Ligamentous Tears Of The Knee
The knee has four major stabilising ligaments that give it stability through range. One I previously mentioned is the ACL. If you have tears in the other 3 ligaments, you may also experience giving way of the knee.
PCL
Right next to the ACL, on the inside of the knee, we also have a PCL. This ligament helps to stop your shin bone from hyperextending.
This ligament is usually injured with dashboard car injuries, where the shin is forced into the dash and the knee hyperextends.
If your PCL is torn, you wont feel stable when you fully straighten the knee and the knee can give out backwards and buckle.
MCL
The major inside stabiliser of the knee is your MCL. This ligament stops the knee from buckling inwards.
The MCL is damaged when your knee is forced inwards. As you are forced into being knock kneed, the MCL is stretched and can partially or fully tear.
LCL
Much like the MCL, your LCL stops the knee from bowing outwards. It is put under strain when there is a force that pushes the knee out, like a kick to the inside of the knee.
What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- How severe is the tear in my meniscus?
- Is the tear likely to heal on its own?
- Will I need physical therapy?
- Do I need surgery to repair or remove the torn meniscus?
- When will I be able to get back to full activity?
- What are signs the injury is getting worse instead of healing?
A note from Cleveland Clinic
A torn meniscus is a very common knee injury. It usually results from twisting your knee suddenly. It can happen playing sports, exercising or just doing daily activities. Small tears often heal on their own, while others may require arthroscopic surgery. Most people fully recover from a torn meniscus and can get back to doing their favorite activities without knee pain.
Last reviewed by a Cleveland Clinic medical professional on 04/17/2021.
References
Addressing The Root Problem
In our modern medical system, a knee meniscus tear on MRI often leads to surgery for the tear. However, operating on a lateral meniscus tear caused by a bad popliteus muscle makes no common sense. The focus should be on the cause and not the effect .
How does the muscle get out of sorts? Patients with low back problems that irritate the nerves that supply this muscle can have a popliteus that has trigger points .
How do you know if this is whats causing your knee locking? Try a simple test. The next time this happens to your knee, look at the picture above and massage the back of your knee hard in this same popliteus area. Do this for a few minutes and then see if the knee is still locking as bad. If it helps the locking, meniscus tear or no meniscus tear, getting someone to remove the torn piece of the meniscus caused by this tight muscle isnt usually a sound idea.
The upshot? Get to know the little muscle that most physicians have forgotten since their medical school anatomy exams. This key to normal knee movement could be the end of your knee locking up and your key to avoiding an unnecessary surgery!
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References
Last RJ. THE POPLITEUS MUSCLE AND THE LATERAL MENISCUS. J Bone and Joint Surg. VOL. 32 B, NO. 1, FEB 1950. doi:10.1302/0301-620X.32B1.93
Jones CD, Keene GC, Christie AD. The popliteus as a retractor of the lateral meniscus of the knee. Arthroscopy. 1995 Jun;11:270-4. doi:10.1016/0749-806390002-0
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A Meniscus Injury Can Cause Knee Pain Popping And A Locking Sensation
Anther possibility for a pop in the knee and knee pain is a patient that comes in that describes a popping or a locking sensation in the knee. They usually dont have a high impact injury and lets just say theyre walking in the mall, or they do a twisting and turning rotation motion, or theyre playing tennis and all of a sudden their knee catches or gets stuck, and then it becomes very hard to straighten and it becomes painful until they get a pop.
That can mean thats somethings actually getting caught in the joint itself, thats keeping them from extending the knee and that oftentimes means it might be a cartilage or meniscus injury. ;The meniscus are two discs within the knee. Theres one disc in the inside, the medial ligament meniscus and then theres a lateral meniscus. You can have a tear in either of those discs. They are actually cartilage discs, so this cartilage over time can get soft and all it can take is just a twisting motion, the catch can create a tear so the discs herethis is the medial meniscus, and this is the lateral meniscus. One meniscus on the inside and one on the outside of the knee joint, and you can have a tear right down the middle, like this, and on this view, looking at the knee straight on, like this, it looks like that.
A Bucket Handle Tear Can Cause Your Knee to Lock
Causes Of True Locked Knee
Some potential causes of true locked knee include:
Meniscal tear
The menisci are two pieces of c-shaped cartilage that sit either side of the knee joint. They act as a cushion between the bones of the shin and thigh.
If a meniscus tears, a fragment can break away and become stuck in the knee joint, causing the joint to lock.
A meniscal tear can occur during forceful twisting or rotation of the knee. Other causes include overuse and degenerative changes to the knee.
Loose bodies in the knee
Like cartilage, bone fragments can also embed themselves in the knee joint, causing it to lock.
Loose bodies such as cartilage and bone fragments can occur due to injury or osteoarthritis.
Patella dislocation
Certain injuries to the knee can cause the kneecap, or patella, to move out of position. This is called patella dislocation. It can cause the knee to lock during extension.
