If I Have A Knee Pain, Should I Get It Manipulated?
If I have a knee pain, should I get it manipulated?-- Alex, Singapore
Whether a knee pain should be manipulated is dependent on the cause of pain. However, as a rule of thumb, most manipulative physiotherapists will not manipulate the knee.
Anatomy Of The Knee
The knee is a joint where its integrity is generally held by the strength of its ligaments, joint capsule and muscles. This is due to the shape of the bones which make up the joint. The knee joint is two rounded condyles of the femur sitting on the flat plateau of the tibia (known as knee joint) with a ‘floating’ bone, known as the patella over the femur (known as Patellar-Femoral joint). The knee joint is similar to like putting 2 oranges on a flat plate, make it fairly unstable. Thus, the stability of the knee comes from the two menisci. They act to deepen the depth of the tibial plateau (to prevent sideway movements of the femur), the ligaments and joint capsule (to prevent excessive movements) and the muscles (to control the joint movement). There is a good animation of the knee and the ligament below.
Causes Of Knee Pain
Due to the make-up of the knee, most causes of knee pain would be due to either strain of the ligaments, capsule or muscles, or degeneration of the patellar. Manipulation is generally used for a ‘locked’ joint and not for strains. Hence, it is not warranted. In most knee pain, mobilization is sufficient to decrease the pain together with strengthening and flexibility exercises.
However, in meniscus tears, where movement is blocked or limited and mobilization doesn’t work, a distraction manipulation might be done but with sever caution. Manipulation can also be used in a degenerated knee but would need to be done by an orthopaedic surgeon.
Video: Anatomy Of The Knee
Experiencing knee pain? Click here to find out more about physiotherapy for knee pain relief and how Core Concepts can help
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