Knee Pain

Knee Pain? Top 3 Causes and What You Can Do.

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Knee pain impacts one-third of all Americans, and annoyingly interferes with activities of daily life. Such activities could be as simple as walking, squatting, going up and down stairs, and getting in and out of the car. This is in addition to the multitude of recreational activities knee pain can impact.

It’s the second most common complaint behind back pain when it comes to musculoskeletal problems. It’s one of the most common complaints I still hear about that started or worsened during the pandemic.

But what if there was a way to address some of the most common causes of knee pain on your own – without procedures or surgery?

Here are three of the most common causes of knee pain I see and what you can do to resolve it – naturally:

1. Patellofemoral Knee syndrome

Also known as “runner’s knee”, patellofemoral knee syndrome (PFS) is characterized by pain in the front of your knee. Usually this is just below or behind your knee cap. With PFS, the source of the pain typically comes from unwanted pressure around your knee cap. This will eventually results in inflammation and pain.

It’s very tempting to just get a cortisone shot or take pain pills to quickly reduce the inflammation and relieve your pain. But the problem with this approach is that you’re only putting a bandaid on symptoms. Inflammation is the result of an angry kneecap – not the cause. What you need to figure out is what is causing your knee cap to get angry in the first place.

Typically, PFS is the result of an imbalance somewhere in your body, typically from poor form and movement habits. Over time, this ultimately causes more pressure at your knee cap. If your hips, quads (front of the thigh), and hamstrings (back of the thigh) aren’t balanced and working together, for example, you could end up with problems with the way your knee cap tracks and functions. This will make your knee cap angry and inflamed over time.

When you figure out the true culprit behind the pressure and inflammation at your knee cap, you’ll not only be able to resolve and manage PFS naturally and for the long-term, but you can avoid temporary band-aid treatments.

2. Iliotibial band syndrome

The causes of iliotibial band syndrome are very similar to that of PFS. Except that your pain and symptoms will be experienced on the side of your knee instead of the front. Your iliotibial band (ITB) is a large band of tissue that runs along the side of your thigh to the bottom of your knee. Your ITB is formed from a muscle in your hip called the tensor fascia latae (TFL). When your TFL gets overworked, your ITB suffers. It will result in what often feels like stabbing pain at the side of your knee.

The most common treatment I see for this is foam rolling and massage. While these are great modalities to relieve your symptoms, they don’t address the root problem. You must figure out why your TFL is being stressed and overworked if you really want to get rid of your pain. Typically, it’s due to weak glute muscles, the deep ones designed to stabilize your pelvis. Your TFL is neighbor to your glutes. So when they decide to be lazy, your TFL loves to help out, and eventually overdoes it. When you can get these two groups of muscles working properly together, you’ll put an end to ITB syndrome.

3. Osteoarthritis

This is a very hot topic and everyone wants to know if they have it. (Spoiler alert – if you’re over the age of 50 – you already do.) Osteoarthritis happens naturally over time and is a normal part of aging. The problem with arthritis is that it only gets paid attention to when you’ve got pain. Then it gets blamed for all your problems. Arthritis certainly plays a role in your mobility and quality of movement. But it’s not the “death sentence” that many make it out to be. Many people find out they have osteoarthritis in their knees and think they have to just “live with it” or get a total knee replacement.

Remember, arthritis is normal and it happens to everyone as they age. What is not normal is for you to think you’re helpless or have to avoid your favorite activities because of it.

Arthritis occurs when the protective cartilage that cushions the ends of your bones wears down over time. There isn’t anything you can do to reverse this process. But, there is plenty you can do to minimize the symptoms you get because of this condition. It all comes down to balanced joints and movement. The more mobility you have, and the more stability you have around your knees, the less symptomatic your arthritis will be.

Some key areas to focus on when you’ve got arthritis in your knees is good core and hip strength. As well as good flexibility in your hips and ankles. If anything is off in these areas, your knees will want to compensate. This could result in compression at your knee joint and aggravation of your arthritic symptoms.

There is no need to rely on pain pills, or believe that procedures and surgery are your only options when it comes to knee pain.

As you can see, three of the most common causes of knee pain are due to – or influenced – by movement problems. Therefore, movement should be your go-to solution – not something you avoid.

If you’re having difficulty using movement as your solution and you want to contact a movement expert who understands mechanical knee pain and can diagnose the root cause of your knee problem – consider speaking to one of my specialists!

In your free Discovery Session we will ask you all about what’s been going on & see if we would be a good fit to help you. Book your free discovery session HERE.

tendinitis and tendinosis

Why Cortisone Shots Often Fail in the Knee

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When you’ve got nagging, persistent knee pain, it’s common for doctors to recommend a cortisone shot in the knee.