Knee joint inflammation
If the structures within the knee joint become swollen and inflamed, they may prevent extension of the knee. Swelling could occur as a result of injury, overuse, or osteoarthritis.
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Your Knee Catches Or Locks Up
If you have catching or locking going from sitting to standing, or bending your knees, it may be a sign of cartilage degeneration in your kneecap or even a meniscaltear. Usually pain and locking is felt on the front of the knee when it is your kneecap and on either side of the knee when it is a meniscal tear. It is important to have this condition addressed as cartilage degeneration is progressive and can result in increased pain and weakness.
The Real Cause: The Popliteus Muscle
What if the cause of your knee locking up and the eventual meniscus tear was a tight muscle that most doctors dont know about or just ignore? Let me explain. The Popliteus muscle is one of those muscles that youve likely never heard of before. Its the key that pulls the lateral meniscus out of the way and unlocked your knee.
it pulls the lateral meniscus back and out of the way so that the meniscus isnt crushed between the tibia and femur bones as the knee flexes. So if this important muscle that keeps the lateral meniscus out of harms way wasnt working properly, your lateral meniscus would be crushed .
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A Locked Knee Is Not Secure
The ankle bones connected to the shin bone
The shin bones connected to the knee boneThe knee bones connected to the thigh bone
The knee, the knee the poor thing gets abuse from above and below.; Dysfunction at the hip or in the foot/ankle can wreak havoc to this dear joint the largest joint in the human body.; The integral relationship of all these joints as they fall in line with gravity means that at any one point, your posture can be dramatically affected, even with what might be perceived as a slight misalignment.
As an instructor I was taught never to use the cue lock your knees for a couple of reasons some people have a natural tendency or capability to hyperextend at this joint , and we do not want to encourage that habit.; The word lock also implies making something fixed.; Movement is dynamic, and while we need to be stable, we are not looking to overly grip on any joints, but for a balanced muscle activation.; So we do look for in many Pilates exercises, is a full extension the knees an active drawing upward of the kneecap toward the hip bone.
Working or standing with locked or hyperextended knees brings that joint aligned slightly behind the ideal line with gravity, putting compressive stress and wearing down of the joint. Long term, a major ligament, commonly referred to as the ACL , responsible for nearly 100% of your knee stability is weakened.; In general, every time you hyperextend the knee, you are compromising yourself to injury.
Why Does My Knee Keep Locking Up And Popping
A meniscus tear
They can occur when you perform an activity where you forcefully twist or rotate your knee, especially when you have your full weight on it. Your knee can lock when the torn part of this cartilage gets in the way of your knee moving correctly. Besides knee locking, symptoms include: a popping sensation.
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# 7 Synovial Plica Syndrome
These are folds in the membrane around your joint in the knee. They are thought to be left over material from the development stage of birth. Kind of like your appendix, they dont serve much of a purpose except to get irritated in some people.
Usually the plica will get caught in the front and inside part of your knee. It can get caught rubbing against your knee cap through movements which involve bending the knee.
Synovial plica syndrome is more common in the younger years of life up to about 30 years old. There is wide variation in the exact prevalence of this condition, however its thought to occur in about 10% of the population.
Basic Anatomy Of The Knee
So first thing youll notice is usually your knee is going to be painful. ;You will feel or actually hear sometimes an audible pop in the knee usually associated with a twisting or turning motion or sometimes from a direct blow or impact. So real quickly were going to go over some of the basic anatomy of a knee. Ive already drawn this on the whiteboard here.
This is your knee, and this is the femoral condyle, and this is the tibial plateau of the knee. The stabilizing structures of the knee are the medial collateral ligament, which is on the inside of the knee. Ill show you here on the model as well. This is a small model but this is the medial collateral ligament in the inside of the knee. This is the lateral collateral ligament on the outside of the knee. These two ligaments stabilize the knee from what we call valgus stress and varus stress.
The Cruciate Ligaments of the Knee
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What Causes A Locked Knee
There are two types of knee locking: a true knee lock and a pseudo knee lock.
A true knee lock occurs when something in your knee joint gets stuck into one position and you cannot move it at all. The knee joint is designed to bend up and down and to rotate. When something blocks the movement of the knee, it might lock and not move. Sometimes this can be very painful.
How Can I Naturally Lubricate My Knees
Foods high in healthy fats include salmon, trout, mackerel, avocados, olive oil, almonds, walnuts, and chia seeds. The omega-3 fatty acids in these foods will assist in joint lubrication. Water can assist in joint lubrication. Make sure you drink plenty of water each day to ensure that your joints are lubricated.
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Heres A Summary Of Dr Bennetts Video On Knee Pain Causes
My name is Dr. J. Michael Bennett. I am a Board Certified orthopedic sports medicine specialist ;welcome to my;Whiteboard Series of patient education videos.
