A great article for you today.

It is a guest blog post from Nick Rosencutter.

Enjoy.

Take it away, Nick.

Injuries are no fun.

They are a pain, literally.

They can stop you from doing something you love.

They can cause nagging aches and pains.

They can affect you mentally.

They can ruin your day.

They are something that most people try to avoid.

On the other hand, they can also be a blessing in disguise. This is something that I have realized first hand.

The Rush of Training

I absolutely love training, especially powerlifting. I love the thrill and rush of stepping on the platform to compete. I love pushing my body past limits and growing stronger both physically and mentally when I push past barriers with my training. I love being in great shape and moving weights that most people can only wish to move. I’ve loved training (notice I said training and not “working out”) for over 12 years without a break (which really isn’t that much and I still have a long way to go).

When I’m not training, I’m helping others train, reading about training or dreaming about training. The deadlift happens to be my ace and pretty much my favorite thing to do in the world. In my opinion, there is absolutely no better feeling than locking out a heavy deadlift as you feel every muscle in your body tighten up to make it happen.

The hip drive, grip strain, the glutes coming through, the back locking out, the traps stabilizing, the intrinsic foot muscles gripping the floor, the blood rushing through the veins and the rush that flows through the body and mind; just an amazing feeling that only certain people will understand. Not being able to do this for a period of time was devastating.

Great little video from Nick on Gluteus Medius Exercises:

Training Stupidity

Flash back to November of 2008. I had just done my fifth meet in about seven months, which was probably a little too frequently. I was on pace to pull my first 600lb deadlift at a bodyweight around 178-180. Training had gone well as I had pulled 610 with band tension, tripled 540 and had made good progress on most of my assistance work. Well, I ended up missing 570ish at the meet when I had nearly locked out 585 a few months earlier. Part of the problem was just training stupidity. I had gone too intense for too many weeks before the meet and had competed too many times. But I knew that couldn’t be the only issue at hand because when I made that attempt, the weight was coming up smoothly; I thought for sure that I had it locked. Then as I approached lockout, I just couldn’t finish it. I was upset to say the least.

The Injury was in the Details

So at this time, I was in my last semester in the exercise science and strength & conditioning program at UW-La Crosse. Luckily, I was surrounded by some very knowledgeable people who knew their stuff. I spoke with one of my mentors, an amazing strength coach who knows a thing or two about the iron game. I showed him a video from my missed deadlift. He immediately pointed something out that I hadn’t noticed or really even thought of. My left leg began to shake as I approached lockout. He looked at another video of a 560 pull I had made easily a few months earlier. I had some rotation occurring through my hips and trunk as I pulled the deadlift. It was subtle, but you could sure see it.

So what the heck was going on?

He evaluated me and found out that:

1. my left glute was not firing as well as my right with hip extension
2. my right shoulder had some issues as well
3. my subscapularis was very fibrotic and was stopping my scapula from moving as efficiently as it could

If you have ever read any of Thomas Myers’ stuff on fascia and exercise, this should make you think of the spiral line: opposite hip and shoulder.

I’m assuming that many who read this page know about the book, Anatomy Trains, so I won’t get into tons of detail, but the spiral line is a line of fascia that wraps around the body and at a certain portion of its path, connects opposite hip and shoulder together; basically meaning that an issue with one can affect the other with various movements.

This had implications with the rotation that was occurring with my movement. So he did some ART on my hip and shoulder (left TFL and right subscap among other things) and gave me a few corrective exercises to fix this imbalance that I had. This was probably my first real personal experience/encounter with the world of muscle imbalances and corrective exercise.

I had been decently well versed in every strength and conditioning modality imaginable but had apparently slacked on this whole other department. I was determined to fix my imbalance and get better. I decided to take some time off of competing and hammer these things out for a little while. The January following this encounter, I would embark on my full time internship in order to finish up my degree, which would turn out to be one of the best experiences of my entire life.

Muscle Imbalances that Affected My Lifting

Enter Indianapolis Fitness and Sports Training with a couple of guys named Mike Robertson and Bill Hartman. I learned a tremendous amount about training during my amazing time there and was totally immersed into the world of analyzing and addressing postural faults and muscular imbalances. I had no choice but to get better.

