Knee and calf
Professional physiotherapist in Southampton, Hampshire, UK.
Knee
The knee joint consists of the femur, tibia and patella. It is a hinge-pivot, one-cavity, two-storey joint. The movements performed in the knee are flexion, extension and rotation. It is actively stabilised by muscles (extensors, flexors) and passively by ligaments, menisci and joint capsule. It is responsible for receiving and transferring body loads. It has excellent mobility; therefore, it is exposed to damage. Damage related to the limitation of human activity (work in a sitting/standing position) and occasional sports (e.g., skiing, ball games, jumping) lead to injuries. Neglecting ailments leads to mobility limitations which complicate everyday life.
Dysfunctions within the knee joint:
- Fractures (patella, femur/tibia)
- Dislocation of the kneecap
- Ligament injuries (ACL, PCL, MCL)
- Meniscus injuries
- Baker’s cyst
- “Jumper’s knee” (patellar tendinitis)
- “Goose foot” inflammation
- Patellofemoral syndrome
- Hip band syndrome
- Inflammation of the muscles (e.g. sciatopharyngitis)
- Damage to the articular cartilage
- Degeneration
- Overloads
Knee Examination
Examination of the knee joint consists of anamnesis, comparing symmetry (varus/valgus knee), assessing muscle strength, gait and limb loads. Bathyaesthesia, kneecap positioning and joint mobility are checked. Special orthopaedic tests are performed to find out which structure is damaged. Red flags and pains radiating from other body areas (e.g., hip joint) are excluded.
Knee Rehabilitation
Rehabilitation consists of reducing pain, increasing range of motion, preventing joint damage, and using exercises to improve joint stability and muscle function. Prevention consists of learning self-therapy, correct training, and neuromuscular re-education.
Knee Surgery Preparation
The physiotherapist will prepare the patient for the surgery, show the proper way of putting on and taking off the orthosis, as well as changing its angular values. He will teach the correct way of using crutches, also on the stairs. It is important to prevent contractures or muscle weakness. Treatments such as laser, magnetron, electrostimulation, manual therapy and Kinesio-taping are particularly effective, as they catalyse recovery.
Early treatment is very important because, over time, the joint may become restricted in movement or even blocked by adhesions, which can only be treated surgically.
Calf
The lower leg consists of the tibia and fibula, connected by the interosseous membrane. The muscles in the lower leg help to bend, turn and reverse the foot and straighten the toes. The triceps muscle of the calf is connected to the calcaneus with the Achilles tendon.
Problems connected with the lower leg:
- Fractures
- Skin/muscle injuries – musculoskeletal overloads of the shin, contusions, muscle tears (e.g., torn Achilles tendon)
- Nerve irritation – such as peroneal irritation, which can cause foot drop or sensory disturbances
- Vascular disorders (lymphatic, atherosclerosis, venous thrombosis)
- Other diseases have an impact, e.g., untreated diabetes can lead to non-healing wounds in the shin area and amputation
- The syndrome of tightness of the shin compartment – due to disorders of innervation, circulation and muscle function
- Pain radiating from other parts of the body, such as the spine, hips and knees
- Shin pain may be associated with periostitis, muscle or tendon overload. They can lead to fractures.
A physical therapist will help reduce pain and swelling by using manual therapy or lymphatic drainage. Massage will reduce muscle tension. Neuro-mobilisation exercises will improve the proper sliding of peripheral nerves and strengthen the recruitment of more muscle fibres, thereby increasing strength. The Bioptron lamp is excellent for treating wounds.
No trauma should be underestimated. Delaying treatment may make rehabilitation and return to physical activity longer.