A cortisone shot in the knee, also known as corticosteroid injections, or “steroid shots”, works by reducing inflammation in your knee joint in an effort to alleviate pain. Sounds pretty straightforward, right?  Well… not so fast.

Assuming your knee pain is truly due to inflammation, then yes, a cortisone shot can be a successful treatment option. For example, it’s often used as a pain management strategy when you’re awaiting a major joint replacement surgery.

Advanced osteoarthritis is a common cause of knee inflammation.  The only real “cure” for this is joint replacement. Periodic cortisone shots may help give you the pain relief you need to pass the time until surgery. But this is a very specific and not common circumstance.

What we see more often than not is cortisone shots either working temporarily, or not working at all in your knee joint.

Patients are often told they need up to three cortisone shots to see results. There’s a problem with this approach. Every time you get a cortisone shot, you risk damaging the cartilage and tissue in your knee joint. This not only leads to irreversible joint damage, but more persistent pain in your joint that gets harder and harder to fix.

So when it comes to whether or not you should get a cortisone shot in your knee – you really want to make sure that the root source of your problem is inflammation.

The reason why so many cortisone injections “fail” is because quite often – they weren’t needed in the first place. Even though the knee pain you are experiencing might be due to inflammation, the underlying cause leading to that inflammation could be something else entirely. Eight percent of the time the knee pain you’re experiencing is due to a mechanical or movement problem.

So while the symptoms you’re experiencing could be inflammatory in nature, the root cause of your issue is not. A cortisone shot is not going to help your knee in this case. Or worse, you’ll get temporary relief that fools you into thinking it worked. This only delays treatment that will give you the long-lasting relief you’re looking for.

So how do you know if you have a true inflammatory problem in your knee?

Let me explain.

Let’s say you have some arthritis and general wear and tear in your knee joint. You have good days and bad days. The pain comes and goes. Certain movements and exercises make your knee feel better while others seem to really aggravate it.

This is a pretty classic presentation of a mechanical knee problem. The mechanical issue (aka movement problem) in your knee can irritate certain structures within your knee joint (like a meniscus or ligament) and cause it to be inflamed.

If you go ahead and just inject cortisone into this knee, it might relieve the inflammation for a short time. It won’t help the underlying movement problem. It’s only a matter of time before the cortisone wears off and the structures in your knee feel irritated again. Not only have you masked the problem, but now you risk creating actual damage to those structures from the cortisone. Studies have shown that repeatedly injecting cortisone into your knee (or any joint) can advance the formation of osteoarthritis.

Another interesting statistic is that 41% of knee pain has been shown to be coming from your spine – even when there is no back pain present.

In this case, your knee could really hurt and appear to be inflamed. If a doctor can’t find any real explanation for this from an X-ray or an MRI (because the real problem is coming from your spine), he or she may assume it’s just inflammation from wear and tear and suggest a cortisone shot. This is not going to help your knee. Once again you risk causing real damage to an otherwise healthy knee joint.

These are just a few examples of where cortisone shots are unnecessary and can go wrong when incorrectly prescribed.

Have you recently had a cortisone shot in your knee and it didn’t work? It could  be that you never actually needed it. Or that the symptoms (inflammation) was being addressed instead of the underlying cause.

If you are considering a cortisone shot in your knee, it’s always a good idea to get a second opinion to make certain you really need it. A mechanical pain expert can tell you whether or not your knee pain is truly due to inflammation. If your knee pain is due to a movement problem (80% of time it is) then a proper movement prescription is your answer.

Are you local to Portsmouth, NH and looking for help with your knee pain NOW?

Consider speaking to one of my specialists.

Tell them about your knee pain and they’ll see if we would be a good fit to help you!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at [email protected].

Want to lose weight in the New Year? Don’t let knee or back pain get in your way.

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If you google “Top 3 New Year’s Resolutions” – you’re sure to find “losing weight” as one of them. While I’m not a dietician or nutritionist, I know that the majority of weight loss has to do with what you eat. However, exercise plays a role too, and that I am an expert in. 

Exercise stimulates endorphins and makes you feel better all around. The better you feel, the easier it will be to stay motivated about your weight loss goal.

Exercise also helps you burn more calories – which certainly isn’t going to hurt your weight loss journey.

But if you’ve got unchecked knee or back pain, not only will you find it challenging to exercise, you are going to be more stressed about it. Stress increases cortisol which interferes with your ability to manage weight. And if you can’t exercise at all because of pain, that will make it even harder to manage stress, never mind your weight. You can see how this vicious cycle from unwanted knee and back pain could completely derail your New Year’s goals.