They discovered some of the same that my mentor at La Crosse had plus more:

• left glute medius was weak
• left glute max had gotten a little better but still wasn’t great
• external obliques weren’t where they needed to be, which meant that I didn’t have optimal control over my pelvis and trunk and was leaving pounds on my lifts
• lower traps were weak, especially the left side, which meant that my scapulae were not as stable as they could have been (implications for all of the big lifts)
• I had a slight shift and rotation with squats and pulls, which was definitely part of the issues listed above.

Those were some of the main problems for me. So I hammered out lots of special exercises to help balance things out and get my lifts up. I did however, make one mistake. I still trained too intensely, too often. I picked a meet that I wanted to do that May and trained for it.

Little clip from Bill Hartman’s Presentation in Muscle Imbalances Revealed – Lower Body Edition:

Now, these issues that I had were things that were probably going on for a long time. In my early days of training back in high school, I really had no true idea what I was doing (though I sure thought I did) as I pretty much just taught myself and learned from random gym rats and magazines back then.

The shifts and rotation that I had with my squat and pull were subtle enough that an average eye would never notice them, so who knows how long that had been going on. While I had gotten along fine and had built up to a respectable strength level and build, fixing some of these things earlier could have saved me lots of trouble and probably helped me to hit bigger weights easier. I mean, locking out a max deadlift with one glute firing versus two glutes firing is kind of a big deal. So anyhow, I was training hard and lifts were going up, etc. until…..

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That is the end of part 1.  I got part 2 coming up very soon.  Big thanks to Nick.  We all have an in jury story.

About the Author

Nick Rosencutter, CSCS, NSCA-CPT, LMT – Nick is a Certified Strength and Conditioning Specialist and Certified Personal Trainer through the National Strength and Conditioning Association and is also a Nationally Certified and Licensed Massage Therapist. He received his Bachelor’s degree in Exercise and Sports Science with a Fitness emphasis and Strength and Conditioning Concentration from the University of Wisconsin La Crosse, and received his diploma in Massage Therapy from Lakeside School of Massage Therapy in Milwaukee. He has worked with all varieties of clients ranging from fat loss to various levels of athletes and is also a competitive powerlifter. He currently trains clients at Southridge Athletic Club in Milwaukee and offers corrective exercise and movement training at Miller Sports and Wellness Chiropractic in West Allis. You can learn more at his website www.rosencutterultrafitness.com

Rick Kaselj, MS

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Great interview for you on ankle sprain exercises.

It is with Matt Ferguson.

Matt is part of a group that has developed a device that is more effective at strengthening the ankle and foot.

In the interview he talks about the importance of ankle strengthening.  Plus highlights how the AFX is more effective than traditional methods of strengthening the ankle and foot.

(To listen to the interview, scroll down to the bottom of this page and click the play button.  If you do not have time to listen to it right now, just click the “download” button and download it to your computer.  Then you can listen to it on your computer when you like or subscribe to the itunes podcast.  Enjoy!)

This is was what Matt goes through:

• Importance of ankle strengthening
• Matt and the rest of his team’s background
• Where the idea of the importance of ankle strengthening came from
• How the feet are the foundation of human movement
• Why traditional ways of foot strengthening are not effective
• Problems with using tubing for ankle strengthening
• What is more effective at strengthening the ankle and foot
• The number one activity-related injury is ankle sprains
• Sample ankle sprain exercises
• How it works and the benefit of AFX (Ankle Foot Maximizer) device
• Highlighting research that demonstrates the importance of ankle strengthening exercises

To learn more about Matt Ferguson of Progressive Health Innovations and the AFX, you can visit him here http://www.progressivehealth.ca/ .

I hope you enjoyed the interview. Let me know what you think or email me and let me know if there is someone I should interview.

Rick Kaselj, MS

P.S. – Other resources that may benefit you on ankle sprain exercises are:

• An Ankle Sprain Exercise You Can Do Anywhere
• Ankle Injury Exercises with Jimmy Smith
• Why Your Ankle Exercise Rehab Program is Not Helping Your Clients

Here is an example of an effective ankle sprain exercise that my help you:

This is a little video on how to download the interview to your computer:

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Overlooked Key to Overcoming Foot and Ankle Injuries with Matt Ferguson [ 17:16 ] Play Now | Play in Popup | Download

Awesome post for you on foot injury exercises.

Enjoy!

