A Common Source of Knee Pain: The Coronary Ligaments

Much pain in the knee comes from chronic injury to one or more of its many ligaments. Fortuantely many knee ligaments are close to the surface, and therefore are very treatable by manual medicine methods without surgery or medications.

The knee is an astonishing joint: It is able to support the entire weight of the body, even while it is flexed, can hinge innumerable times without friction or pain, and also can control the positioning of the leg and foot.  Of course it is the entire system of bone, cartilage, ligament and muscle that performs these miracles.  But I'm going to argue that it is the ligaments of the knee that makes the whole thing hang together.

There are the major ligaments, like the Cruciates and the Collaterals which literally keep the thigh attached to the lower leg.  If you tear these in half, you have a big problem.

Then there are other ligaments whose function is more mysterious.  Many of these surround the knee and resist various stresses, especially torsion.  They also create a capsule that keeps the workings of the knee bathed in joint fluid.  Because they surround the knee, they are not very deep and as I mentioned before, they are easy to treat by manual medicine methods.

Finally, there are some ligaments which are a bit odd.  I'm thinking of the Menisco-Tibial ligaments, which as their name implies, arise from a meniscus (the main cartilage of the knee, and which disappears in advanced arthritis) and then attach to the tibia, the main bone of the lower leg.  These are also known as the Coronary ligaments because they wrap circumferentially a bit of the way around the knee, like a crown goes around a head.

Technically these are not ligaments, because ligaments run from one bone to another, not from cartilage adhering to a bone, to another place on the same bone.  Orthopedists call them capsular ligaments because they are part of the joint fluid retaining capsule.  After that, the agreement ends.  It is assumed that these ligaments stabilize the meniscus and help it resist wear and tear.  (See other articles in this Blog for the importance of preventing cartilage damage.)

I have found that the Coronary Ligaments are a common source of knee pain.  Since these ligaments are oriented circumferentially, I believe they are very important in resisting rotation.  The knee really does not like rotation.  When you're moving in one direction, and plant your foot and change direction suddenly (as when playing basketball or racquetball,) you are putting rotational force through your knee, and sometimes this damages the Coronary Ligament, causing lasting pain, even years later.

I treat the coronary ligaments with Graston Technique, an instrument-assisted soft-tissue manipulation method which stimulates the body's own healing mechanism in well-understood ways.  Usually three or four treatments make a huge difference in knee pain caused by these ligaments.

If you have a question about the coronary ligaments and knee pain, or whether Graston Technique might help you, please call me.