Main types of knee injuries and relief methods:
1. Knee Meniscus Injury
The human knee is the largest joint in the body and bears the brunt of body weight. It consists of the lower end of the femur and the upper end of the tibia, with the patella in front and a “cushion” known as the meniscus in between. The joint is stabilized by strong joint capsules, muscles, and ligaments surrounding it.
Body weight exerts vertical stress on the knee joint, while complex human movements such as twisting during sports or squatting to use the toilet create lateral stress. When excessive force is applied, the two menisci in the knee joint are prone to injury, especially when rotational forces are too strong, leading to meniscus tears.
Meniscus injuries are often accompanied by damage to the joint capsule. Due to the rich blood supply in the area, bleeding can easily occur, leading to blood accumulation in the knee joint cavity, pain, and swelling. Twisting injuries and knee pain during trips are common, but as long as there’s no swelling, there’s no need to worry about a meniscus injury.
The meniscus is made of cartilage tissue with almost no blood supply. Once damaged, it’s difficult to heal, which is why it often causes post-injury joint pain. Surgical removal of the meniscus or removing small or linear tears using arthroscopic techniques are commonly accepted and effective methods. Not all meniscus injuries require immediate surgery. Walking carefully and maintaining knee stability can still allow joint movement. However, small fragments may sometimes shift due to walking on uneven surfaces or awkward postures, getting stuck in certain parts of the joint space and causing sudden, severe pain that prevents walking—a condition medically known as “joint locking.” Movement or treatment can “unlock” the joint, and symptoms disappear instantly with a popping sound. It’s important to be aware of this unique phenomenon. Experienced patients often learn to unlock the joint themselves by relaxing the lower limb muscles and gently shaking or flexing and extending the knee joint (flexion-rotation technique) to relieve discomfort.
2. Knee Loose Body
Joint locking is not only caused by meniscus injuries but also by loose bodies within the joint. These are tiny fragments, essentially small pieces of cartilage that have detached from the joint surface due to trauma or degeneration. About the size of a pea, non-calcified ones don’t show up on X-rays. Occasionally, you might feel them but then they disappear, moving quickly around the joint, hence the nickname “joint mice.” They can also get stuck in the joint space, causing locking, which may recur and lead to fluid accumulation in the joint cavity. Since they usually don’t cause pain, they’re often overlooked. The symptoms and treatment are similar to those of meniscus injuries.
3. Chondromalacia Patellae
Another common cause of knee pain is chondromalacia patellae. The patella is a round bone at the front of the knee and part of the knee joint, located in front of the intercondylar fossa of the lower end of the femur. The cartilage surface at the back of the patella forms a joint with it. During knee flexion and extension, the contact between the patellar and femoral joint surfaces acts as a pivot point. The patella is connected by ligaments both above and below. When the knee is straightened, the quadriceps tendon pulls the patella backward against the femoral condyle, helping stabilize the knee joint.
Repeated knee twisting or improper movement posture can lead to wear of the patellar joint surface, where the cartilage loses its luster and elasticity. Some cartilage softens and peels off, and moving the patella can cause pain. Daily activities may still be tolerable, but fatigue sets in easily. Slightly more activity can lead to knee pain. Patients unfamiliar with medical knowledge often mistakenly think it’s full patellar softening, but the actual issue is softening of the patellar cartilage. Excessive walking or uneven surfaces can cause fluid accumulation in the knee joint, leading to swelling—an unpredictable issue during trips. Resting promptly leads to quick recovery. If activity must continue to stick to a schedule, a visit to the hospital for an intra-articular corticosteroid injection can help alleviate symptoms faster.
How should we prevent injuries?
When descending a mountain: 1) The knee joint is constantly in an alternating state of bending and bearing weight. At this time, the ligaments are relaxed, and the joint is very unstable, relying entirely on supporting bands to maintain stability. When the joint shifts laterally, the supporting bands are highly susceptible to injury, resulting in tiny fiber tears and capillary bleeding. Symptoms include pain on the inner or outer side of the knee, which is more pronounced when descending. 2) When the knee is bent, the joint is unstable. Lateral external forces or slipping, along with an unstable center of gravity, can twist the knee joint, causing meniscus injuries. Symptoms include intense pain inside the joint, inability to bend or extend, and joint capsule damage leading to swelling.
Avoid carrying excessive weight. If you want to exercise, start gradually instead of overexerting yourself with sudden, intense hikes. Maintain a steady and energy-efficient pace.
Take appropriate breaks along the way, ideally lasting 30 minutes to an hour, and stay hydrated.
Wear knee pads to enhance joint protection.
For those with existing knee conditions, avoid steep slopes or large staircases.
In short, don’t forget to protect your joints while hiking so they can function better and last longer.