Foot Injury Exercises: How to effectively address issues in the foot, through SMR, mobility, and stability

The foot is a very complex structure for both fitness and health professionals to assess effectively. Bearing weight for the majority of the day it is responsible for absorbing and transmitting forces between a contact point (usually the ground) and the rest of the body.

By far the most commonly diagnosed condition in the foot is plantar fasciitis. While this may be common, many conditions may develop in the foot. Without a proper diagnosis, methods of rehabilitation become blind and often ineffective.

Below are some of the most common foot conditions to keep in mind during your assessment:

• Plantar fasciitis: Pain is present in the heel or underside of the arch. Pain usually decreases with rest, and is worst during the first few steps after long rest periods (ie: the morning). Heels spurs, or bony growths, may also show up on x-ray to help confirm this diagnosis.  (For plantar fasciitis exercises, check out Rick’s Plantar Fasciitis Exercise Solution)
• Severs Disease: Heel pain that presents in children between the ages of 8-14. Pain is similar to plantar fasciitis however, spur development is uncommon. This condition is caused by inflammation of the growth plate in the calcaneus (heel). Pain gets better with rest and is recreated by squeezing the heel.
• Fractures: Fractures can present with minimal or no swelling. Stress fractures are quite common in toes 2-5. Pain does not decrease with rest, the bone may be tender to the touch and night pain may also be experienced.
• Neuromas: A neuroma is a benign tumour originating from nerve cells due to regional irritation. Pain is quite localized and is most common between the 2nd and 3rd toe. There may be a palpable nodule that is very tender to the touch.
• Tendinopathies: Any of the tendons that assist in stabilizing the arch can become irritated due to repetitive strain. Pain may be present at the start of activity, disappear during and resume post activity. Pain presents as a dull ache and may extend up into the calf.  (For Achilles Tendinitis exercises, check out Rick’s Achilles Tendinitis Exercise Solution)
• Sprains: Impact sprains may happen especially in flat feet. Pain is sharp, tender to touch, and may be accompanied by localized swelling.
• Peripheral Neuropathies: Nerve entrapments higher up in the leg and back can cause pain in the foot, especially on the medial side (mimicking plantar fasciitis). Night pain may be present and symptoms are paired with problems elsewhere in the body (ie: “calf or hamstring tightness causes my heel to flare up”).
• Degenerative Changes: The most common arthritic development in the foot happens at the big toe. Pain is localized to the big toe, and may be present at night. There may also be the presence of a bony growth. Bunion formation can present similarly at this joint, however bone growth happens on the inside of the big toe.

Simple Assessment Foot Injury Assessment

Assess the foot in non-weight bearing first. If a person has an arch while non-weight bearing, you should recognize there is potential for that person to create an arch. Without forces of gravity and load the foot is structurally sound. With optimal function this arch presentation should remain stable upon the foot hitting the ground.

If the arch collapses in assumption of standing, the therapist/coach should start thinking of ways to improve arch stability.In individuals with arch collapse while non-weight bearing, chances of true structural issues are higher. Functional rehabilitation should still be carried out, but without expected progress an orthotic may be needed for full resolution of symptoms. In my experience orthotic prescription is required less if a correct rehabilitation protocol is followed under sound patient compliance.

Is Self Myofascial Release Good For The Foot?

Pes Planus: The majority of conditions happen because of the foot’s inability to be stable in a gait cycle. This loss of function leads to pronation of the foot or dropping of the arch (also known as pes planus). Pronation of the foot leads to lengthening of the tissues in the bottom of the foot. The result is pain, and irritation due to loss of mechanics.

Self myofascial release (SMR) in these instances creates less tissue stiffness, and greater instability. In cases of forefoot and rearfoot pronation a coach/therapist may be better coaching SMR of the hips and pelvic girdle. Addressing tight fibrotic musculature that maximizes function of the pelvis will certainly create better opportunity for function in the foot.

Read the rest of this entry »

I got an email from a reader who was looking for some ankle sprain exercises.

Hi Rick,

I am wondering if you have any ideas for a calf exercise for a person with an ankle injury. They are non- weight bearing and have very little ROM in the ankle (a few degrees of flex/ext). The Dr. would like him to continue strengthening the leg, in particular the gastrocs, however pain levels are quite high.

Any suggestions?

Thanks! I have really enjoyed your updates and the muscle imbalances revealed.

Nat

I have one exercise for Nat.

