Locked Knee

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The knee is a hinge joint that is responsible for weight-bearing and movement. It consists of bones, meniscus, ligaments, and tendons. The knee is fully designed to fulfill various amounts of functions, including the following below:

  • Provide enough stability.
  • Helps lower and raise your body.
  • Allows twisting of the leg.
  • Makes walking much more efficient.
  • Supports the body in an upright position without the need for muscles to function.

Additionally, the knee is also one of the most complex joints in the human body. It connects the thigh bone (femur), to the shin bone (tibia), and also includes a smaller bone, the fibula, which is located next to the tibia, and finally, the knee cap (patella). Tendons connect these bones to the leg muscles, while ligaments connect the knee bones to each other and make the knee stable. In addition, two C-shaped pieces of cartilage (the medial and lateral menisci) provide a cushion between the femur and tibia, in effect, as shock absorbers.

Knees are designed to bend up and down and to rotate slightly. When a knee is unable to perform those specific functions, it impacts mobility and the ability to complete daily living activities, such as sitting, standing, squatting, or kneeling. When a knee cannot be bent or straightened, it is called a locked knee. There are two types of locked knees. A true locked knee occurs when the knee joint is literally locked into place and cannot move. A pseudo locked knee occurs when pain makes it very difficult to move the affected knee joint.

Causes & Symptoms

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The most common cause of a locked knee is a tear in the cartilage that cushions the knee joint. Typically, once the cartilage has been torn or damaged, it gets stuck in the joint, making it difficult to move the knee. In addition, the knee may also swell, make a popping sound, stiffen, and / or cause pain during standing, bending, or kneeling. Torn cartilage in the knee can be caused by either a sudden physical trauma or gradual wear and tear on the joint.

A true locked knee may be caused by decreased blood supply to the knee, or by what’s known as a “loose body” in the knee joint. The most common type of loose body is a detached fragment of bone. When a loose body becomes wedged in the knee joint, it causes it to lock. A loose body may result from a knee fracture, or from an underlying condition, such as arthritis of the knee. Foreign objects left in the body during past surgery can also act as loose bodies and cause joint locking.

While a locked knee is primarily characterized by the inability to fully extend the leg, the condition can also be accompanied by swelling, a small bump that moves when touching the knee, and joint stiffness. The primary symptom of a pseudo locked knee is pain that prevents movement of the knee. This pain may be associated with a sensation that the knee is locking up or catching when moved. There may also be a sensation that the joint frees up when moved a certain way.

Generally, a pseudo locked knee can have several causes. For instance, the knee may be fractured, dislocated, or affected by bursitis or tendonitis. Pseudo locked knee may also be caused by the inability of the kneecap to move correctly. This is called patellar maltracking. When this occurs, pain occurs at the front of the knee when running, ascending, or descending. Pain may also happen when sitting for a lengthy period of time, and the knee joint may feel unstable or locked.

Who gets a Locked Knee?

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Several risk factors associated with locked knees include the following below:

  • Sports – Locked knees are commonly caused by playing in contact sports such as football, volleyball, and soccer. They can happen when an athlete changes direction suddenly while running.
  • Age – Older adults are more prone to developing a locked knee due to degeneration (arthritis).
  • Patellar tracking disorder – If a patient is already developing a disease known as patellar tracking disorder, he or she is also more likely to experience knee locking and kneecap dislocation. Patellar tracking disorder is when the kneecap shifts out of place when you bend and straighten your leg. It occurs when there is a problem with the bones, tendons, muscles, ligaments, or cartilage that hold the kneecap in its normal position.
  • Obesity – Patients who are overweight are more prone to knee locking due to putting more stress onto their knees.

How Does it Affect You? How Serious is it?

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Locked knees can be a cause of a more serious complication known as plica syndrome. A plica is a fold in the membrane that protects your knee joint. Most people have four folds in each knee. Sometimes the plica located in the middle of your knee becomes irritated. This is called plica syndrome and it is characterized by pain, swelling, and instability.

Furthermore, if your locked knee is left untreated, the condition can eventually limit your daily life and ability to participate in exercise and sports. In severe cases, it can develop into long-term knee problems, like arthritis. In addition, moving around with a severely locked knee could pull fragments of the cartilage into the joint causing larger knee issues which could require more significant surgery in the future.

