.

The knee joint is sub­ject­ed to all sorts of forces com­ing from above (down through the hip joint), from below (up from the ankle joint), and even from out­side of the body (an offen­sive line­man in foot­ball block­ing an oncom­ing rush­er).

These forces aren’t all straight for­ward and back. They come at your knee from all angles. So the knee joint has to be able to adapt to them.

Here’s a pic­ture of the knee joint that shows how the sys­tem works.


diagram of the knee

Knee Anato­my

See that white area labeled “artic­u­lar car­ti­lage”? It’s at the end of the thigh bone (the femur) on the inner side (the medi­al side).

There’s a sec­ond zone of artic­u­lar car­ti­lage at the end of the femur on the out­er side (the lat­er­al side). These two zones of artic­u­lar car­ti­lage rock fore and aft, each on its respec­tive car­ti­lage pad (known as the menis­cus).

This design makes it easy for the knee to flex and extend.

But these two areas of artic­u­lar car­ti­lage are dif­fer­ent sizes.  So they don’t rock back and forth even­ly.   When the knee flex­es, the femur tends to rotate on the tib­ia.

You need mus­cle pow­er to con­trol how much rota­tion is allowed under any giv­en cir­cum­stance.  For­tu­nate­ly, under nor­mal cir­cum­stances, this mus­cle con­trol hap­pens auto­mat­i­cal­ly.  You don’t want to have to take time to think about it – if you did it would take a few hours to walk a sin­gle block.

Isn’t the body bril­liant?

Yet you can see how easy it would be for the entire sys­tem to go awry. If those artic­u­lar car­ti­lages get out of sync with each oth­er, or if your mus­cle con­trol gets out of cal­i­bra­tion, you’re in trou­ble. You’ll have extra wear and tear on those artic­u­lar car­ti­lages and menis­ci. And extra stress of the mus­cles that oper­ate the knee joint.

And knee pain.

That’s how George was able to help me. He used pal­pa­tion to check the free­dom of rota­tion of the knee joint and found that my mobil­i­ty was restrict­ed.

Then it was a mat­ter of a sim­ple joint adjust­ment. For­tu­nate­ly, my prob­lem was a mild one so after only a treat­ment or two I was good to go.


Deepen Your Body of Knowledge

Run­ning is good for your knees

Goldilocks and your knee car­ti­lage


About Ronald Lavine, D.C.

Dr. Lavine has more than thirty five years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods. His website, askdrlavine.com, provides more information about his approach. Please contact him at drlavine@yourbodyofknowledge.com or at 212-400-9663.
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