On Your Knees

Continued...

Swelling at the sides of the knee joint, or underneath the kneecap tendon, is generally due to bursitis, an accumulation of fluid in the bursae, small sacs that cushion the tendons where they glide over bone. Bursitis can result from direct trauma or overuse.

Overlying the knee joint is the patella, or kneecap. It is held in place by the tendon of the quadriceps (thigh) muscle, which is attached to the top of the tibia. When the knee is fully extended or straight, there is no tension on the kneecap.

Sit on the floor with your legs extended and relax your muscles. Then wriggle the kneecap back and forth. It will move a few millimeters in either direction side to side.

Now bend your knee about 30 percent and you'll notice the patella is very tightly pushed against the femur and will not move. As you bend your knee, the patella moves up into a groove between the two prominences of the femur. This is called the "tracking" of the patella between the condyles (the rounded ends of the bone) of the femur.

Some people have a problem with the tracking of the kneecap. When the knee bends, the patella can move laterally to the outside of the leg instead of staying in the middle. If this happens repeatedly wear and tear on the cartilage undersurface of the patella results. This painful condition is called patella-femoral arthralgia.

When observed in surgery the damaged cartilage has a "crab meat" appearance called chondromalacia. Since cartilage will not repair itself, surgical treatment involves shaving off the worst portions.

The patella is most vulnerable to this tracking problem in women with certain biomechanical alignments of the leg. A woman with a broad pelvis is more likely to have such an alignment. The broader pelvis makes the knees angle inward to a "knock-kneed" position.

You can see whether this applies to you by standing in front of a mirror and putting your ankles together. If your knees appear to be "squinting" toward one another; you have this alignment.

What are some other symptoms?

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Foreword: Billie Jean King

Comments by Barb Harris
Editor in Chief,
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