punching the kneecap

[juszczec]

Doc

I've heard its possible to dislocate the kneecap by punching it. Fist (lotsa little bones) vs kneecap (bigger bone, backed up by even bigger bones) isn't exactly my first choice of targets.

However, can you comment on the chances of doing damage to the knee by punching it?

Mark

[doc]

I wouldn't exactly think of punching the kneecap as being my first choice in target areas. Now, kicking the kneecap (patella) makes more sense. But, let's think about the patella and what it does.

The patella is a bone which is enclosed by the quadraceps tendon (the quads are the muscle group on the anterior part of the thigh, which are responsible for extension of the lower leg). Underneath the patella is a mass of cartilage, which rides on the cartilaginous surface of the distal end of the femur (thigh bone). In a way, the patella plays a role here in physics, it kind of works like a fulcrum, carrying the quadriceps tendon over the knee joint. It protects the knee joint, and enables extension of the leg to occur more easily. Fracturing the patella can make walking painful, dislocating the patella is tough, but can be done if there is a lot of trauma to the knee area, or if the circumstances are right.

People can get pain in their knees from irritation to the patella cartilage, either from overuse (such as doing deep squats while holding weights), or from long distance running. Sometimes the patella cartilage gets irritated and worn down just from common use. This condition is called chondromalacia of the patella, and it can be painful. Punching someone in the patella area when they have chondromalacia of the patella can cause significant pain. So, if you know your opponent's medical history, it might be a decent option.

Fracturing the patella (it usually shatters into many pieces, usually from hitting a car bumper or automobile dashboard) can result in relative immobility. It's kind of hard for the knee joint to work properly when that fulcrum gets destroyed. But, generally speaking, it would take more force to fracture than what a fist could supply. The fist would probably suffer more damage, because the strength of the bones in the hand are probably not as strong as the patella.

Punching the patella (or the knee, more likely) from the side could cause some injury though. But, because of the thickness of the patella, hitting it from a lateral standpoint is difficult without hitting the distal end of the femur, or the proximal end of the tibia. Because the knee joint is not a terribly stable joint (it derives its stability from the strength of the surrounding muscles), and because the knee joint is relatively weak from a lateral standpoint (being held in place by the medial and lateral collateral ligaments), striking the knee from a lateral direction can cause significant damage. But, generally speaking, the hand would not be the first weapon of choice, though it could effectively damage a knee when used from a lateral striking position. And, I might add, an open hand would probably suffer less damage in such a strike, than a closed fist, but, this depends upon the conditioning that the striking hand underwent in the past.

The physics of a punch is fairly interesting, considering how the bones in the hand line up, and what striking surface of the hand is used. How the hand is held, what part of the hand is used for striking, and what kind of strike it is, all dictate the relative strength of the strike. What the hand is striking will also dictate whether or not the hand gets injured in the process. Again, simple physics come into play. There's a "hardness" scale that actually assigns numbers to the level of "hardness" an item has; diamonds scratch glass, glass does not scratch diamonds, so diamonds are "harder". Same thing with bones. The thicker the bone, the more calcium, generally the more stronger. Striking the lower part of the tibia with the upper part of the tibia will generally lead to damage to the lower part of the tibia; it's just a smaller, and weaker, area of the tibia. Striking the small bones of the hand against the thicker and stronger frontal bone of the skull, will generally lead to injury of the hand and not the skull. Kind of like the "paper, rock, scissors" concept. What's stronger generally will come out on top. Striking the hand bones against a patella, in my opinion, would probably not result in patella fracture, but, if applied correctly, in the right circumstances, could most definitely lead to knee joint injury.

[daodejing]

I'd have to agree with Doc here. If you're really intent on attacking your opponents knee (and thus not very concerned with your oppenents health, or simply very concerned with not letting him kill you) punching is not the best attack, and it is infinitely easier to throw feinted punches at the head of said opponent to distract him from the fact that you're simultaneously kicking in his lead knee from the front or laterally.

It really doesnt take alot of force in a kick which strikes the lateral portion of the knee to knock the opponent down. However in the same situation under optimal conditions, it takes either a) alot of force, or b) very high level of skill in internal movement and jing manifestation to achieve the same results with a punch to the knee as you could with a kick.

Look at it this way, you're legs are already down there at knee level. And besides, its very easy to kick someones knee out when they think you're trying to punch them in the face.

As for dislocating the patella, that's pretty hard to do. You have a better chance of being able to dislocate a patella through rough massage then you do through a punch. Much simpler to settle for kicking the area in question and tearing the connective tissue.

[doc]

Oh, got carried away there. Didn't answer your question. Can you dislocate the patella by punching it.

Well, if you look at a cross section of the knee, which shows how the patella rides in the femoral sulcus, I think you can get the idea that the patella rides in a groove, and, also, that the patella is relatively thin from a lateral viewpoint, and thus fairly difficult to strike on its own, without hitting the distal end of the femur. The patella, given the proper amount of force, if it is hit, can be forced out of the femoral sulcus, generally in a lateral direction, but, as you can see from the below image, has a better chance of sliding back in, than, lets say, a dislocation of some other joint. Also, something like a fist is can do this, though, as a fist is much larger than the cross section of the patella, much of the force from the fist would most likely hit the femur also. However, given the right circumstances, a fist, or a foot, or leg, striking the patella, can cause it to dislocate. The stronger the quadriceps, the less likely a patellar dislocation, as the quadriceps provides the tension to keep the patella within its groove. Conversely, the weaker the quadriceps, the more likely the patella can dislocate.

