Skip to content

Suffering from Knee Pain?

- By Dr. Rob

Treating Knee Problems

IMG_5918 (2)Knee problems are something that we see in the office every day. They have numerous different causes and treatments so we first have to figure out what the cause of your pain is. This is done in a number of different ways. We use general orthopedic tests to gauge the overall stability of your knee. We will generally find these positive when there is a specific trauma that preceded the onset of your pain. In most cases though, this is not how people’s knee pain has set in. With the majority of the patients, the knee pain has been going on for a while and has been getting progressively worse. They have tried many things on their own to no avail, and that is when they come in the office. In these cases the problem is generally a joint function problem, and we then look to find where the dysfunction is.

A lot of knee problems stem from foot and hip issues. A decrease in flexibility in either of these areas will make the knee over work and move in directions it was not designed to move. When this occurs you will have extra wear and tear on the knee joint. With extra wear and tear it is only a matter of time before pain starts. Each of these joints should be checked separately but you can get a good idea by looking at a couple of functional tests:

Lunge Test

A lunge test can give you a lot of information about how the lower body is working. You can determine hip flexibility and strength very easily. A big thing you will see people with knee pain do while lunging is the toe landing and push off. When you step forward into a lunge to want to see the heel of the foot land first and the heel initiate the push off the ground. Many people will land on their toes and push back off with the toes. This is making your body use the muscles in the front of the leg (the quads) more to do this motion which will put excess stress on the knee cap and patellar tendon. When we are using the heels we are using the much stronger muscles of the hips and glutes to perform this and they are much better at this task.

Overhead Deep Squat Test

0703_ohead_squat-resized-6001The overhead deep squat test gives you a tremendous amount of information about what a person’s body can and cannot do. In order to do this perfectly you need a lot of different muscles and joints doing their job perfectly or you will see a lot of different compensation patterns. Big things that we will see for people specifically with knee issues would be the knees bending in as you sit into the squat, the knees going past the feet during the squat or the heels not staying down throughout the squat. If the knees are bending in then the hips are not as stable as we need them to be. If the knees go forward or they come up on their toes they are either not rotating in the hips or they cannot flex in the feet, we would need to look at these joints independently to determine why they are doing this. Throughout the squat you should be driving down through your heels and never going on to the toes to push back up.

For those who have cartilage damage or arthritis in the knees a high quality glucosamine and chondroitin would be helpful. These aid in the rebuilding of cartilage. The important thing here is quality though. Many of the glucosamine and chondroitin products you will find are glucosamine and chondroitin hydrochloride. These are cheaply made products that will give you minimal results. What you want is glucosamine and chondroitin sulfate. The sulfate group is what attracts water and that is primarily what cartilage is comprised of.

Different Treatment Options We Offer

In the office we have several different ways of treating your knee pain depending on what your specific needs are. After a thorough evaluation we can determine the best course of action to remedy the situation. There are several different options and we will briefly go over them now:

Cold Laser: This is an exceptional tool for joint and soft tissue injuries. It works at the cellular level to get nutrients in and waste out of the cell. It also stimulates the cell to start regenerating and heal itself.

Recovery Boots: These are very effective when the primary problem is muscle tightness in the lower extremity. They are essentially a deep tissue compressive massage to the legs while in a zero gravity chair. This allows all of the waste products that have accumulated in the muscle to be pushed back in to the blood stream so that they can be eliminated from the body. Small injuries over time will result in more waste products and adhesion formation in the muscles.

Image12ART/Graston: These are soft tissue techniques to break down adhesion or scar tissue formation in the muscle. With injury to a muscle we heal with scar tissue. If there is a large enough amount of scar tissue they are referred to as adhesions. When we have adhesions in the muscles, the muscle fibers are not as flexible. This will make the muscles pull improperly on the joints they connect to, which leads to joint dysfunction, and eventually wear and tear damage.

Exercise: For many people they simply squat or lunge incorrectly and that is the major cause of their problem. We spend a lot of time working with patients to change their motor patterns to something that is more biomechanically efficient. All this means is getting you to use your body the way it is supposed to be used. Even for those who do not exercise, or say that they don’t do squats or lunges, you do these motions every day whether you are aware of it or not. Repetitive stress injuries are what we see in the office all the time. We don’t think of it because they are just a few here and there but that adds up over a life time.

Joints will do what you ask them to do for as long as they can, but when you start feeling pain that is your body telling you that you are doing something wrong, so don’t just try and ignore it or take an aspirin to cover it up. Do something about it now so that you are not in a position to have to get a knee replacement later.

– Dr. Rob