Here are four tips to help you not let knee or back pain get in the way of your weight loss in the New Year:

1. Mobility Before Stability

Your muscles can’t function at their best if you don’t have optimal joint mobility. In other words, you don’t want to strengthen around a joint that isn’t moving at its best, or you’ll encourage compensation. If your nagging back or knee pain is due to inadequate mobility, you’ll run into problems. You will be in more pain if you suddenly increase your exercise or activity level. We saw this happen at the beginning of the pandemic. People started walking and exercising more and we saw a huge influx of unexpected back and knee pain as a result. Their joints weren’t accustomed to moving so much and it highlighted the lack of mobility and compensations. Don’t let the same thing happen to you. Make sure all of your joints, including your spine, can move fully and freely without any pain before you begin a new exercise program.

2. Pace Yourself

It’s very tempting to go “all in” on your new exercise or weight loss goal… but remember… the tortoise (not the hare) won the race. It’s important to not beat yourself up if you’re not seeing immediate results. If you’ve been out of shape for a while and doing something completely new, expect to be sore. But if you’re limping around for days or experiencing sharp pain in your back or knee, there is a chance you overdid it or worse case injured yourself.

My general rule of thumb is to monitor your soreness on a scale of 1 – 10. I tell my clients to not let their pain go above a five when they are pushing themselves or returning to an exercise they haven’t tried in a while. If you find that your pain level goes above a 5, or persists at that level (or higher) for more than a day, there’s a chance you’re overdoing it and setting yourself up for an unwanted injury. When in doubt, listen to your body. And if you’re not sure what it’s saying – enlist the help of an expert.

3. Stay Hydrated

Most people don’t drink enough water during their regular day, never mind when they increase their activity level. Drinking lots of water has two great benefits: It will give you the extra hydration you need if you’re planning to be more active; and it will help you lose weight by curbing your appetite. Some additional benefits of staying hydrated include increased muscle strength and stamina, more lubrication in your joints, more supple skin, better cardiovascular function, and improved energy and mental alertness. One really easy tip to jumpstart your day is to begin with 10 oz of water first thing upon waking. And a good rule of thumb when you’re trying to stay adequately hydrated is to drink at least half your body weight (in ounces) of water every day.  

4. Get Assessed by a Mechanical Pain Expert

If you’ve got nagging back and knee pain, see a mechanical pain expert before you begin your new exercise routine. Your first thought might be to go see your medical doctor. However, it’s important to understand how different medical professionals assess different problems. Medical doctors are trained to screen your whole body and typically rely on imaging to make their diagnosis. This is a great approach if you’ve had an accident or trauma. Or if you are presenting with what could be a serious pathology. But for 80% of musculoskeletal pain – including knee and back pain – X-rays and MRI’s are overkill.  They put you at risk of being led down a path of unnecessary referrals, treatments, and procedures. They will definitely put you at risk of being told not to exercise at all.

A mechanical pain expert, on the other hand, is trained to assess your pain with movement tests – not imaging. This is going to reveal a much more realistic picture of what you can and can’t do. It will also reveal what movements will make you better or worse. This allows you to go into a new exercise routine with a more informed approach. Also, with a plan to exercise around your pain and make it better.

Is exercising and losing weight is part of your New Year plan? If so, I hope these tips help you go into 2023 with confidence. If you’ve got lingering or unwanted knee or back pain that’s not going away on its own – get it checked.

 

Are you local to Portsmouth, NH? – CLICK HERE to speak with one of my specialists. We will ask you about what’s been going on – and see if we would be a good fit to help!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

knees

Spooky creaks and cracks coming from your knees?

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Does the cracking in your knees “spook” you out?

Yes – it’s Halloween – and we’re having some fun over here… But in all seriousness – when it comes to cracking in your knees (or any joint for that matter) – people get nervous.

First of all, cracking in your knees (as well as your other joints) is quite common – and most of the time there’s a reasonable explanation for it.

Crepitus is the term used to describe any grinding, creaking, cracking, grating, crunching , or popping that occurs when you move a joint like your knee. You can experience this at any age – but it’s certainly more common as you get older.

So what causes crepitus – and should it be a concern…

The most common causes of crepitus include air bubbles popping inside your joint, tendons or ligaments snapping over your joint’s bony structures, or the degeneration of your joint’s cartilage that generally occurs with arthritis. You may experience uncomfortable sensations, or even a tiny bit of pain when this happens, but in most cases, none of this should scare or concern you.

It’s all a normal part of aging and wear and tear.

But if the cracking in your joints starts to become more regular – is accompanied by joint swelling and more constant pain – or if the cracking turns to “clunking” and your knee starts to feel unstable… then you’re smart to be concerned and it’s possible something more serious could be going on.

