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knee pain treatment

Knee Pain

Those suffering from knee pain
Pain with running, walking inclines, doing stairs, squatting, getting on or off the floor, or pain at night?  Here are some simple things to consider when it comes to managing your knee pain and get back to doing what you love. 

In addition to these suggestions, a good Postrual Restoraition specialized physical therapist is a must if your pain is not changing.  The longer you wait, the longer it is to recover. A good Postural Restoration physical therapist will be able to evaluate all issues.

Postural Restoration will also help find the root to the problem and will not just focus on the knee.  Often knee pain can be the result of mobility issues in the joint above or below the actual knee. A good Postural Restorative physical therapist will be able to educate you on how to breathe, restore range of motion, improve proprioception, balance, stability and strengthen through a customized program to improve your individual mechanics.

knee pain

Trendy footware 9/10 times does more damage than good:

Shoe trend tend to not be great shoes for our body when we are working out on a flat hard gym floor.  Most of us did not grow up running barefoot on sand, dirt roads or grass. If we did, we would all most likely have perfectly straight teeth, little to no pain and be able to deep squat, get on and off the floor and sleep without disruption.

Most of our parents put us in shoes from the time we could walk, making us much less adaptive to hard surfaces.  A good shoe helps right the body in a good mechanical position against gravity.  It allows the body’s posture to access better range of motion and mobility when walking, running, jumping, or lifting on hard or stabile surface.  A good shoe helps with joint pain, alignment issues, balance, proprioception, and performance.  I am all for being barefoot and “feeling or sensing” the groun but it is much better to do this while walking on thick long grass or sand at the beach to achieve the “wibble and wobble” when need when we are barefoot.

Flip-flops, sandals, and heels do not give the body the support or the input to the brain that it needs to help you maintain a safe and functional posture. These shoes are okay for special occasions or short durations, but good shoes should be a staple in your closet. See the link below for an annually updated shoe list from the Postural Restoration Institute.  I perform individualized shoe fit analysis to evaluate and find the perfect shoe for your individual body. I would highly recommend this as an option.

Low Impact Activities in the Beginning:

My clients often feel that more is always better.  I make it a point to educate them that this is not the case.  Low impact activities like breathing, repositioning, meditation, cross-country skiing, yoga, Tai Chi, rock climbing, and Pilates are all good ways to keep knees strong and healthy but continue to challenge yourself when you are in the healing process.

These exercises burn calories and increase cardio muscle strength without overloading the knee joints. Biking is a particularly great low impact activity for early knee rehab. It moves your knee through a fairly large range of motion, with resistance and will build strength without loading the joint.

Knee go beyond your toes:

Once you have passed the more restorative phase and you are into more dynamic and heavier activities, please remember that knees are meant to BEND while weightbearing.  The old adage of “knees do not go past toes” is old school thought. Your knees can bend up to 145 degrees. They are meant to bend people.  Work on squatting and lunges making sure that the knees go far over the toes.  You only want them to go as far as they can while putting pressure through your heels. Once the weight transfers to the toes, you have lost control of good and safe movement of the bending knee.  You will know you have lost good control as it is likely the knee will hurt.

Weight management:

Weight management can be a tricky topic.  Weight can be an ugly word and not a topic that I make a practice of focusing on.  If weight is a serious and potential contributor to knee pain, it can be addressed in a positive and impactful way. When walking, the load at your knee can be up to 3 x body weight each time you put your foot on the floor. By running the loads at the knee joint can be up to 12 x your body weight. In other words, losing even 1 lb. in weight will result in 3 lbs. less load at your knee joints each time you take a step when walking and 12 lbs. less load if you are running.  Often with a good, individualized program by a PRI athletic trainer or physical therapist, weight can begin to change without much intentional thought.

From squat to standing:

There is a lot of gym-myth about how to squat, but really the function of a knee during squatting or getting in/out of a chair/floor/ or toilet is very simple. Your knees are made to BEND.  As I said before, the old wise tail of “your knees should never go past your toes” is ancient history.  Normal knee range of motion is around 130-145 degrees of bend.  Why have we been taught for years to only strengthen them to 90 degrees?

Try keeping your feet hip-width apart. Keep your knees pointing forward in the same direction as your toes. Load weight through your heels as you rise, letting your knees bend forward to stand up.  In this position, your shins and trunk should be parallel (looking from the side) – this will help share the load between your hips, knees, and ankles, protecting the knee long term. These are just a few tips. Come see me and we can talk about many other fun strategies to address knee pain.

Feel free to reach out to me for a consultation appointment so we can begin your path to improved health.
- Paige McNerthney MPT, PRC, PCES, CSCS, CKTP