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Smarter Ways To Save Your Knees & Help Knee Pain

2024-08-27

Moderate Training, Strenuous Training, Extreme Training, Uncategorized, Foundational Programs

pain

LAST 2 Days To Save On Our Chronic Pain Masterclass starting Tuesday April 15th HERE (yes, recordings are available to all those that sign-up)

Jessica Bento, Physical Therapist (Creator DVRT Restoration Certification, DVRT Rx Shoulder, Knees, Pelvic Control, & Gait Courses)

knee pain

This week we have discussed how to make shoulders and low backs better, but what about knee pain? Over 36% of people in the US experience leg pain with knee pain being one of the most common. Knee pain tends to get more prevalent the older we become and like so many things we have talked about, it isn’t due to ONE thing! That is a very different take on knee pain (as well as the rest of the body) because the slide I showed at my recent presentation really highlights where you can go right or wrong with how you address common issues like shoulder, low back, or knee pain.

The Body Is NOT A Machine!

I remember learning about all the “parts” of the body in physical therapy school as though we were assembling a body in a factory. We rarely talked about the interconnected nature of the body, but as I grew as a physical therapist, the more I started to realize the body is more of an ecosystem where an issue in one system or area of the body could transmit all throughout the body.

Unfortunately, most of the advice online keeps discussing issues like knee pain as though we are mindless inorganic machines. It would be MUCH easier to tell. you to work on a single muscle or to try to sell you on the idea that ONE exercise solves your issues. However, as a medical professional that would be incredibly dishonest to tell you when we know so much more!

For example, did you know that your low back has been linked to knee issues (1,2). Ankle mobility has a strong correlation to knee pain (3,4). The hamstrings are JUST as, if not more important, than strengthening the quadriceps for knee pain (5). Deep breathing exercises and social connection can also help experiences of knee pain (6). Chronic stress also can make knee pain worse which makes things even more complex no? (7)

It quickly becomes apparent telling you to do one thing can’t possibly address all the different factors that could be contributing to one’s knee pain. You might be thinking, “but my friend who did X’s program solved their knee pain.”

That is fair, but we have to consider a few things. For one, did they believe it was going to help their knee pain? Research has shown that up to 85% of relief from knee pain in various treatments can be attributed to placebo (8). Now, that isn’t a bad thing as if someone feels better they feel better. We should even try to cultivate placebo whenever possible. However, the issue becomes if someone does NOT believe the treatment will be effective or they start seeing a reduction in the effectiveness of the treatment, what do we do then?

The other thing we have to consider is that if a program in subtle ways you may not be aware of increase your ankle mobility, your core/pelvic stability, has more single leg work, in other words, works on qualities you may not have been prioritizing and now are, that could make the program more effective. Yet, I see many times people overlook these factors and want to give a singular “magical” answer to what created the solution.

Instead, we can take a comprehensive approach and address a wide variety of factors all within one program.

For example….

Your warm-up may involve exercises like 2-3 from our Myofascial Integrated Movement system especially drills like silk reeling below…

Adding 2-3 drills from our Restoration program to reinforce the stability of the pelvis/core and lower body is key.

Check to see if you have an ankle mobility issue…

Use exercise that connect the foot and the entire leg/pelvis together like the drills below…

Use better progressions to teach the lower body to stabilize while producing force like I show below…

References:

  1. Murata Y, Takahashi K, Yamagata M, Hanaoka E, Moriya H. The knee-spine syndrome. Association between lumbar lordosis and extension of the knee. J Bone Joint Surg Br. 2003 Jan;85(1):95-9. doi: 10.1302/0301-620x.85b1.13389. PMID: 12585585.
  2. Suri P, Morgenroth DC, Kwoh CK, Bean JF, Kalichman L, Hunter DJ. Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken). 2010 Dec;62(12):1715-23. doi: 10.1002/acr.20324. PMID: 20799265; PMCID: PMC2995827.
  3. Coelho, B. A. L., Rodrigues, H. L. d. N., Almeida, G. P. L., & João, S. M. A. (2021). Immediate Effect of Ankle Mobilization on Range of Motion, Dynamic Knee Valgus, and Knee Pain in Women With Patellofemoral Pain and Ankle Dorsiflexion Restriction: A Randomized Controlled Trial With 48-Hour Follow-Up. Journal of Sport Rehabilitation, 30(5), 697-706. Retrieved Aug 27, 2024, from https://doi.org/10.1123/jsr.2020-0183
  4. Tan JM, Crossley KM, Munteanu SE, Collins NJ, Hart HF, Donnar JW, Cleary G, O’Sullivan IC, Maclachlan LR, Derham CL, Menz HB. Associations of foot and ankle characteristics with knee symptoms and function in individuals with patellofemoral osteoarthritis. J Foot Ankle Res. 2020 Sep 23;13(1):57. doi: 10.1186/s13047-020-00426-8. PMID: 32967701; PMCID: PMC7509922.
  5. Al-Johani AH, Kachanathu SJ, Ramadan Hafez A, Al-Ahaideb A, Algarni AD, Meshari Alroumi A, Alanezi AM. Comparative study of hamstring and quadriceps strengthening treatments in the management of knee osteoarthritis. J Phys Ther Sci. 2014 Jun;26(6):817-20. doi: 10.1589/jpts.26.817. Epub 2014 Jun 30. PMID: 25013274; PMCID: PMC4085199.
  6. Larsen KL, Brilla LR, McLaughlin WL, Li Y. Effect of Deep Slow Breathing on Pain-Related Variables in Osteoarthritis. Pain Res Manag. 2019 Jun 3;2019:5487050. doi: 10.1155/2019/5487050. PMID: 31281558; PMCID: PMC6589254.
  7. Nah S, Park SS, Choi S, Jang HD, Moon JE, Han S. Association between Chronic Knee Pain and Psychological Stress in Those over 50 Years of Age: A Nationwide Cross-Sectional Study Based on the Sixth Korea National Health and Nutrition Examination Survey (KNHANES 2013-2015). Int J Environ Res Public Health. 2021 Sep 16;18(18):9771. doi: 10.3390/ijerph18189771. PMID: 34574694; PMCID: PMC8467605.
  8. Fazeli MS, McIntyre L, Huang Y, Chevalier X. Intra-articular placebo effect in the treatment of knee osteoarthritis: a survey of the current clinical evidence. Ther Adv Musculoskelet Dis. 2022 Jan 31;14:1759720X211066689. doi: 10.1177/1759720X211066689. PMID: 35126683; PMCID: PMC8808023.

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