If you suspect something like this could be happening – get your knees checked out by an expert.

But assuming you haven’t let your knees get to the “concerned stage” yet… and the most annoying thing to you right now is the cracking, grinding, or crunching…

There are things you can do to prevent it from getting worse.

The first thing I always recommend is to keep moving.

Motion is lotion.

And regular movement throughout the day helps keep your joints lubricated. It’s like applying WD-40 to a creaky door hinge – when your joints creak – move them to lubricate them.

The second important thing to consider if you want to reduce crepitus and prevent it from becoming something more serious is your biomechanics.

Biomechanics refers to how well your muscles and joints function together.

If you’ve got imbalances – it will impact the way your joints move and function – causing more creaking and cracking.

For example, let’s say your hips are on the weak side. How your knees tolerate various activities depends a lot on how strong your hips are. I’ve experienced this first hand… I love to hike. And if my hips aren’t doing their part, I feel the entire hike in my knees, especially on the way down.

And you know what else happens?

My knees crack a lot more on the days after I hike.

The imbalances in my body cause more stress on my knees and the result is they crack a lot more. Now, as I mentioned previously, this isn’t a big concern for me… yet. My knees don’t hurt – they are just very noisy. But in the interest in prevention – I make a conscious effort to regularly stretch my quads, and strengthen my hips and core – so that I can keep this problem at bay and not let it get worse.

My FAVORITE way to do this is with Pilates.

Specifically… on the Pilates Reformer!

When you use the Pilates Reformer – it allows you to both strengthen and lengthen at the same time – as well as focus on your coordination. These three things – when combined together – help to significantly optimize your biomechanics.

If you’ve never used the Pilates Reformer and want to give it a try – check out our Pilates program HERE.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth. To get a FREE copy of her guide to knee pain – CLICK HERE

Failed Knee Surgery

Knee Surgery Gone Wrong? It’s More Common Than You Think.

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Arthroscopic knee surgery is one of the most common surgeries performed. Despite research telling us that it’s not nearly as effective as most people are led to believe.

Science tells us that people who do undergo arthroscopic knee surgery are likely to have knee arthritis that advances rapidly. This results in a total knee replacement that you could avoid.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint. It’s done if  you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

Well… it is until it isn’t.

The big problem is that arthroscopic knee surgery is not necessary for most cases of knee pain.

If there is a complication – which there are many even with “minimally invasive” procedures – you could end up being worse off than when you went in.

Plus – if you never even needed the surgery to begin with – you just put your knee through unnecessary trauma that you’ve got to now heal from. This further delays you from addressing the root cause of your knee pain.

The truth is that most people can get full relief of their knee pain as well as full restoration of knee function without any type of surgery or procedure. This is true for 70% of all knee pain cases.

An early research study from 2002 by JB Moseley and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery.

Since then, numerous studies have proven similar results. This means that even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment.

So why then – despite all this research – are surgeons still performing arthroscopic knee surgery more than ever?

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management of knee pain. If you’ve gotten physical therapy and it wasn’t effective, people believe that the physical therapy “didn’t work”.

But more often than not, you just haven’t found the right physical therapist yet – someone who understands how to diagnose knee pain properly and get you the customized approach that is required to avoid surgery.

And then there’s the elephant in the room…

It’s very common for knee pain to be coming from somewhere other than your knee. Knee pain can come from your ankle, hip, or back. One study showed that 40% of the time – knee pain is caused by your back – even when you don’t have any back pain.

MRI’s add even more confusion to this. It’s entirely possible to have degenerative changes, a torn meniscus, or advanced arthritis in your knee – and still have your knee pain stemming from a source other than your knee.

Over the course of my 20 year career, I’ve seen many knee surgeries go wrong.

Most of the time, it has nothing to do with the procedure itself. It has everything to do with an incorrect diagnosis going in. Say your knee pain can be resolved conservatively. Then you put it through unnecessary trauma (surgery). There’s a good chance you’re going to have more problems afterwards. You get knee surgery when your knee problem isn’t even coming from your knee. Then you’re definitely going to have problems afterwards.

The moral of this story is to make absolutely certain that:

1) Your knee problem is really a knee problem and

2) You’ve fully exhausted all (quality) conservative therapy options before going under the knife.

Remember that 70% of all knee pain cases do not need surgery.

Science has proven this. Don’t resort to knee surgery unless you’re 100% sure you really need it. Because it can go wrong and when it does – it’s much harder to come back from then if you had avoided it to begin with.

Want help with your pain now? CLICK HERE to talk to one of my specialists for free – you can tell them all about your knee pain and we’ll let you know if we can help. 🙂

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at [email protected].

