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.
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.