#Repost @ascoltostudio with @make_repost ・・・ Knee 膝 To say the knee is a hinge joint seems to oversimplify its actual movement: it is a very special joint, in that your lower leg (tibia + fibula) has a minor degree of rotation (see photo) so your foot can turn outward and inward. However, do not think it is like your ankle or hip - it performs flexion extension and a small degree of rotation internally and externally. 除了屈曲伸直，膝關節還有一個幅度小卻重要的方向- 內外旋轉；膝關節不會是一個普通的單方向門骹式關節，但也絕非靈活如腳踝或髋關節（大髀骹）。 To have a healthy knee, you need the followings （健康膝關節由此👇🏼起）: 1. Synchronized movement of your menisci with your tibia 🦴 (小腿脛骨和半月板的活動方向是一致同步） 2. Intact ligaments and muscle tendons with no fibrosis or abnormal tension (韌帶要穩健、肌腱沒有不尋常阻緊張或纖維化） 3. Nerves & blood vessels supplying the knee joint be healthy, capable of smooth gliding throughout knee joint full range of motion (支配膝關節的神經線和血管要在膝頭活動時靈活滑動、神經線要健康） 4. The bones are in good density and alignment (骨頭要健康，沒有骨質疏鬆，位置適當） Today’s focus is #1 : if the menisci do not move in regards to knee’s movement, with time, the menisci would have tear, or erosion, or degeneration. In internal rotation of lower leg in knee flexed position (only 10 deg, as in photo), the medial meniscus (the bigger C-shape one) should be able to move up (as in photo) at most 10-12mm; in lateral rotation of lower leg in the same position (30-40 deg), the lateral meniscus (the smaller one) should be able to move up to at most 5-6mm. Your therapist should be able to check this for you to understand if meniscal movement is possibly one of the causes for your knee problem. But of course, the big picture is, there are organs affecting your meniscal movement 🤓. Let’s talk about this later. 今日先討論 #1: 假設半月板不能和小腿骨同步移動、他們就會有撕裂、退化（因為他們像水牛芝士夾在兩塊三文治之間😆）; 在屈膝90度後，小腿內旋大概有10度，內側半月板要向上移動（最多10-12mm）；同一位置，小腿外旋大概有30-40度，外側半月板要向上移動（最多5-6mm）。你的治療師應該要為你檢查你的半月板活動，是否構成你膝關節問題的一部分。當然，宏觀的角度是，原來背後還有內臟器官會影響半月板活動。🤓有緣再談。 一Ivy Mok :: Health & Therapy https://mewe.com/p/ivymokhealththerapy #visceralmanipulation #jointpain #meniscus #meniscustear #studygram #physiotherapy #osteopathy #osteopatia #fisioterapia #movementanalysis #jointmobility #barralinstitute #jeanpierrebarral #膝 #半月板損傷

The Knee - menisci - they need to move properly when we flex/extend our knees A patient took a MRI and consulted 2 orthopaedic specialists after a fall, which revealed horizontal tear of medial meniscus, fissure of retro-patellar cartilage. Operation done and it was found to have something that surprised the specialist - a quite crucial loosening of the anterior horn of lateral meniscus undetected by the MRI was found during operation, which if left unrepaired, would render the patient functional problem e.g. walking, despite the repair of medial meniscus be done. Menisci are shock absorbers, friction preventers of the knee, they protect the cartilage and improve knee joint stability. It moves posteriorly whenever the knee flexes, with medial meniscus slides back from 5 to 6mm while lateral meniscus slides back from 10 to 12mm. Before taking the MRI, patient came for a treatment. I found the medial meniscus was pretty good in movement while the lateral meniscus stuck and did not move to the front in assessment. MRI results and orthopaedists’ comments both focused on the medial meniscus and I was convinced that I was wrong in the assessment. It was until the operation was done and the surgeon found out that the lateral meniscus was functionally more problematic than the medial one, that it was in dysfunction despite a pretty ok structure. MRI can only showed something in static motion that has structural problems. Problems arise during movement (motor dysfunction) cannot be picked up by MRI. Defective kinetics do not depend on a structural lesion or misalignment of the meniscus or joint. “Osteopathy matters most is NOT a joint components position but rather its capacity for movement” (Barral JP & Croibier A, 2011) While MRI is not sensitive enough to pick up some conditions, it doesn’t mean the patient’s sufferings is psychological or that they can be denied. To be able to help patients, we cannot only study, but to train our hands to be able to pick up the problems of the patient, to understand the lesion, and to facilitate the joint to restore proper movement. To do this, you have to understand where the problems lie.