Holding Knee with Arthritis

Three Tips to Protect Your Knees From Arthritis

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Knee arthritis is one of the most common forms of osteoarthritis.

Knee arthritis accounts for more than 80% of all osteoarthritis and impacts at least 19% of Americans over the age of 45.

For many, a diagnosis of knee osteoarthritis leads to chronic, debilitating knee pain that stops them from doing all of their favorite activities. Sometimes it’s simply due to the limiting belief that once you have arthritis – you’ve got “bad knees” for life.

Other times it’s because you’ve been told you have “bone on bone” in your knee and there’s nothing you can do – except to scale back on activity so that you don’t make it worse. This line of thinking is flawed and often leads people to unnecessary procedures and surgery. One of the best things you can do to protect your knees from the debilitating effects of arthritis is to keep moving.

Here are three tips to help you protect your knees from arthritis as you age – so that you can keep doing all of your favorite activities and avoid any major procedures or surgery:

1. Strengthen Your Hips and Core

Your knee joint is situated just below your hips and core. And research has shown that when you have poor control of your upper leg muscles – you get more stress through your knee joint.

The strength of your upper leg muscles is very much dependent on your hip and core strength. Your thigh bone – or femur – connects your knee and your pelvis – and your core strength controls your pelvis.

If your pelvis isn’t stable – your femur is going to have a difficult time staying in alignment – which will ultimately have an impact on your knee joint. If you’ve got arthritis in your knees, it’s critical you minimize any added stress to your knee joints.

Strengthening your core and having good hip strength is going to help prevent and minimize the symptoms of arthritis and keep you doing activities you love longer.

2. Keep Your Knees Mobile

Mobility before stability is my mantra.

And I say this for just about every joint in your body. But it’s especially true for your knees. There are joints whose primary function is stability – and there are those whose major function is mobility.

Your knee needs to be mobile.

Its major purpose is to bend all the way so you can squat and pick things up – and it needs to straighten all the way to give you stability when you need it. When either of these motions are lacking – your ligaments and surrounding muscles will suffer.

A lot of folks just “accept” that their knees are stiff – especially if you’ve been told you have arthritis in your knees. The limiting belief is that stiffness is par for the course. But the truth is that if you keep your knees mobile as you age – you can not only maintain the mobility you have but improve what is lacking.

If your knees are stiff – start moving them. The thing to understand about arthritis is that it’s a normal part of aging. Debilitating mobility is not. Even a 10% improvement in your knee mobility – which can happen even if you’ve got arthritis – will result in huge improvements in your knee function.

It can be the difference between a natural solution to knee pain vs undergoing a major surgery like knee replacement.

3. Don’t Stop Your Activities

When people find out they have arthritis – and especially if they’re in pain – they often think that slowing down or stopping activity will help protect their knees.

This couldn’t be farther from the truth.

Study after study – including one from the Center for Disease Control – shows that severe joint pain among adults with arthritis is worse with inactivity. When you remain active, you keep blood flowing, your knee joints mobile, and your muscles strong. These are very important factors in managing your arthritis. Sometimes, the knee pain you feel when you’re doing certain activities has nothing to do with your arthritis. Statistics show that only 15% of patients with evidence of knee osteoarthritis on X-ray even had symptoms.

That means that the other 85% is walking, biking, and running around enjoying their most favorite activities – despite the fact their X-ray showed arthritis too. The point here is to keep doing your activities – whether you’ve got arthritis already or not – it’s one of the best ways to prevent and protect your knee joints as you age.

So – to review…

If you want to optimize your knee health as you age – which you still can even if you’ve been told you have “advanced arthritis” – prioritize your core strength, the mobility of your knees, and stay active.

Focusing on these three things can have a significant impact on how arthritis affects you – and can help you avoid major (often unnecessary) surgery in your future.

Is knee pain keeping you from doing your favorite activities? Are you considering a major procedure or surgery but not sure if you need it?

Join us on Tuesday Oct. 25th from 6-7pm for our Free Masterclass for Knee Pain Sufferers.

Sign up using this link —> Knee Pain Masterclass.

We hope to see you there!

Can’t make it live? All participants will receive a complimentary replay of the class 🙂

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at [email protected].

Man getting knee pain treatment

Four Reasons Your Knee Pain isn’t Going Away

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Approximately 25% of adults suffer from chronic knee pain and for many, they don’t have a clear reason or diagnosis as to why. They’ve been told to accept that their knee pain is due to arthritis, age, or wear and tear. So why then, are some people able to get rid of their pain with proper knee pain treatment while others continue to suffer? It starts with the correct diagnosis. And for many chronic knee pain sufferers, this is the problem.

