Hi, this is Dr. Steve Gangemi. In this second part of the knee video, I’m going to talk about the most commonly injured area of the knee, the inside, the medial aspect of the knee, where people feel like they have, or maybe have, injured their medial meniscus or medial collateral ligament. And we’re going to talk about the back of the knee, sort of the hamstring/calf area. Moving around to the backside of the knee now, the most common muscle you’re going to see injured actually is not the hamstrings that a lot of people think about, because they injured their hamstring muscles or they think they did, but actually the calf muscles.
So, if you’ve got pain in your knee, especially with flexion, like this, whether your toes are pointed or flexed — this is dorsiflexion or plantar flexion — but I’m feeling pain in my knee or instability in my knee, yeah, you can have a problem with your hamstring obviously because that has to do with this motion too. But more so, more often are calf problems, calf injuries, that have to cross the joint, the crease in the back of your knee and attach into the femur here.
So you’re going to look for tender spots there, on the inside, or the outside here, and the inside of your…just above the crease of your knee. Hold these spots here and here. If they’re tender, rub them out, or you can hold them when you constrict or contract your leg like this, if they feel better, the knee feels better, rub them out, that’s where the trigger points are. If you have a problem in the back of the knee or an instability in the knee or especially if you’re doing a hard jump or a hard landing especially.
So the last quadrant we’re going to talk about is the inner part of the knee, the most commonly injured part of the knee. You’ve got your medial meniscus there, and your medial collateral ligament. People are always injuring their medial collateral ligaments and their medial meniscus through a sheering type of injury. If you’re landing wrong, jumping and landing wrong, getting clipped if you’re out playing around, or landing in a hole and twisting your knee the wrong way.
But a lot of people end up injuring their medial meniscus because the muscles that support the inner part of your knee there are not functioning properly. And a lot of times, it’s actually those muscles that are weak, that are fatigued and not functioning, so you feel like the meniscus is injured when it really isn’t. Again, you still need to have this checked out if it’s not healing up properly. Let’s talk about how you can assess and check out those muscles that support the inside of your knee.
So there are three muscles that attach to the inner part of your knee here just on the inside of your tibia, and they’re called your pes anserine, which stands for goose’s foot. It’s three muscles that attach just like this. One of them is your hamstring. The inner part of your hamstring comes obviously from the back of your thigh and comes right into that inner part of your tibia bone there. The second is the longest muscle in your body called your sartorius. It starts just above your hip bone here right where your tensor fasciae latae attaches but just to the front part of it, wraps around the front to the inside here.
And the then third part, the third muscle, is your gracilis, which is your groin muscle. So that muscle, a lot of times when people feel like they’ve pulled their groin, that’s your gracilis and then they all attach into here. So to assess these muscles, you’re basically following the trigger points along the muscle, even hold way up in your groin, and if you feel better on the inside of your knee, especially this type of motion. As you can see, my hip is rotated a little bit, then I’ll know that I need to check out and work a trigger point either in my groin, in the hamstring, anywhere along the hamstring in the back here, or the sartorius, starting just in front of the hip all the way down to the inside.
So, again, the last thing I want to be clear about on the injuries to the inner part of the knee, the most common area is, again, if it’s really sharp in there, especially if you can’t bend it very well, have that checked out. Go see your doctor. You may need an MRI to assess really what’s going on in there. But also you don’t want to be typically poking around actually where you’re going to feel the pain on the pes anserine area. You want to assess the muscles and treat the muscles linking, connecting to that area. So stay off the injured area. Look for where those muscles are injured leading up to the injury. And that’s how you go about checking out how your knee is functioning or not functioning properly.
i followed your advice and went for MRI. both medial menisci have degenerative tears. the orthopedic doctors suggested nothing. they are against miniscectomy (leads to arthritis), arent sure about meniscus transplant and stem cells. so which can be my next step?
Dr. Stephen Gangemi "Sock Doc" says
Best for something that severe is to find a doc or therapist to evaluate and help you.