Your knee joint is naturally a very stable joint and is capable of performing activities of varying intensities. Be it regular jogging, participation in sports or different types of household chores, your knee supports you in all such activities.
However, sometimes, some disturbances resulting in damage to the patellar ligament1 or knee joint can interfere with your regular activities. One such common complaint is knee buckling, in which the knee feels unstable. Pain or discomfort causes buckling results in sudden retraction of lower leg from putting weight on affected knee while knee stays in flex positon. This condition is commonly experienced as a feeling of 'knee giving way' or that the knee has suddenly lost its stability. In addition to this, there may be other associated symptoms depending on the underlying cause.
Knee buckling can be considered as a protective response of the knee and its surrounding tissues, to prevent further damage. The sensation of popping or locking makes it obvious to stop movement and particularly weight bearing on the affected knee joint. While this is more often seen in case of injured knee joints, certain bone and joint disorders like osteoarthritis may also contribute to it.2
What Can Cause Knees To Buckle Or Knee Buckling
There are various causes affecting the knee joint that can cause knees to buckle and which needs to be properly evaluated.
Injuries That Can Cause Knee Buckling
Injuries are a common cause of knee buckling especially when injuries result in acute or chronic knee joint pain.3 The problem can occur after an acute injury or may be seen gradually after repeated strain on a sprained knee. The knee joint is supported by anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial and lateral collateral ligaments, medical and lateral meniscus and muscles that enable free movement of the knee. Each of these ligament and meniscus has an important role to play in knee movement in particular directions. Any blow, sports activity or forceful movement that causes strain on these structures can cause damage or tearing of these ligaments or meniscus, leading to instability of the knee joint.
The commonest injury is the ACL tear, which can cause a popping sensation in knee or knee buckling. It may be associated with other ligament and meniscus tears. A meniscus tear is caused during twisting motion and can block the normal knee movement with a locking sensation. Depending on the nature and severity of these injuries, there may be associated pain, swelling and bruising around the knee joint.
Joint Conditions That Can Cause Knee Buckling
Certain conditions like osteoarthritis due to wear and tear of the knee joint or an injured joint too can cause instability of the knee.2 The weakened muscles or ligaments, unstable kneecap can also play a role in reduced stability, which can make the knee feel buckled during certain movements.
Other conditions in which trauma or degeneration lead to bony fragments, broken spurs or loose bodies to float in the knee joint can cause feeling of knee buckling during knee movements. Sometimes calcium can get built up in knee tissues causing inflammation in a condition called chondrocalcinosis. While some types of arthritis can cause knee buckling; oversensitive joint and tissues too can lead to a feeling of 'Knee giving way' or Knee Buckling.
Treatment & Management Of Knee Buckling
Clinical examination, assessment of knee joint and its range of motion, performing clinical tests to determine injury or instability of muscles and tissues may help to give an idea of the problem causing knee buckling or feeling of knee giving way. Precise diagnosis can be made using imaging studies and other investigations. Management of Knee Buckling depends on the underlying causes.
In case of acute injuries or inflammation causing swelling and pain leading to knee buckling, R.I.C.E (rest, ice, compression, elevation) formula is applied. Medications like anti-inflammatory drugs and pain relieving measures are advised. Knee braces for knee buckling may be prescribed to support the knee during movement while the damaged tissues are allowed to heal. Nutritional supplements like calcium, vitamin D and others may be considered where appropriate.
In case of knee buckling caused due to severe injuries ranging in higher grades of ligaments or meniscus tears may need surgical correction. Loose bodies or bony fragments may have to be surgically removed so that they do not disturb the natural knee movement.
Best Exercises For Knee Buckling
Whatever may be the cause or treatment modality for knee buckling or knee giving way, exercises are a vital part of the treatment and prevention program for knee buckling. Strengthening the knee muscles and ligaments can help in improving the stability of the joint and preventing knee buckling. The muscles that need to be worked on includes the quadriceps (thigh), hamstrings group (back of thigh), gluteus (buttocks) and calf muscles.
Exercises For Knee Buckling: Knee Strengthening Workout
- Lie on back; tighten thigh muscles to allow the knees to touch the floor. Hold for few seconds. A rolled towel can be placed under the knee.
- Lie on back and tighten buttocks muscles; hold for few seconds and release.
- Lie on back with knee straightened on the floor; tilt the toes towards the body to feel the stretch in the calf muscles.
- Lie on back; raise your leg with knee straight as much as possible; hold for few seconds and release.
- Lie on back; keep pillow under your knee. Raise the leg to straighten the knee, while rested on the pillow; hold for few seconds and release.
- Lie on stomach; bend knees and bring heels towards the hips, hold and straighten them again.
- Sit on a chair with heels on the floor; raise your leg to straighten the knee, hold and bring it down. This can be gradually performed with weight tied around the ankles.
- Stand with legs apart as wide as shoulders. Hold the chair in front and with back straight, slightly bend knees as if trying to sit. The knees should not bend beyond the toe line; release and come back to standing position.
Regular exercises and physical therapy can help to keep your leg muscles supple and strong and prevent untoward complaints of knee buckling or feeling or knee giving way. Maintain a healthy weight and consume a nutritious diet. Avoid overexerting your knees and participate in low impact exercises as advised medically. Follow your physician's advice about rest, activities and other supports like knee braces. Evidence of patellar tendon buckling during passive knee extension.
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