Here are four reasons why your knee pain might not be going away:

 

1. Mobility Before Stability

I’m a firm believer in this concept.

Our joints function better when they have full and free mobility. With knees in particular, everyone tends to focus on how well a knee is bending, but a lot of people miss when a knee isn’t fully straightening. Most knees have a certain amount of what we call hyperextension.

For example, your knee might look and feel straight, but if it’s naturally capable of “over-straightening”, and you don’t restore that completely, your knee will have problems.

I see it all the time, especially in folks who’ve had previous knee surgeries. If their full knee motion wasn’t restored properly during rehab, or perhaps they didn’t have any rehab at all (common practice now after most arthroscopic knee surgeries), knee pain will persist, and won’t go away no matter how much you strengthen it.

This isn’t something that can be seen on an Xray or MRI. Only a trained expert who knows how to look for this will be able to detect it, teach you how to restore it, and finally help you get rid of your chronic knee pain.

2. It’s Really a Back Problem

When the source of your pain is truly coming from your knee, it tends to be pretty specific and very localized to the knee joint itself. But if your pain tends to move around your knee, or perhaps travel up and down your leg, there’s a good chance your knee pain is coming from your back.

A recent study found that 40% of all extremity pain (including knees) comes from a source in your spine – even when you don’t have any back pain.

How does this happen? Typically it’s due to an irritated nerve that sends pain primarily to your knee and nowhere else. If you’ve been treating your knee for months and it’s either not going away or perhaps getting worse, consider that your knee problem is not a knee problem. Get your spine checked by a proper movement/mechanical therapist who can screen for this and figure it out.

3. Poor Core Strength

Your abdominals, low back muscles, hips, and glutes all make up what we call your “powerhouse” or core.

We all know that a strong core is important to help prevent back pain. But, it’s equally important for healthy knees. If your core is weak, or doesn’t activate properly, it will have an impact on how fluid your joints will move during activities.

If you aren’t stabilizing yourself well with a strong core, your knees might try to help out by adding stability. Knees aren’t really meant to do this – they are meant to be mobile. But when your body lacks stability, your joints stiffen up in response, which can cause knee pain over time or aggravate arthritis that’s already there.

If your knees chronically ache – especially during activities – this could be why. You can treat your knees all you want, but if you don’t also address the deficits in your core, your knees will continue to hurt.

4. Stiff Ankles

When your ankles are stiff it will have an impact on your knees.

Do one or both of your ankles lack mobility during certain activities? Especially running, hiking, and squatting?  Your knees may strain themselves trying to help out and compensate.

Over time, this pattern will lead to knee pain. Do you notice a lot of stiffness in the front of your ankles? Or pain/fatigue in the front of your lower legs after repetitive walking or running? This could be a sign that the real problem is coming from stiffness in your ankles.

Stop working on your knees and start mobilizing your ankles instead. Your knees should start to feel better in no time. Knee pain can be tricky to figure out – especially if it’s chronic. Arthritis, age, and wear and tear aren’t common reasons for chronic knee pain. But they are definitely reasons that mislead people into thinking they’ve just got “bad knees”.

At least 70% of the time, knee pain can be resolved naturally and with movement – but you must make sure you’ve got the correct diagnosis nailed down first.

Want some help getting rid of YOUR knee pain?

Talk to one of my specialists for free by CLICKING HERE.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at [email protected].

Knee Pain Causes

Top 3 Causes of Knee Pain and What To Do.

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Knee pain is the second most common complaint when it comes to musculoskeletal problems. Right behind back pain. It impacts one-third of all Americans at any given time. I speak to a lot of folks in their 50’s and 60’s who love to ski, run, hike and bike. Their biggest fear is that ongoing knee pain could bring an eventual end to their active lifestyles. The good news is that eighty percent of all knee problems can be resolved without procedures or surgery. But, it starts with accurately identifying knee pain causes.

Here are three common Knee Pain Causes and what you can do to resolve it.

1. Patellofemoral Knee syndrome

Also known as “runner’s knee”, Patellofemoral Knee Syndrome (PFS) is characterized by pain in the front of your knee. Usually just below or behind your knee cap.

With PFS, the source of the pain typically comes from unwanted pressure around your knee cap. That eventually results in inflammation and pain. It’s very tempting to just get a cortisone shot or take pain pills to quickly reduce the inflammation and relieve your pain. But unless you’re certain where the inflammation is coming from, you’re really only addressing the symptoms of your knee problem.

In other words, what causes the pressure in your knee cap to begin with?

It doesn’t just happen spontaneously. If you truly want to put an end to PFS, you’ll need to find the root cause of your problem.

Typically, PFS is the result of an imbalance somewhere in your body. Over time, it has resulted in poor form and movement habits that ultimately cause more pressure at your knee.

