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Carrie working on a knee

When Your Knee Problem Isn’t Really a Knee Problem…

Knee pain is one of the most common complaints that brings people to physical therapy.  Since most of our clients are in their 40’s, 50’s, and 60’s, many of them fear that knee problems could bring an end to their active lifestyles. But that doesn’t have to be the case!

Ironically, the truth about knee problems is that they’re often not actually knee problems!  

There are many folks out there who struggle with chronic pain, instability, and stiffness in their knees. Naturally, they wonder why after countless treatments — sometimes even surgery — their knees still hurt.  Even worse, they start to accept having “bad knees” as a way of life. But if treating the knee directly has been consistently ineffective, it’s time to look elsewhere. Sometimes, even though you may experience pain in your knees, the root of the problem is elsewhere.

Let me explain…

With most knee pain, we can trace the underlying issues to a locality directly below the knee (the ankle or foot) or directly above it (the pelvis, hips, core, and low back). If you don’t engage your core throughout your daily movement, it actually puts a huge amount of strain on your knees. As your legs swing and rotate, the torque that should be occurring through your pelvis and hips gets overloaded onto your knees. So as we age, we may start feeling a sense of wear and tear or weakness in our knees that actually comes from a lifetime of improper movement.

The mainstream medical model is focused largely on treating symptoms rather than identifying the root cause of WHY the problem is occuring in the first place.  Pain pills, injections, and even surgery are often recommended before more conservative and natural treatments! And because these quick fixes are merely addressing the symptoms, the physical problems return for the majority of affected individuals. That’s because those knee issues actually stemmed from a different part of the body, and the knee will continue to be overloaded until those biomechanical problems are addressed directly!

So how do you I figure out what’s causing my knee pain?

Physical therapists go through extensive training in order to analyze your strength, mobility, and body mechanics. These factors allow them to figure out exactly what deficits are contributing to your knee pain, and develop a plan to optimize your movement patterns.

The purpose of a physical therapist is to train you in correct, healthy movement that both relieves your body of pain in the short term and protects it from further damage in the long term.  

Poor balance is a common symptom of a weak core, and being off balance in your movement is bound to affect crucial joints such as your knees — especially in simple everyday activities like climbing stairs and walking. That’s one of the many reasons why we like to combine physical therapy with Pilates in our practice. Pilates-based rehabilitation is a unique, core-centric approach to teaching healthy movement patterns. We love seeing our clients become stronger, balanced, and pain free as they are able to combine the full body workout of Pilates with the practiced eyes of a physical therapist who can identify movement problems and guide the client through correcting them.

The fact is, knee problems are rarely just knee problems, and if you have chronic knee pain, it’s worth asking a physical therapist to help out! If you want more accessible information about knee pain, check out our Facebook Happy Hour video right here! Then you can even request a free discovery session with us to see what PT is all about, and how we can work together to create a customized plan of action for your individual needs. We’d love to hear from you!

Is Running Bad for Your Knees when you’re Over 50?

This is a question we get asked a lot — especially by clients who are getting older and worried that they won’t be able to keep running into their 50s and 60’s.

The short answer? No!

If you experience knee pain when you run, it’s not that you’ve “aged out” of the sport! It’s probably just a biomechanical issue that can be fixed with proper education and strengthening (best offered by a specialist physical therapist).

In fact, research supports that running may actually be GOOD for your knees!

Here are some factors that could be responsible for knee pain when you run:

1) Poor ankle mobility

Ankle mobility affects the way force hits your foot, which can in turn impact your knee. According to Trail Runner Magazine, “if your ankle can’t move adequately, then excess forces are shifted up to the knee. The knee may be forced to flex, and/or rotate, and/or tilt more than it should. This may result in loads that the tissues of the knee can’t handle.”
A physical therapist can help you improve ankle mobility in order to prevent long term damage to the joints, tendons, and ligaments of your knees. This might be especially important for you if you’ve ever sprained or twisted an ankle in the past!

2) Weakness

There’s a widely perpetuated myth out there that runners don’t need to strength train. That’s simply not true! Adding strength training to your running regimen makes it way less likely that you’ll suffer an injury. When it comes to protecting your knees, developing strong lower limb muscles is critical. The hamstring and quadriceps groups play a crucial role in stabilizing the patella, otherwise known as the kneecap. Running is an extremely repetitive action and consequently requires durability and endurance from your joints — something that is lost quickly when you neglect strength training.