It focuses on range of motion in the ankle and working the gastroc at a low level.

Here it is:

Ankle Sprain Exercise

==>  Ankle Sprain Exercise in Supine

Ankle Sprain Exercise in Sitting

==>  Ankle Sprain Exercise in Sitting

Ankle Sprain Exercise on the Floor

==>  Ankle Sprain Exercise on the Floor

Ankle Sprain Exercise on the Wall

==>  Ankle Sprain Exercise on the Wall

I will put up some more ankle sprain exercises soon.

Rick Kaselj, MS

Read the rest of this entry »

I have a guest video blog post for you today.

It’s from Justin Price.

Justin answers the most common question he is asked during his courses and at the conferences he presents:

What Causes Over-Pronation?

In the video, Justin shares with you:
- What over-pronation is
- What causes over-pronation
- How the shoes you are wearing can be making your pronation worse
- The influence of gluteus maximus on pronation
- How the illiotibial band and tibia affect pronation

Here is the “What Causes Foot Over-Pronation?” video from Justin Price.

Justin Price will be coming to Vancouver to present his course for the first and only time in March of 2011.

In this course, Justin will focus on Day One on the assessment side of things, and on Day Two he will focus on what exercises to give based on the assessment.

I selected Justin as one of the international experts to bring to Vancouver because I have learned a lot from him when it comes to lower body assessment, and his assessments of the foot have been very helpful.  Plus, I find his corrective exercises very unique and quite different from others I have seen.

That’s it for today.

On Wednesday, I will have a very exciting announcement for you – I can’t wait to tell you about it!

Rick Kaselj, MS

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I would like to talk about some fun stuff about Knee Injury Solution.

I am very proud of Knee Injury Solution.

After 11 webinars, 3 manuals, and numerous books, I am getting closer to what fitness professionals are looking as it pertains to exercises and injuries.

I have made some mistakes, and I have received great feedback from thousands of health and fitness professional on how I can improve my programs.  With Knee Injury Solution, I feel that I am there.

Fun Stuff #1 – Video of the Exercises

The number one feedback from trainers, coaches, and therapist was that they wanted videos of the exercises.

In the past, I would write things out and talk about them in my video presentation. People also want to see the exercises being done.

I have started to do this.  Sometimes I don’t do the exercises right or they are too advanced for me, but I hope people see that I am not perfect and have lots of room to improve on as well. I know having me or someone else go through the exercise will help people out.

Fun Stuff #2 – Hottest Day of the Year

I decided not do the videos myself for the 9 Exercises a Day Keeps Knee Pain Away and 10 Minutes to Stronger Knees workouts.

I got a local female soccer player to help me out.

We filmed her doing the exercises during the summer.  Of course, we picked the hottest day of the year.

She was a trooper, but she went through 4 liters of  water before we knew it.

We had to head into the shade to finish the rest of the exercises.

It was great to take the exercises outside and show people that the exercises can be done anywhere.

It was also great to have a female go through the exercise, so that you can see how she does them and how her body reacts to fatigue.

Fun Stuff #3 – A Guide to Refer To

Other feedback I received was that people like something they can print out and quickly refer to.

I created a little guide with photos, descriptions, and a few details that people can refer to quickly in order to remind them of the exercises and what to do.  If they want more detail, they can watch the video.

I think that’s it.

Make sure you email me and let me know what you think of anything I do.

With Knee Injury Solution, I know that I am closer to getting it perfect.

Take care, and I will talk to you soon.

Rick Kaselj, MS

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This small blogging world is cool.

I have been reading other bloggers in the physical therapy and research world.

It is amazing how much incredible information is out there.

Let me know if you have some recommendations on blogs that I should be reading.

Let me get to today’s blog post on knee injuries.

Everyone Has Messed Up Knees

Speaking of one of the blogs that I like to read, this one was posted on Eric Cressey’s blog.


Eric brought up some great points:

1. Do a thorough assessment
2. Focus in on movement issues
3. Address the movement issues before the structures, which have increased stress on them, lead to pain and injury

These are all great points and excellent ideas for future blog posts.

Let’s look at what they covered in the research.

What They Looked At

They looked at 56 knees of 28 males that are 14 to 15 years old that had no pain or injuries (asymptomatic).  One group were soccer players and the other group were not.