If your hips, quads, and hamstrings aren’t balanced and working together harmoniously, you could end up with problems in your knee.

Once you figure out the culprit behind the pressure and inflammation at your knee cap, you’ll be able to resolve and manage PFS naturally and for the long-term.

2. Iliotibial band syndrome

The causes of iliotibial band syndrome are very similar to that of PFS. Except that your pain and symptoms will be experienced on the side of your knee instead of the front.

Your iliotibial band (ITB) is a large, thick band of tissue that runs along the side of your thigh to the bottom of your knee. Your ITB is formed from a muscle in your hip called the tensor fascia latae (TFL). When your TFL gets overworked, your ITB suffers, and will result in what often feels like stabbing pain at the side of your knee.

The most common treatment I see for this is foam rolling and massage. While these are great modalities to relieve your symptoms, they don’t address the root problem.

You must figure out why your TFL is being stressed and overworked if you really want to get rid of your pain. Typically, it’s due to weak glute muscles, the deep ones designed to stabilize your pelvis.

Your TFL is neighbor to your glutes. So, when they decide to be lazy, your TFL loves to help out, and eventually overdoes it. When you can get these two groups of muscles working properly together, you’ll put an end to ITB syndrome.

3. Osteoarthritis

Many people find out they have osteoarthritis in their knees and think there’s nothing that can be done. They either have to “live with it” or get a total knee replacement.

First, arthritis is normal and it happens to everyone as they age. What is not normal is for you to think you’re helpless or have to avoid your favorite activities because of it.

Arthritis occurs when the protective cartilage that cushions the ends of your bones wears down over time. While there isn’t anything you can do to reverse this process, there is plenty you can do to minimize the symptoms you get because of this condition.

It all comes down to balanced joints and movement. The more mobility you have, and the more stability you have around your knees, the less symptomatic your arthritis will be.

Some key areas to focus on when you’ve got arthritis in your knees is good core and hip strength, and good flexibility in your hips and ankles.

If anything is off in these areas, your knees will  compensate, which could result in compression at your knee joint. This will aggravate your arthritic symptoms.

“Motion is lotion” isn’t just a saying.

It very well could be the difference between you suffering from debilitating knee symptoms versus living an active lifestyle despite your osteoarthritis.

If you’re suffering from knee pain, remember that there is a very good chance you fall into the eighty percent of people who can successfully get rid of it completely on their own.

There is no need to rely on pain pills, or believe that procedures and surgery are your only options. As you can see, three of the most common causes of knee pain are due to movement problems.

Therefore – movement should be your solution – not something you avoid.

Are you Local to Portsmouth, New Hampshire and experiencing knee or any other type of pain?

CLICK HERE to book a discovery visit with one of my specialists. Someone from my team will reach out to you. They’ll find out what’s been going on, and see if we’re a good fit for you to get you back to doing the activities that you love.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at [email protected].

How to Prevent Knee Pain When Hiking

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Hiking is a popular way to stay active during the summer months – but it can also wreak havoc on your knees.

Personally, I love to hike. My pup (Bodie) and I are currently in the process of conquering the 48 4K footers of the White Mountains – and the very last thing I want is for knee pain to get in the way of that journey.

The good news is that there is quite a bit you can do to prevent knee pain when hiking. So when one of my readers asked this week – “How do I prevent knee pain when hiking?” – I couldn’t wait to answer it.

Here are 4 of my top tips to help you prevent knee pain when hiking.

 

1. Strengthen your hips and core

Your hips and core provide much needed support for your knee joint to function properly. The large bone in your thigh, called your femur, makes up your knee joint on the bottom, and your hip joint on the top. Your hip joint is connected to your pelvis, which houses major core muscles groups like your glutes.

Let’s say your glutes (part of your core) and hip muscles aren’t as strong as they could be. When you’re trying to climb up a large rock or steep trail, for example, your glutes and hip muscles are supposed to stabilize your pelvis so that your femur can easily extend your hip. When not strong enough, your pelvis will tilt to compensate – which impacts the alignment of your femur – and ultimately the alignment of your knee.

When I hike a 4k footer – I get in approximately 27,000 steps. If your knee is compensating for every one of those steps – it’s eventually going to hurt. If hiking is something you love to do, it’s critical that you strengthen your hips and core.

2. Keep your knees mobile

One of the biggest mistakes I see when it comes to knee problems is a lack of full mobility. Your knee shouldn’t just straighten, it should be able to hyperextend a little bit. When you bend your knee, you should be able to tolerate a full deep squat without any pain. These full end range movements are pretty essential to have when it comes to hiking. Your knee needs to be able to squat, pivot, and tolerate stress on those uneven trails. When you lack full mobility, it impacts your knee’s ability to tolerate these micro-stresses and over time – your knees will ache.

