Normal Knee function
The knee does two things - it flexes and straightens and it also rotates, to allow you to twist and turn as you walk and run. It is this rotation that seems to cause the problems, probably because we encase our feet in concrete and walk on flat surfaces most of the time, we rarely turn at the knee, and when we do, it causes problems. Everyone knows they can bend and straighten their knee, but not everyone appreciates that knees can also "rotate". When the rotation goes wrong, you end up with a "twisting injury" of the knee and when extension and flexion go wrong, you have a hyperextension injury or dislocation.
The Medical History
The diagnosis is almost always in the history. By understanding what happened and how the patietn felt you can work out what happened. And once you know what happened, you can work out what has gone wrong, and that is your diagnosis. Knowi what has gone wrong and you can put it right
Today's case is of a man in his late thirties, early forties, not particularly fit, who lost his footing on a path and fell heavily. He landed heavily on his shoulder and hip and twisted his knee. I saw him three months after his original injury. His shoulder was better and his hip was better but his knee had not improved.
And if you are a patient stick to the point - we don't need smart ass patients! The answer to the question "What seems to be the problem?" is not "Well you are the doctor, you tell me" On the other hand saying "It is my cartilage" is equally unhelpful. As a doctor, you want to hear facts and then put the relevant facts together to make a medical history which leads you to the diagnosis.
The skill in taking a medical history is in being able to tease out what details are medically relevant and which details are just padding.
Many people nowadays are extremely unfit, with little sense of balance and even when they do exercise it is in a gym and not outside in the real world
Copyright (c) Dr. Liz Millerwww.lizmiller.info
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