Anatomy of a “Bad Knee”


The knee is a relatively simple joint required to do a complicated job…to provide flexible mobility while bearing considerable weight. While walking down the street, our knees bear three to five times our body weight. When climbing upstairs, that force can multiply to seven times our body weight. That force is borne by compact structures of bone and cartilage, supported by muscles and ligaments. When the knee is overstressed in sports or in everyday activities, these structures can break down — and knee injury occurs.

Injuries to the knee can be divided into two categories:


Acute Macro-traumatic Injury: An example would be a rupture of a ligament which is a part of the passive restraint system of the knee. The most common of these injuries is the Anterior Cruciate Ligament or ACL. This type of injury results from over rotation of the joint and usually occurs in sports or occupational activities when excessive twisting is involved.


Micro-traumatic Injury: Is overstress to normal tissue. Instead of one event, the knee suffers repetitive injuries over time resulting in an overuse syndrome. This often occurs when there is a sudden increase in exercise level like when a runner progresses their mileage or when a tennis player plays extra sets.


Rehabilitation acutely after knee surgery or a knee injury primarily centers around decreasing swelling in the knee joint. Even a small amount of fluid inhibits the quadriceps muscle on the front of knee by slowing the signal for movement traveling from the brain to the muscle. Manual techniques to decrease muscle spasm, and improve length tension relationships of soft tissue are also incorporated. Gradually, exercises to increase strength, range of motion, and functional mobility are introduced.


Return to Function and Maintenance is highlighted by increasing the amount and intensity of weight bearing exercises in preparation for return to work or sport. These activities include squats, leg presses, lunges, step ups, and step downs, proprioception activities, and agility drills. Work and sport specific simulations are also incorporated.


Whether you’re currently suffering from a knee injury, or trying to avoid one it all starts with a careful evaluation.


  1. Evaluation: Your therapist will take the time to talk with you and perform a thorough physical evaluation to identify your knee condition or predisposing factors.
  2. Therapy: Your therapist will plan a treatment regimen suited to your individual condition and begin working to restore motion and muscle performance.
  3. Teaching: Our therapists will constantly be reviewing information regarding your diagnosis and progress with you. We believe the more empowered patients are the better the patient complies with necessary lifelong changes.


Common knee injuries seen by physical therapists include:


  • Strain/Sprain
  • Arthritis Pain
  • Muscle Weakness
  • Ligament Sprains
  • Tendinitis (ie: Patellar, Pes Anserinus)
  • Chondromalacia Patella
  • Patellofemoral Syndrome/Knee Pain
  • Pre/Post-Operative Therapy


For an in-depth look at a specific injury visit the PTandMe injury center’s knee section click here: