Introduction
Knee is the largest and one of the most complex joints in the body. Regardless of your daily routine being sedentary or moving, your knees can experience heavy wear and tear, so it’s important to take good care of them.
Three large bones come together to form the knee joint: The femur, the tibia, and the patella. Each one is covered at the ends with a cushioned, elastic material called cartilage that works like a shock absorber.
These bones are additionally supported by two muscle groups: The hamstrings at the back of the thigh, and the quadriceps at the front of the thigh.
Although knee injuries can happen to anyone, some activities and demographics are at higher risk than others, such as:
- Athletes
- Runners, especially if wearing improper footwear
- Obese people
- People who sit too long in uncomfortable position.
As the most important joint in walking, sitting, running and moving around, knee joint is the most prone one to get injured. Pain and swelling of the knee are the most common symptoms. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Physical therapy and knee braces can help relieve some injuries. But in some cases, however, your knee may require surgical repair.
Signs & symptoms
- Pain
- Swelling and stiffness
- Redness and warmth to the touch
- Bruising
- Weakness or instability
- Popping or crunching noises
- Inability to fully straighten the knee
Causes
Various types of trauma to the knee joint
Pathophysiology
Many types of injuries are possible for knee joint. The pathophysiology depends upon the type of trauma and injury. Major injuries include:
Fractures
Fractures can happen with any bone in the knee joint. They can occur as a result of trauma or direct injury or diseases like osteoporosis.
Dislocation
The bones of the knee joint may sometimes fall completely or partially out of alignment. It has a high chance for recurrence also.
Anterior cruciate ligament (ACL) injury
Athletes who often quickly change direction or jump will often have ACL injuries. Many hear it “pop” when the ligament is either torn or strained.
Meniscal tear
The menisci are two cartilages that protect the joint from stress as you walk. They can be damaged during sports activity, or due to ageing, or arthritis.
Tendonitis
Tendonitis in the knees is sometimes known as “jumper’s knee” because it often affects athletes who jump regularly. There are two tendons involved in the knee joint, around the quadriceps and patellar bones, and both can be stretched, torn, or worn down with time.
Diagnosis
Case taking to confirm any history of trauma
Physical examination to locate the site of tenderness etc.
X ray
USG
MRI
Treatments
Mild knee injuries are treated by rest, ice, compression, and elevation. (RICE)
Physical therapy to strengthen the joint and restore its range of motion.
Surgery is for the most serious knee injuries.
Prognosis
The prognosis is usually good to moderate when managed well. If the treatment and immobilisation is delayed, the prognosis will not be good.
Complications
Increase in pain, joint damage and disability
Chance of having similar injuries in the future.
Ligament instability
Injury to the Meniscus
Osteoarthritis
Gait problems
Disease & Ayurveda
Sandhichyuta/Bhagna
Nidana
Kshata
Purvaaroopa
Not mentioned
Samprapti
Due to kshata, Vaata vitiates at the site immediately and causes severe pain, unbearable for the person to move. Along with Vaatakopa, the Pitta-Rakta gets vitiated, bleeding & bruising happens and the circulatory system is involved resulting in swelling & inflammation. The latter may trigger the onset of a fever suggestive of inflammation.
Lakshana
Atitivraruja – Unbearable pain
Slathasandhi – Unstable joint
Divisions
Not mentioned in the case of knee joint
Prognosis
Krichrasaadhya
Chikithsa
Samana
Snehana
Bandhana
Immobilisation
Sodhana
Daahakarma for pain relief in some cases
Commonly used medicines
Murivenna
Brands available
AVS Kottakal
Home remedies
- Previous injury. Having a previous knee injury makes it more likely that you’ll injure your knee again.
- Keep extra pounds off. Maintain a healthy weight; it’s one of the best things you can do for your knees. Every extra pound puts additional strain on your joints, increasing the risk of injuries and osteoarthritis.
- Be in shape to play your sport. To prepare your muscles for the demands of sports participation, take time for conditioning. Work with a coach or trainer to ensure that your technique and movement are the best they can be.
- Practice perfectly. Make sure the technique and movement patterns you use in your sports or activity are the best they can be. Lessons from a professional can be very helpful.
- Get strong, stay flexible. Because weak muscles are a leading cause of knee injuries, you’ll benefit from building up your quadriceps and hamstrings, which support your knees. Balance and stability training helps the muscles around your knees work together more effectively. And because tight muscles also can contribute to injury, stretching is important. Try to include flexibility exercises in your workouts.
- Be smart about exercise. If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the way you exercise. Consider switching to swimming, water aerobics or other low-impact activities — at least for a few days a week. Sometimes simply limiting high-impact activities will provide relief.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Curd – causes vidaaha and thereby many other diseases
Fried non vegetarian foods
- To be added
Light meals and easily digestible foods
Freshly prepared Non vegetarian and seafoods
Green gram, soups, sesame oil, warm fresh goat’s/cow’s milk, ghee etc.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Nuts and dry fruits in small quantity.
Behaviour:
Stick onto immobilisation and rest advised.
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Avoid lifting heavy weights and other vigorous physical activities.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid day sleep and sitting awake late night.
Yoga
In acute injuries, fractures and inflammations, the person should be advised to take rest at the time of injury.
After healing and regaining normal health, specific yogacharya including nadisuddhi pranayama, bhujangaasana, pavanamuktasana, suryanamaskara etc is recommended depends on the site of injuries and condition of healing.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Suryanamaskara
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4670212/
https://pubmed.ncbi.nlm.nih.gov/6513760/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211979/
Author information
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