Surgery can be done by performing a knee replacement, however, there are several complications that can occur after surgery has been dealt with, such as the following below:

  • Infection – All surgeries require incision; cuts that allow surgeons to open an area of the body and make repairs. Therefore, this means there is a chance of infection, but it’s an extremely small possibility. When infections do arise, they’re considered serious.
  • Longer-term stiffness – It’s normal to feel stiff and swollen for a few months after surgery. However, sometimes that stiffness can last longer than usual. Longer-term stiffness is typically caused by excessive scar tissue. Oftentimes, lack of use or exercise can cause scar tissue to build up in the soft tissue around the joint.
  • Persistent knee pain – Some discomfort immediately after surgery may be normal. The pain usually lessens after two or three months, however, some patients can continue to have persistent knee pain after surgery.

Recommended Treatment & Rehabilitation

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When a knee locks repeatedly or is so painful that mobility has been heavily reduced, it is important to consult with a physician. Your doctor will first examine the joint, review the relevant medical history, and if necessary, request imaging, such as an X-ray, CT scan, or magnetic resonance imaging (MRI) scan. 

When a true locked knee is diagnosed, surgery may be required to remove the damaged cartilage or bone fragment. Typically, this surgery is performed arthroscopically. Several small incisions are made in the knee, and a tiny camera is inserted to locate the exact site of the tear or damage. The camera is also used to guide the use of tiny instruments that repair or remove the damaged cartilage. When the surgery is completed, the cuts are sutured and covered with a bandage. Most patients leave the hospital after the surgery and use crutches or a brace to keep pressure off the knee until the cartilage heals.

Locked knees can often be managed without surgery. A physiotherapist can help control pain and swelling in the knee area and work with you to restore full strength and mobility to your knee. Some of the following physiotherapy treatments include:

  • Manual therapy – Your physiotherapist may apply manual therapy (a hands-on treatment that may include massage, stretching, or joint mobilization) to help reduce swelling and stiffness and restore muscle function around the knee.
  • Ice therapy – Your physiotherapist will apply ice packs to the knee to help control any pain and swelling and may instruct you to apply icing at home. Swelling is an important guide during your rehabilitation and can indicate your level of ability and recovery. If you experience an increase in swelling, your physiotherapist will modify your treatment program or activity level to ensure your safest, most effective recovery.
  • Compression – Your physiotherapist may recommend the use of compression bandages, stockings, or pumps to assist in the reduction of or prevent further accumulation of edema. Your physiotherapist may include them as part of your regular treatments and teach you and your family how to use them at home.
  • Supporting equipment – It may be necessary to use supporting equipment such as crutches, a cane, or a walker in the short term. Your physiotherapist will also make recommendations about which device is best for you and will then instruct you on how to use it properly.
  • NMES – Your physiotherapist may use a treatment called neuromuscular electrical stimulation (NMES). NMES uses electrical current to gently stimulate / contract the muscles around your knee to help improve their strength.

Your physiotherapist will design exercises to build and maintain your strength during recovery and help restore full movement to the knee. You will be given a home program of exercises that are specific to your locked knee. Strengthening the muscles around the knee and throughout the leg helps ease pressure on the healing knee tissue.

Therefore, here are some exercise examples you can try at home:

 

Mini squats

First, stand with your back against a wall, with your shoulders and head against the wall. Your feet should be shoulder-width apart and one foot from the wall. Next, bend your knees slightly to bring your buttocks toward the ground. Stop at about 15 degrees of bend, feeling the muscles in your thighs working. Hold this position for 10 seconds, then repeat 2-3 times a day at a slow pace.

Hamstring heel digs

Lie on your back with your knees bent and feet flat on the floor. Afterward, flex your feet so only your heels are touching the ground. Dig your heels into the ground and slowly slide them about 4-6 inches away from your body. Bring your heels back toward your body, returning to your starting position. Repeat this method 8-10 times a day.

Leg extensions

Sit on a sturdy chair or bench with your feet flat on the floor. Flex your right foot and lift your foot off the floor, straightening your right leg. Next, slowly lower the foot back to your starting position. Repeat this exercise 10 times on the right side, then once again on the left leg 2-3 times a day.

Alternative & Homeopathic Treatment

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There are several ways to treat a locked knee homeopathically. The following are some treatments for you to try at home:

  • Rest – Limit activities to include walking if the knee is painful.
  • Ice applications – This is used to help reduce pain and swelling. apply it for 15-20 minutes every 3-4 hours for 2-3 days or until the pain and swelling are resolved.
  • Compression – Use an elastic bandage on your knee to manage swelling.
  • Elevation – with a pillow under your heel when you are sitting or lying down.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) – Anti-inflammatory medications such as ibuprofen and naproxen can be used to help with pain and swelling.