MUSCLES OF THE KNEE THIGH AND THEIR ACTIONS:
FLEXORS: KNEE Hamstrings (semi membranosus, semiteninosus, biceps femoris) Gastrocnemius popliteus
EXTENSORS: KNEE vastus medialis, vastus lateralis, vastus intermedius, rectus femoris
LIGAMENTS: KNEE Medial and lateral collateral, anterior and posterior cruciate,

COMMENTS: The main movements of the knee are flexion and extension. Common dysfunctions of the knee are; (i) being too compressed, (ii) the other moving too far laterally in the intercondylar groove. Both cause abrasion of the cartilage, leading to inflammation and degeneration. (i) Due to increased flexion of the knee which is caused by sustained tension in the hamstrings, Iliotibial band and gastrocnemius or by a shortened joint capsule this compressive force is dramatically increased when a person climbs stairs or gets out of a chair. (ii) If the patella is compressed laterally in the groove it is called patellar-tracking dysfunction. Two causes are a anteverted hip, lateral tibial torsion, and pronated ankle. Secondly a weakening of the vastus mediallis Oblique and a overdevelopment of the vastus lateralis, lateral retinaculum, and tensor fascia lata.

INJURY: Factors predisposing to knee pain. Abnormal position of the patella. Instability caused by weakness in the static or dynamic stabilizers. Muscle imbalances (tight flexors weak extensors see below) altered gait. Soft-tissue fibrosis especially in the joint capsule or lateral retinculum. Abnormal alignment. (genu valgus, genu varus, genu recurvatum). Femoral anteversion. Internal tibial torsion. Pronation or an unstable ankle. Rigid foot, which reduces shock-absorbing capacity. Immobilization, previous surgery. Change in exercise routine. Fatigue with most knee injuries happening at the end of the day/performance /race /match. Previous injury.

IMBALANCE: Muscles that tend to be tight short facilitated: Iliopsoas, Tensor Fasia Lata, Iliotibial Band, Rectus Femoris quadratus lumborum, Pectineus, Gracilis Adductors, hamstrings (especially Biceps Femoris, Soleus, Gastrocnemius, iriformis and other external rotators of the hip.

Muscles that tend to be weak loose and inhibited:   Gluteus maximus, hip abductors, hip internal rotators, Vastus intermedialis and medialis especially the Vastus Medialis Oblique and the dorsi flexors of the ankle, tibialis anterior.

ASSESSMENT: Using Biofeedback Good verses injured leg. Visual Postural Assessment, palpation verbal client case history.

MASSAGE: Muscle Energy Techniques, Trigger Point Therapy, specific techniques to relax over tight muscles with an aim to restoring functional balance to the joint. Soft Tissue Release is especially useful on the quadriceps.

CORRECTIVE EXERCISE/STRETCHING: Strengthening of stabilizer muscles improvement of tilting /righting reflex. Nervous system re-education. Correction of faulty recruitment patterns. Strengthen the weak muscles correcting knee function in all primal movement patterns squatting lunging etc. Specific stretches targeting tight muscles.