They performed MRI scans on the knees of both groups and looked at fat pad, meniscus, articular cartlage, bone marrow signal changes and the amount of fluid in the knee.

What They Found

Of the soccer player group, 64% of them had some knee abnormalities when looking at the MRI, while 31% of the non-soccer group did.

Take Home Message

No Pain, No Injury? - Just because the person is not in pain or the stress placed on their tissues (ligament, cartilage, tendon, muscle, bones, nerves, etc.) is at a point that the tissues can handle it, does not mean that there isn’t an injury waiting to happen.

Assessment of the Lower Body - With clients, you need to assess their lower bodies and identify any issues.  One of the assesments that I do is a muscle imbalance assessment.  After the assessment you can address any issues.

Don’t Freak Out Over MRI Results - One should not freak out when they get their MRI results.  There is a good chance, if you are active or inactive, that you will have knee abnormalities.

Preventative Exercises – Those in sports should do a dynamic warm up that helps prepare the knee and prevent knee injuries.  I go through an example in the 9 Exercises a Day Keeps Knee Pain Away workout:

Where to get more information: Soder RB, Simões JD, Soder JB, Baldisserotto M. (2011). MRI of the knee joint in asymptomatic adolescent soccer players: a controlled study. AJR Am J Roentgenol. 2011 Jan;196(1):W61-5.

Prehabiliation Before Knee Replacement Improves Strength and Function

What They Looked At

They had a group of 36 with severe osteoarthritis (OA) who were waiting for a knee replacement (knee arthroplasty).  They were put into two groups.  One group who received the usual care, and the other group got usual care and exercise.

The exercise group did a comprehensive prehabilitation program that included resistance training using bands, flexibility and step training 3 times per week for 4 to 8 weeks prior to their knee replacement.

What They Found

The group that exercised prior to knee replacement had an improvement in knee strength and function.

Take Home Message

Can Be Done at Home – These exercises can be done at home with very little and inexpensive equipment.  I like that.  Going to the gym or the clinic can be difficult for clients but there is a benefit for doing specific exercises at home.

Exercise Before Surgery – Every individual is different, but if the surgeon recommends an exercise program, there is benefit when it comes to strength and function if they start an exercise program prior to knee replacement surgery.  Who does not want that?

I go through osteoarthritis exercises in the Exercise Rehabilitation of the Knee course:

Where to get more information:  Swank AM, Kachelman JB, Bibeau W, Quesada PM, Nyland J, Malkani A, Topp RV. (2011). Prehabilitation Before Total Knee Arthroplasty Increases Strength and Function in Older Adults With Severe Osteoarthritis. J Strength Cond Res. 2011 Jan 6. [Epub ahead of print]

Rick Kaselj, MS

I want to thank everyone that took the time to comment on the blog post ( What Do You Want From Me ).

I have read the comments and emails.  This is what people have asked for:

#1 – Client Case Study

What do you think of this:

I have an idea for you: What if you had people blog in about problems they are having and you answer them like you do with your journal reviews. Perhaps you thought of this already and you would certainly have to put a limit on how many you answer, like three as you do for the journals.

For example:

I have a client that golfs. He had a left shoulder injury from a fall years ago. This year he fell off his bike and was experiencing impingement. After osteopathic treatment, and yoga to aid in ROM and keeping asymmetries in check, he is experiencing deep right hip pain upon leg extension. I gave him the glute medius exercise, no change. We are working on keeping the left scapula from winging. I did the shoulder test you mentioned from Eric Beard and he has limited internal rotation of the left shoulder. We did the thoracic mobility exercise. As a golfer he has increased rotation to the right vs left. I am stuck as to why he is getting recurring right hip pain (particularly after lots of walking or lots of sitting) and suspect a glute max imbalance. I am unsure how to fix it as I do not understand what is causing it. I have given him foam roller exercises with right leg crossed over left and rolling on the right butt cheek, and pigeon pose to stretch it this week, not sure how to strengthen it.

S

I like the idea.

I think it is great.

When I teach my courses/seminars live, I know the registrants enjoy the fact that they can ask me questions relating to their clients and themselves.  Great idea on answering client case studies.

#2 – Recorded Seminars

With this little blog, it has been able to help people from around the world.

Just last week I was talking on the phone with a personal trainer from Trinidad Tobago.

How cool is that?