If you’ve got pain or stiffness in your knee in either direction of movement – it’s important to try and push that movement and work through it rather than avoid it – even if your knee seems painful at first. More often than not, the more you move your knee joint, the better it will feel. If that doesn’t happen – then you know it’s time to talk to an expert about it and have them take a closer look at your knee.

3. Work on your balance

Hiking can involve everything from uneven terrain, water crossings, and rock hopping. Good balance is essential for these activities and without it – your knees will suffer.

So how do you work on your balance?

Aside from the obvious (practicing balance exercises), it’s also important to look at a few other things – namely – the mobility of your toes, foot and ankle joints as well as the strength of your arch (plantar fascia). These structures all play a role in how well you’re going to be able to balance. You can do all the balancing exercises in the world, but if you’ve got faulty mobility in your ankle, for example, or a flat, weakened arch – balance is always going to be really difficult for you.

Perform regular stretching of your ankle and calf muscles, Be sure to move those toes – can you lift your big toe up by itself when you’re standing? And use a small ball to regularly massage the arch of your foot to keep it flexible. These small activities can play a huge role in helping you to be able to balance with more ease – especially on the trials.

4. Use Trekking Poles

Even if you implement every single tip I mentioned above, depending on your overall level of fitness, and the condition of your knees prior to when you decided to get into hiking, you could still have some knee pain despite doing “everything right”.

Trekking poles can be a real life saver – or should I say knee-saver.

They help take away some of the stress from your knees and lower legs – especially on really long hikes and technically challenging trails. Plus, if you’re carrying a backpack, trekking poles help to disperse that extra weight away from your knees and into your arms. And added bonus – hiking with poles gives your arms a little extra workout at the same time and keeps your hands and fingers from getting puffy on those extra hot and humid days.

If you love hiking as much as Bodie and I do – then I know the last thing you want is for knee pain to keep you from hiking. I hope these tips help you to ease any knee pain you might currently have as well as prevent future knee pain on the trails.

Do you love to hike but knee pain is currently getting in the way? CLICK HERE to talk to one of our specialists. 

They’ll let you know if we can help – and if you’re a good fit for what we do – they’ll get you on our schedule right away.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at [email protected].

Holding Knee with Arthritis

Arthroscopic Knee Surgery – Does it Even Work?

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While researching for my latest article in the Portsmouth Herald, I came across an interesting study titled: “Arthroscopy for degenerative knees – a difficult habit to break.”

The title of this study is telling.

Arthroscopic knee surgery is still one of the most common surgeries performed, despite research telling us that it’s not nearly as effective as most people are led to believe.

Furthermore, studies now indicate that people who get arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly – resulting in a total knee replacement that could have been avoided.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

But over the years, research has shown that this procedure is really not necessary in most cases.

Most people can get pain relief and restore function in their knees without ever getting surgery.

One of the earliest studies from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have shown similar results. Even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment like physical therapy.

Despite all this research, surgeons are still performing these procedures more than ever.

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management and not giving therapy enough time to work.

In our office, we often see people after they’ve tried regular physical therapy first. Since we have a more specialized approach, and we’re able to spend more time with our clients, we tend to get better results and can help clients avoid surgery all together.

But not all physical therapy clinics are afforded that luxury. In those cases, people are led to believe that the physical therapy “didn’t work,” and they get scheduled for surgery.

But what’s the big deal really?

If outcomes are the same regardless of whether you get surgery or not – why not just get it? It’s quicker, and far more convenient than going to weekly therapy appointments…

But despite the term “minimally invasive,” it’s still surgery.

You will have bleeding, swelling, and recovery time. There is trauma that is caused to the soft tissue in and around your knee that has to heal. There’s also the risk of infection, which comes with a whole set of different complications.

And then of course there’s the elephant in the room that nobody likes to talk about…

I’ve seen many of these arthroscopic surgeries performed that had clients feeling WORSE than before surgery. Because it turns out the procedure wasn’t even necessary. Luckily, we’re still able to rehabilitate them. But it’s completely demoralizing and discouraging for our clients.

In general, despite how small the procedure may seem, you want to avoid surgery whenever possible.

Although small, the risks that can happen with surgery simply aren’t worth it – especially when you can get the same results from natural, conservative treatment.

For some, arthroscopic knee surgery really is necessary. But for most, it can be avoided.

If you’re currently suffering from knee pain and want to learn more about what you can do to avoid surgery and heal your knee pain naturally and on your own – DOWNLOAD our Free Guide: 7 Ways to Get rid of Knee Pain Naturally.