微信搜索关注公众号《康复小南宁》，本公众号是小编业余时间，用来学习分享，因此有添加小编微信号kangfxnn或者留言的同道，回复有所怠慢请见谅！
If I weren’t so motivated to educate, I would get frustrated by the number of people in my office prepping for knee surgery.如果我没有积极地接受过教育，我会为办公室里那些准备进行膝关节手术的人感到难过。
These patients have often been misled to believe that the structural findings on imaging warrant surgical intervention.这些患者常常认为影像学发生结构改变的需要进行外科手术干预
With all due respect – what bull!恕我直言——荒唐！
These nerves relay knee pain to the brain:
– obturator nerve
– femoral nerve
– tibial nerve
– common fibular nerve
– L3-S1 spinal nerves
– saphenous nerve
– lateral sural cutaneous nerve
以下这些神经把膝关节疼痛感受传递给大脑：
-闭孔神经
-股神经
-胫神经
-腓总神经
-L3-S1脊神经
-隐神经
-腓肠外侧皮神经
It baffles me how many nerves innervate the muscles, bursae, and the structures of the knee joint that they cross.还有很多我不知道的神经支配着肌肉、滑囊和它们穿过的膝关节的结构
Yet, if pain is present, we jump to a structural change as a causative factor.然而，当膝关节发生疼痛，我们草率的把结构性的变化认作诱发因素
That makes little anatomical sense.这在解剖学上是没有什么意义的
Most of the ligamentous and cartilaginous architecture is poorly innervated (if at all), with poor arterial supplies.由于动脉血供少，大多数韧带和软骨结构是极少受到支配的（如果有的话）
But then, let’s not forget why most knee pain arises: the bursae.但是，为什么大多数膝关节疼痛会出现：因为滑囊
A bursa is a synovial fluid-filled sac between a muscle and bone. This bursa is LOADED with pain reception – as a warning to stop the friction of a structure across the adjacent bone.滑囊是位于肌肉和骨骼之间的充满滑液的囊。 这个滑囊充满了疼痛感受器——作为一个警告要停止结构摩擦相邻的骨头。
广告
---------------------------------------------------------------
I have my fair share of patients that blame knee pain on torn menisci, “bone on bone” osteoarthritis, the like. But my elderly patients full of degenerating joints many times get quick relief from pain with our work.我有相当一部分患者把膝盖疼痛归咎于半月板撕裂、骨头摩擦、骨关节炎之类的。 但我接触的患有退行性关节炎的老年患者通过我们的治疗很多时候能快速快速缓解疼痛
Did I repair torn structures, like menisci? No.我是否修复了半月板磨损的结构？不是
Did I reverse degenerating knee joints? Unlikely.我是否恢复了退变的膝关节？不大可能
I help them improve their movement, so they stop irritating the knee bursa.我帮助他们改善运动，这样它们就不会刺激到膝关节滑囊了。
While my approach may not be novel, it’s a nice alternative to surgery! It would also explain why knee pain doesn’t always resolve after surgical procedures.虽然我的方法可能没有多创新，但它是手术的很好替代选择，这也解释了为什么膝盖疼痛在手术后并不总能消除。
Get to know your knee bursae. Consider that the knee might be hurting because its working too hard, rubbing structures across pain-sensitive bursae.试着了解您膝盖的滑囊，考虑下膝盖可能受伤是由于它过度使用，会刺激到疼痛敏感的滑囊
Eliminate this potential by getting assessed and corrected by a movement professional.通过运动专家的评估和纠正来消除这种隐患。
Delay your surgery, and give therapeutics a shot before going under the knife.推迟您的手术时间，在手术之前给予治疗
Additionally, read the Moseley research, to understand that knee pain is not even just structural or functional, but also could be in your mind.此外，阅读Moseley的研究，了解到膝盖疼痛不仅仅是结构性或功能性的，也可能是中枢性的。
Go to a surgeon, and you can’t be surprised if surgery is recommended去看外科医生，如果建议做手术，你不会感到惊讶
——本文完——
本文为分享类文章，不做商业用途
文章仅供个人学习参考，如有侵权请联系后台
继续下拉
文章来源：Dr. Kathy Dooley
编辑排版：康复小南宁
小编微信：kangfxnn
医院介绍：广西医科大学第二附属医院康复医学科
