Landmarks of the Knee with Bonnie Southgate

 In Knee

The obsession begins…

For us at Pilates Therapy, we feel that understanding the anatomy and biomechanics of both the knee and the foot are of utmost importance. Recognising how they should work in relation to movement can be the difference between optimal and sub-optimal movement…and ultimately, cueing the correct movement can help our clients to move optimally without pain.

So if you’re here, you’ve probably seen our social media updates – May is our month to obsess over the knee and foot. Perfectly timed since our Knee and Foot courses are coming up over the next few months in our 3 separate locations…

On our first post in the knee and foot series takes us to Bonnie who eases us in with an overview of the knee. She shows us the bony landmarks as well as palpation points such as tendons and muscular attachments, all of which can be really significant when observing movement and treating your clients.

Here is the full video, but for those of you who like to read, we’ve also outlined the landmarks covered so you can follow along too!

Let us know what you think – We love to hear feedback from all of our fellow Pilates trainers out there!

 

Bony Landmarks: 

Medial Epicondyle – This is a bony landmark which is found on the distal end of the femur on the medial side. To palpate this, you’ll be looking for the gap between the femur and the tibia – Moving up slightly onto what feels like a bony edge.

Lateral Epicondyle – Found on the distal end of the femur on the lateral side. To palpate, you’ll be feeling for the gap between the femur and the tibia and then just moving up slightly onto the epicondyle.

Fibula Head – Heading up towards the knee along the lateral side, you’ll find a bony prominence which is the head of the fibula. Whilst this isn’t a supportive bone, it does form the attachment point for the Biceps Femoris. The fibula can also influence what happens to the knee and the ankle in flexion so it’s important that this bone can move to allow optimal movement and function of the bones and muscles surrounding the knee and foot.

Tibial Tuberosity – The bony prominence located on the front of the leg just below the knee cap (patella) This forms the attachment of the Rectus Femoris muscle – And it’s often a site of issue in knee conditions such a Osgood Schlatters.

Tibial Plateau – Think of a mountain, the plateau is that flat surface on top so working from the Tibial Tuberosity, move upwards and you’ll be able to feel the Tibial Plateau where you can almost sit your thumbs on top of it.

Pes Anserinus (Goose’s Foot) – Attachment point for 3 muscles which cross the knee joint. The Pes Anserinus can be tender to palpate but it’s located on the medial side.

Gerdy’s Tubercle – The Iliotibial Band attaches into this tubercle. Working from the Fibula Head, move medially, feeling for a bony prominence. The Gerdy’s Tubercle is located on the Tibia.

Base of Patella – The base is the top portion of the patella on the anterior side of the knee.

Patella Apex – Moving down to where the knee comes forms a slight point shape is what’s known as the Apex of the Patella.

Palpation Points – Tendons:

Quadriceps Tendon – The Rectus Femoris muscle runs along the front of the thigh and attaches over the kneecap into the Tibial Tuberosity. However, it starts to become a tendon above the knee and this is the Quadriceps Tendon

Patella Tendon – The Patella Tendon encloses the knee cap (patella) and attaches onto the Tibial Tuberosity

Semitendinosus Tendon – This is easier to palpate if your client is laid on their front, with one knee bent. On the medial side, you should be easily able to feel what Bonnie calls a ‘pingy tendon’

Semimembranosus Tendon – The Semimembranosus tendon is a flatter tendon compared to the Semitendinosus. Moving further medially, the Semimembranosus runs underneath the Semitendinosus.

Biceps Femoris Tendon – Located on the lateral side this tendon is often easy to palpate when your client is laying on their front with the knee bent.

Palpation Points – Ligaments:

Medial Collateral Ligament – This essentially holds the femur and the tibia together – And it’s a small band which crosses the joint on the medial side of the knee.

Lateral Collateral Ligament – This ligament has more of a rope texture to palpate, it’s a lot thinner than the MCL and it’s located (as the name suggests) on the lateral side of the knee! Both of these ligaments help to stabilise the knee

Palpation Points – Fossa:

Popliteal Fossa – This is best palpated by asking your client to lay on their front with their knee bent. You’re looking at the space on the back of the knee. This fossa contains the Popliteus muscle and the Popliteal Artery. The Popliteus muscle crosses the knee joint in back, and it helps with the screw-home mechanism. The Popliteus muscle helps to unlock the knee in flexion. The Popliteal Artery is a major artery located back here so be sure not to press too hard when palpating over this!

So this concludes our first instalment of our Knee and Foot Series – If you found this interesting or you’d like to learn more, we have 3 courses coming up dedicated to the knee and foot. These courses all take place over a weekend in 3 separate locations:

London: 18th-19th May

Dorset: 8th-9th Jue

Gatwick: 16th-17th August

If you’d like to book onto one of these weekend courses, you can either visit the Knee and Foot course page here, or you can email us at info@pilatestherapy.co.uk

 

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