Is It Only Your Knee? How the Joints in Your Leg Work Together
Ever wonder how that pesky, unrelenting knee pain started? Not the pain from sudden knee injuries from a wrong turn in a soccer game or a fall on the ice – we know where that pain comes from – but rather, the pain that creeps up over time and becomes chronic and a bit baffling. To understand how knees can start to deteriorate, it is necessary to understand the relationship between all joints.
If one joint is stable and fixed, the joints above and below it are more mobile and flexible. The knee is a mostly stable, fixed, hinge joint (with a small bit of rotation) that moves in one plane to extend and flex the lower leg. It allows us to sit and stand with ease, to climb and descend stairs, and even fold ourselves into tiny airplane seats. If we didn’t have hinge flexibility in our knees, imagine how unbelievably hard it would be to get up from a chair or climb stairs….seriously, imagine. At the same time, if we didn’t have the lateral (side-to-side) stability of the knee as well, we’d be walking around like the scarecrow in The Wizard of Oz. Part of the stability comes from the structure of the bones themselves, and part from the myriad of ligaments that stabilize the knee.
Above the knee is the hip, a mobile, circumducting joint. It moves around the radius of a circle: side to side, back and forth, at angles. The hip gives us the ability to move more freely and with precision. Below the knee is the ankle, also a mobile joint. It extends and flexes to allow us to walk, run and climb stairs. It everts and inverts so we can make quick lateral movements as in tennis or quickly sidestepping.
The general relationship from top to bottom is Mobile (hip) – Stable (knee) – Mobile (ankle), and this is th pattern that follows through the entire body. This relationship happens in the arm, too: Mobile (shoulder) – Stable (elbow) – Mobile (wrist). Problems can arise when a mobile joint like the hip is compromised through injury, wear and tear, or tight muscles; it becomes stiff. People in whom this has happened will shuffle or take shorter strides. Since the body likes to maintain efficiency, the actions a joint usually performs now must fall on the next joint – in this case, the knee. What is normally a unidirectional stable joint must now try to move in directions in which it wasn’t meant to move. The insidious creep towards dysfunction ensues, from aching knees to meniscus tears, cartilage damage, osteoarthritis, and more.
The next time your knees ache, don’t assume it is an inevitable, permanent outcome of age or injury. You may be able to prevent deterioration by examining how all of your joints are working together. Gaining correct mobility in your hip or ankle may be one solution to easing knee pain, and restoring healthy knee function. Finding a good massage therapist will balance the body by easing tight, overly-facilitated muscles and activating weak, inhibited ones. Following up with a physical therapist, trainer, yoga instructor or Pilates studio can re-educate the muscles and continue to improve function and range of motion in your hips and ankles so that your knees can go back to doing their job of stabilization.