But, given the proper circumstances, lateral dislocation of the patella is possible. If the quadriceps muscle is lax, if there has been previous dislocation of the patella, or injury to the quadriceps tendon, or, if the lower leg is in flexion when the patella gets struck (ie, the knee is bent or twisted, rotational injuries can cause this), or, if the person has alignment problems of the lower leg, the patella can dislocate laterally, whether it be struck by a fist or some other object. Concurrent fracture of the lateral condyle (the lateral portion of the distal femur) also increases the possibility of patellar dislocation. Generally, the patella does not dislocate medially because of the shape of the distal femur. Flexion of the knee puts the patella in an area of the femoral sulcus (groove), which allows it to more easily slide out, again, usually, laterally.

Dislocation occurs when the patella pops out of the groove. Subluxation occurs when the patella slides out of the groove a little ways. Also, the patella, because of the shape of the groove, usually falls back into place, unless there is significant damage to either the patella or other parts of the knee. Evidence of patellar dislocation is found when the appropriate mechanism of injury occurs, resulting in pain, sweling, hemarthrosis (blood in the knee joint), and obvious deformity. Usually treatment involves getting the patella back into its groove, providing support, correcting any fractures or other deformities, and strengthening the quadriceps.

[sunbird]

Hehe, seconds before performing ying shou gun i hit my knee quite hard with the staff. Ever since I hear a snapping sound just before i go down to a 90 degrees bent knee like in ma bu stance. Its like something in the knee is being strained and just before i should settle it snaps, brakes into two pieces or something with a snapping sound. Iave had this for half a year now, it doesnt hurt, not even when its snapping but im hella freaked out by it. It doesnt hurt so it shouldnt be much of a problem, i just have to live with it right?
The snapping thingy can be felt with hand on the left side right above kneecap on left leg.

[doc]

There is a possibility that you subluxed the patella when you hit it with the gun. Subluxation occurs when there is a small displacement from the patella out of its groove; it might very easily have relocated itself in the proper position, but, during this movement, caused some damage to either the patella or the femoral condyles, so that with flexion of the knee, the patella slides slightly out of the groove, causing this sensation of "snapping". The sensation of "snapping" that occurs around a joint is usually due to a tendon that is traveling somewhere that it normally doesn't go, such as getting stuck on a piece of the bony joint for instance.

Best thing to do is get some radiological exams to see if you suffered some sort of fracture of the femoral sulcus area. An orthopedist could best explain, by feeling the patella as it travels in its sulcus, why you get that sensation. Treatment for these types of things, once a fracture has healed if one exists, is physical therapy aimed at strengthening the quadriceps muscles. A strengthened quadriceps would keep more tension on the patella as it traveled over the femoral sulcus, thus preventing it from wandering too far and causing these sensations that you describe.

And yes, you have to live with it. But, it might go away in time. Oh, and low mabu, especially with weights on your body, is not good for this. Take it easy.

[sunbird]

re

Thanks for your reply, tons of information as usually, what would we do without you?

About Ma Bu. I can see why its not good to sit in 90 degrees ma bu when or not used to it, like me i can only do it for 2 minutes. But when your stronger and can sit like 20 minutes then one ought to be strong enough for it not to be unhealthy, right? Aw, my english sux as usual, please bear with me.

[daodejing]

No problem sunbird, your english is still infinitely better than my mandarin.

Well, while we've got an open form on knee injuries, my left knee frequently makes crackling noises when I'm coming out of a very low stretch where I'm putting alot of weight on that particular leg. Is this serious or just a joint that's still healing from my judo days? There's no pain involved, simply a brief crackling noise when i recover from a very low stretch such as a straddling split or any of the particularly low taiji stances where the left leg is bent and the right is straight (my other knee doesnt seem to make those noises). Anything to worry about doc?

[doc]

Well, I wouldn't worry about it. There are a lot worse things you could have.

As you have no pain, it probably signifies something that is chronic. The things that cause joints to make crackling noise, usually consist of some sort of joint arthritis, or overlying tendon irritation, from "catching" onto either bony spurs or other tissue. Also in the knee, old meniscus injurie that have not healed well (they usually don't heal all that well, and do take a lot of time) can cause what you're describing. Patellar injuries, where by the cartilaginous aspect of the patella (the part that rides in the femoral sulcus), is also prone to damage; partial destruction of this usually smooth surface can also give you that sensation.

Sounds like a chronic thing, something that shouldn't be fretted over. But, it is something that you should remain aware of. You certainly don't want to reinjure the area and make it worses. And, even though people will proudly make statements of being able to stay in mabu for three hours, such things are not necessarily good for your knee joints. Got to be careful when you deeply flex the lower leg and "get down"; that position puts a lot of stress on the knee joint, a position that we humans were not necessarily designed to put a lot of weight on.

[shaolinstylee]

dislocating the patella is tough, but can be done if there is a lot of trauma to the knee area, or if the circumstances are right.

Mine was acompanied by a partially torn lig (PCL?) and a strained acl and mcl....
I've seen a patella dislocate from a kick, never seen someone go for it with the hands though. The kick was perfect as far as if it was for actually dislocating something (which it wasn't... effective all the same). Round kick, the ball of the foot hit the guys patella... it just "slid right out."

[sunbird]

Originally posted by shaolinstylee
Round kick, the ball of the foot hit the guys patella... it just "slid right out."

Oh holy ****, thats just what we dont want to hear *feels sick*

[shaolinstylee]

I've had my patella dislocate... I was working out, my leg just move a little funny, then all of a sudden I was sitting on the floor. My knee was throbbing, I grabbed at it and found my patella to be on the wrong side, so I grabbed it and slid it back around, it went right back under the ligament. It hurt much more than the time before I injured a knee that bad.