Black and white; off and on; on the straight and narrow all give the impression life is linear and movement in one plane. For those of us living, however, life is anything but: there are grey areas, standby positions, and routes off the beaten path. Picture the human skeleton. The average body is made up of 206 bones. Bones connected to each other by tough and somewhat flexible connective tissue called ligaments. A joint is made where two or more bones meet; and is designed to allow movement via muscle engagement.
The knee is the body’s largest hinge joint. It is designed for movement in primarily a single plane, the sagittal plane, but faces the challenge of a three- dimensional world. The knee allows for a small amount of medial and lateral rotation confined within the transverse plane. Note, however, there is no movement allowed in the frontal plane.
When humans became upright beings and moved into bipedalism, the knee took on added significance. It plays an essential role in supporting the weight of the body during horizontal and vertical movements. An example of horizontal movement would be walking; whereas jumping would be a vertical movement.
Our bodies are made to, and need to, move to remain healthy. However, as mentioned above, life’s movements usually aren’t limited to one plane. Think of the cutting or pivoting involved in football, soccer, or basketball. Each of those sports can exert a tremendous amount of force on the knees. Whether from contact with an opponent or a misplacement of footing, knees can be at serious risk of injury.
The most common type of knee injury due to physical activity is classified as medial knee injuries involving the medial ligament complex. This ligament complex is made up of:
- Superficial medial collateral ligament (sMCL),
- Deep medial collateral ligament (dMCL), and
- Posterior oblique ligament (POL)
Medial knee injuries are classified into grades (I,II,III) dependent on the amount of medial joint space gapping (or amount of tearing) found. Unlike tears of other ligaments in the knee, particularly the anterior cruciate ligament (ACL), surgery isn’t warranted as treatment for most medial knee injuries. Even with grade III injuries, surgery isn’t the first course of action unless other components of the knee are involved.
For most medial knee injuries RICE (Rest, Ice, Compression, Elevation) will be the appropriate treatment with complete healing within a couple of months. To reduce the likelihood of medial knee injuries incorporate activities to improve knee stability, strengthening the adductors, abductors, hamstrings and quadriceps—especially the vastus medialis which is located directly above the knee. Full mobility in the hips also reduces the amount of stress the knees endure. Stable knees, with balanced and toned muscles, will keep you knee-deep out of the pain of medial knee injuries.