3) Unstable core

It may seem like running is all in the legs, but in reality, every physical action begins at the core. You derive all your power, speed, and stamina from your core muscles, and if they are weak, all your joints suffer — especially your knees. A stable core is key for maintaining balance and rhythm. It also keeps your weight distributed between your legs and prevents undue stress from resting on your knees.
Our favorite way to improve core strength is Pilates! If you are a runner but think you could benefit from a stronger core (let’s be honest, we all could), consider giving it a try — for FREE.

4) Running form

It doesn’t matter if you’re a marathon runner or an occasional jogger — running form is important. It determines where and how the impact of every step is distributed throughout your body. If your body mechanics are compromised — for instance, you’re dragging your feet or running with your shoulders tense and shrugged — you’re more likely to suffer from chronic knee pain, or even experience a serious injury. Work with a movement specialist – like the PT’s in our office – to analyze your form and help you be more efficient when you run.

Running is good for you at any age, if you do it right!

Research shows running can actually slow knee arthritis. According to an article published by Outside Online, “animal models show that exercise promotes cartilage thickening and protects its stretchy properties… instead of wearing down your bearings, running may grease them. That’s key, because cartilage thinning and the loss of elasticity are both prominent causes of osteoarthritis.”

Want to make sure you’re running right? Get in touch!

You can even schedule a FREE Discovery Session if you have chronic knee pain (or any type of pain) to talk about what you’re dealing with and figure out the course of action that works best for you.

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Where is your pain REALLY coming from?

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Don’t assume that where your pain is… is where the problem is!

This is a very common assumption and one that that we’ve been seeing a lot lately. If you watched our most recent Happy Hour on Facebook Live, then you know the story of the young guy who came to us looking for help with his heel pain. I checked out his heel, foot, and leg, but didn’t find any issues that would be causing the pain that he had been experiencing for four years.

I had planned on addressing the heel specifically before examining his back, but when he mentioned that he also felt a lot of tightness from his back into his leg, I decided to check it out. We did a test on his back and when he stood up, he immediately told me that his heel felt better! I was just as surprised as he was.  He was able to walk with less pain and his movement felt better overall. But when he started stretching his calf to his heel again, the pain came right back.

All that stretching he’d been doing day after day – to the area that he thought was the problem – may have actually been doing him more harm than good!

Now, it’s pretty clear that this young client doesn’t have a foot problem – where is pain actually was.  He has a back problem. And that’s something we can work through and fix! But if he never saw a specialist physical therapist like myself, he probably would’ve continued to believe that there was just something irreversibly wrong with his heel, and maybe even limited certain areas of his life, like football and sports, because of that.

Why should this matter to you?

You might not have heel pain or even noticeable back issues, but maybe you have pesky knee pain, a hip that hitches when you walk, or an achy ankle. Maybe you just feel muscle tension that never seems to go away, or weakness performing certain tasks.  These could all be indicators of a problem in your back!  Or somewhere else that just hasn’t been looked at yet, because it doesn’t match the main area of your pain.

If you’ve tried a lot of things and it’s not going away, it’s an indicator that your haven’t found the real source of your problem yet. Especially if you’ve gone to a doctor for pain in another part of your body and they’ve told you that there’s “nothing wrong.” Or maybe you’ve been stretching, massaging, and foam rolling religiously every day – only for it to keep coming back like a vicious cycle.  You might think that by doing this, you’re helping your problem and keeping it from getting worse – and you might be – but you certainly aren’t doing anything to actually address the problem and you aren’t any closer to a real solution. That’s why physical therapists are so important to have as part of your healthcare team – we’re trained to examine and treat the whole person – not just the foot/knee/hip/heel.

Getting Help

We know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer free Discovery Sessions out of our practice in Portsmouth, NH! All you have to do is fill out this brief form here and we’ll contact you. Discovery Sessions are a great opportunity to talk with a specialist about creating the best plan to get you healthy and feeling your best – without any obligation or commitment.

Feel free to reach out anytime, and be sure to like our Facebook page to stay up to date on Friday Happy Hour videos in the weeks to come!