Today were going to discuss the causes of;knee pain, which is a question we get quite a bit. When many patients come to our clinics,;their primary complaint is, My knee just popped, and now its swollen and hurts. What do I do? Were going to go over some things today regarding knee pain and a popping sensation in the knee and what exactly that means. ;If youd like;to learn about whats involved in an;orthopedic knee exam, please watch our video.
Surgeons Cut Out Everything But The Cause
If your lateral meniscus is getting crushed 100s of times because your popliteus isnt pulling it out of the way, your lateral meniscus would get a tear, that you can see on MRI. In our modern medical system, your trained to go to an orthopedic surgeon to get an MRI when you have pain. A knee meniscus tear on MRI usually leads to surgery for the tear. The thing is in meniscus tear surgery nothing is repaired, the surgeon cuts out of the piece of meniscus getting in the way. Operating on a lateral meniscus tear caused by a dysfunctional Popliteus muscle makes no common sense. The focus should be on the cause and not the effect .
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What Is Knee Locking Or Locked Knee
Knee Locking or Locked Knee is the term used to describe a painful condition that occurs as result of knee extension at certain angle.1 During extension of knee joint, extension is restricted at 10 to 30 degree to prevent pain. Patient is unable to achieve optimum normal extension. Any further extension beyond the restricted angle causes severe intractable knee pain. Most common cause of locked knee or knee locking is meniscus tear, congenital defect, injury or disease like osteoarthritis.
Seeking Treatment For Knee Pain
Assessment by one of our awarded;orthopedicsurgeonscan diagnose the problem causing the pain and tailor a treatment plan that is specific for the problem.
The awarded team atTotalOrthopedicsandSportsMedicine focuses on both the surgical and non-surgical treatment of bone, joint injuries, ligament and tendon injuries.; Renowned expertsDr. CharlesRuotoloand;Dr.Richard McCormackleadour;KneeTeam.
Fortunately, many patients can be treated non-surgically with a combination of conservative modalities coordinated by theTotalOrthopedicsandSportsMedicineTeam. If surgery is necessary, the practice uses a multidisciplinary approach to create a treatment plan that focuses on the patients lifestyle and activities and helps them get back to those activities quickly and effectively. Total Orthopedics and Sports Medicine haslocationsthroughoutLongIsland, Brooklynand the Bronx.
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How Can I Adjust My Knees Myself
If the torn portion of the meniscus is large enough, your knee may lock up. You may momentarily feel like you are unable to fully bend or straighten out your knee. This happens because a torn part of the meniscus flaps into the joint and gets caught within, preventing the knee from functioning normally.
What Causes A Knee To Lock
The most common causes of knee locking are as follows:
Knee Pain
You may perceive that your knee locks up because it becomes suddenly painful. In this situation, there is not a true mechanical block, per se, but your motion becomes limited secondary to severe pain i.e. your body doesnt want to cause you more pain so it reflexively prevents motion.;
While this is most common in the setting of painful arthritis, there are many causes of knee pain. These include:;
- Knee trauma e.g. fracture, dislocation, infection , or tendon tear, sprain or strain
- Knee arthritis may cause swelling, pain
- Plica syndrome Plica is the tissue the lines the inside of the knee. It can sometimes become injured or inflamed, which results in pain.;
Loose Bodies;
Loose bodies are small or large fragments of cartilage or bone within the knee joint that can move or float into a position within the knee that causes it to become locked in a certain position.
Loose bodies may be formed as the result of trauma.;
Torn Meniscus
A meniscus is a disc-shaped structure that acts as as a shock absorber in the knee joint. There are two in each knee joint, a medial and lateral meniscus. Menisci are susceptible to damage with certain sudden, twisting, falling, awkward landing movements.
Tears of the meniscus can also cause the knee to lock. When the meniscus is torn, the torn portion can flap into the joint and block motion similar to how a loose body may also block motion.;
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What Is The Prognosis For People With A Torn Meniscus
Most people who tear a meniscus can return to full activity. If you have surgery to repair a torn meniscus, your knee should be fully recovered after a few months of physical therapy.
If you have surgery to remove all or part of your meniscus, you may be at higher risk of developing arthritis down the road. Thats because you now have less shock absorption in your joint. Over time, the joint can break down.
How To Keep From Locking My Knees
A complex joint consisting of ligaments, muscles, cartilage and tendons, the knees can be a vulnerable spot during athletic or fitness activity. Because of its vulnerability, fitness trainers and teachers often warn against locking out your knees, or hyperextending your leg, when working out.
When the joint is locked, the stress is taken off of the supporting muscles and placed onto the knee; as a result, the soft tissue in the knee becomes damaged, greatly increasing the risk of a knee injury. Being aware of your body, balancing your muscles and working out with proper techniques can help keep your knees in the correct position and decrease your chance of sustaining an injury.
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