Autumn Update 2014

Autumn 2014 Update from BRITPT

Dear Friends, 

This October makes 20 Years in the USA for me! October is also the month I started the BritPT business 9 years ago, and personally I chalk up another year on the path of "Life's Adventures." 

Autumn means it is glorious weather to Get Outside !! Whether you love to walk by yourself, with friends, with dogs, run, bike, or hike, this is the time of year where everything flows! The skies are that exact shade of Carolina Blue and the sun is still shining, but we can inhale fresh air while we exercise! It is my very favorite time of the year!

So with all this exercise that you are now inspired to do, let’s talk about your knees. They will be taking much of the stress of you being out and about on uneven surfaces during those weight bearing activities, and they can be tricky to heal once they get into trouble. Here are some thoughts about how to take care of your knees.

Understand the Anatomy

The Right knee from the right side.

(This is an image by the surgeon and anatomical artist Frank Netter.)  

Your "knee joint" is actually a complex joint. 

1. There is a main joint between the two long bones of the leg, the femur above, the tibia below; the cartilage or meniscus is sandwiched between them as a buffer, to absorb shock and forces such as twisting. The meniscus has a poor blood supply and so, when injured, it is very slow to heal; it creates pain and swelling and sometimes causes either locking or giving way of the leg to occur. It is becoming apparent that surgery is not a great solution for many meniscal injuries. The "guy ropes" on either side of the joint are the Medial and Lateral collateral ligaments, and the two ligaments inside the joint that cross each other, are the Anterior and the Posterior Cruciate ligaments; these four ligaments stabilize the main knee joint.

2. The knee cap, or patella, floats on top of the femur, but is guided in a slight gutter type system by the pulley mechanism of the quadriceps, or thigh muscles. Grinding and popping is common with this joint, especially when bending and straightening a leg all the way through range. Muscle imbalance in the quads, roughening under the knee cap, and swelling in that small space can create some stubborn knee pain which will interfere with many daily activities and positions. Balanced strengthening of the quads and hamstrings is vital to have functional and pain-free knees. 

3. The superior tibiofibular joint at the side of your knee needs to be able to glide very slightly up and down as well as back and forwards to allow normal walking. Restriction can lead to knee pain and ankle pain, but also may be associated with sensation changes such as tingling along the outside of the leg when it is not moving well. It is very closely associated with the peroneal nerve

If a joint ever hurts with every step you take on it, you should ALWAYS get it imaged; start with an x-ray, but leave it until a couple of days after the injury,if possible, (Icing Only, Avoiding Heat) allowing for inflammation to decrease and for de-calcification to occur. You will see a much more accurate picture then.

Also consider that the stress your knees may be absorbing could be over compensation from issues in both the ankles or the hips. Sometimes too much movement occurring, sometimes not enough, the results will be similar in that the imbalance will throw the stress to another body part, causing symptoms there and further clouding the picture. If you have a migrating issue, then it is time to surrender yourself to the plumbline. Give us a call and we will get you taken care of.

In Health and Harmony,



Lorraine Kingham PT, MTC, MHSC, CMTPT


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