He has been using the stuff that he learned in Muscle Imbalances Revealed and Scapular Stabilization Exercise Program for himself and his athletes.

I got it, more recorded seminars.

#3 – Specific Injuries

I know, injuries are big things.

I am so glad I heard from you all on the kind of injuries you would like me to write about.

People asked about these injuries:

• elbow injuries (more than just tennis elbow), including wrist and forearm pain
• ankle injuries
• shin splints
• acute injury recovery tips
• chronic pain injury tips
• dealing with pain at the back of the knee when walking

Let me know if you want me to work on any others.

Read the rest of this entry »

What isPlantar fasciitis?

Introduction

Plantar fasciitis is an overuse injury involving the plantar fascia, a tough, fibrous band of tissue that supports the longitudinal arch of the foot.  Also known as jogger’s heel, tennis heel or Policeman’s heel, plantar fasciitis is one of the most common injuries affecting athletes and individuals who are constantly on their feet for a long period of time. Severe heel pain, usually is described as knife-like especially during the first few steps in the morning.

According to the American Academy of Podiatric Sports Medicine, heel pain is the most common presenting symptom of patients who seek treatment from podiatric practitioners. It is estimated that each year, 10% of foot injuries associated with running are attributable to plantar fasciitis (Buchbinder, 2004).

Read the rest of this entry »

It was an amazing weekend in Indianapolis at the NCAA March Madness Final Four.

The city of Indianapolis was a great place to visit, the event of the NCAA Final Four was incredible and the basketball was superb.

While I was sitting in the stands watching the Duke Blue Devils celebrate the National Championship, I began to reflect on what I learned over the weekend.

5 Things that I Learned when Watching Butler & Duke University While at the 2010 NCAA Final Four in Indianapolis

Read the rest of this entry »

I received a question from a personal trainer who has a number of clients with meniscal injuries; she was looking for some suggestions on program design and exercises.

There is a lot to consider when it comes to lower body injuries and exercises.  I go through all kinds of exercises for the lower body in the following courses:

Exercises Rehabilitation of the Knee

Balance Training for the Rehab Client

I will focus on a few key points to remember when strengthening the knee that has a meniscus injury.

What Does the Meniscus Do?

Taking a step back, the menisci act to spread the load of the body’s weight and reduce friction during knee movement.  When your client talks about “torn cartilage in the knee” they are often talking about meniscus.

5 Keys to Help Your Clients with a Meniscus Injury

Time Load on the Meniscus

Look at your client and see the amount of time they spend standing, walking, running and exercising during the day.  All of these activities puts load on the meniscus and if the meniscus is damaged, it will lead to inflammation.  It is important to load the meniscus, but the amount of time they load their meniscus needs to be monitored and your client needs to address any inflammation they have.

Plus a decrease in the load during the day on the meniscus will allow the meniscus to heal better and allow your client to do more during their exercise program when it comes to weight bearing and leg strengthening exercises.

Get on the Bike

Whatever your opinion is of the bike, the bike is great to strengthen the injured knee while putting low load on the internal structures of the knee, like the meniscus.

Get your client on the bike in order to strengthen the muscle around the knee.

Collapsing Feet

If your client has excessive pronation (flat feet) during gait, this will lead to increase medial load on the knee.  If their cartilage issue is the medial meniscus, this will put greater stress on their meniscus when doing day to day activities.  You need to assess you client to see if this is making the meniscus symptoms worse and slowing down their recovery.

Other Knee Strengthening Exercises

A lot of the common exercises given for the meniscus injury are hip flexion and hip extension exercises.  This is important, but does not address knee extension.  Few exercises that your client can do to strengthen the quadriceps:

Supine Tubing Leg Press

In a supine position straightening the legs out against resistive tubing.

Changing Stance Width

With the typical closed chain exercises like squats and lunges can be tough for a client with meniscus issues.  What you can do is play around with the hip width that your client performs the exercises.  Sometime varying the distance between their feet will decrease the load on the injured area of the meniscus and allow them to perform the exercise.

I have to thank Barb for the question about meniscus injuries and exercises.

Do let me know what you think of the post and if you have any tips for other fitness professionals on exercise and meniscus injuries.

Rick Kaselj, MS

Before I go, one last thing.

The picture above gives you an idea of how it looks in the knee.

1 = meniscus

2 = femur (thigh bone)

3 = tibia (shin bone)

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