Meniscus tears, patellar tendonitis, knee bursitis, knee arthritis, patellafemoral syndrome, and IT band syndrome are some of the most knee conditions that we see at Movement Solutions. Almost everyone will experience knee pain at some point in their lives. This pain can vary from mild to severe. It can be short-lived or long-lasting. However it happens, knee pain can make many everyday activities difficult to perform.
There are common risk factors that can contribute to having knee problems. These include mobility restrictions at the hips and ankles. In addition, weakness of the core, and buttock muscles can affect how an active person moves. In some cases, movement errors can lead to a knee injury. This might include trouble engaging with glutes when squatting, lunging, ascending/descending steps, or walking.
Having prerequisite mobility at the hips and ankles are crucial for normal movement. When a loss of mobility is found in these areas, common manifestations are caving of the knees and an inward tracking of the kneecap during keep knee movements (i.e. kneeling, lunging, and squatting). Dynamic loading with these imbalances can place stress on sensitive structures of the knee including tendons, cartilage, and menisci.
In our physical therapy office, we first step we often take in reducing pain and restoring mobility is performing hands-on manual therapy. This might include dry needling, soft-tissue mobilization, joint mobilization, or manipulation. The effects of some of these treatments can be reinforced with foam rolling. By simply applying pressure through tense and stiff muscles, tension can be released and mobility can be gained. Some of the exercises that we prescribe patients include foam rolling the t-spine and lats as seen in the videos below.
However, foam rolling alone won’t provide any lasting gains in mobility. The reason for this is because stiffness and tension is usually driven my weakness of the stiff muscle as well as the muscle groups above and below that region. More over, the body needs to learn to actively use the motion it gains through passive implements (manual therapy and foam rolling). In order to develop lasting mobility, inactive muscle groups must be activated and strengthened. We have specific exercises that we we intentionally use to target these weak regions. Some of these can be seen below.
Once we have reinforced mobility, the next step is to work on stability. Knee stability begins with hip engagement or “creating space” in the hip socket. Engaging the hips in this way protects the sensitive tissues that run around the knee when performing exercises that require a great degree of knee flexion and extension. Creating space in the hips can be done with with a mini- band.
Mini band bridges help counteract the tendency for knees to cave. Using a mini-band provides feedback so you know that you are using the muscles on the outside of the hips.
Finally, we know that if our patients have good mobility and stability in static positions but still have knee pain when moving or exercising, our rehab program isn’t very effective. We teach our patients to move well under load and use the mobility and stability they have in dynamic exercises. One of the best exercises for knee health is the banded goblet squat.
In our physical therapy office, we use kettlebells because they provide a counterbalance which makes squatting easier when learning the movement. When performed with good technique, kettlebell goblet squats develop strength though the hips and thighs. It often takes good coaching and practice to keep an upright posture while descending into a deep squat. But it’s a skill worth mastering as it translates to all squat based movements including the barbell squat and getting up from a low chair.
In the absence of pain or injury, the above strategies are an excellent way to prevent injury to you knee. However, if your knee is in pain, a more nuanced approach is necessary. The reason for this is because pain changes movement. Movement compensations need to be identified through an assessment. An individualized plan needs to be developed to correct dysfunction. Manual therapy should be considered in the presence of pain and mobility restrictions. And a carefully planned exercise progression should be undertaken to recover from pain and injury and return to activity.
If you live in Greenville, South Carolina, are active (or want to be active), are between ages of 40-60s, and have knee pain, the providers at Movement Solutions would be happy to talk about how we can help. We are happy to begin with a free phone consultation where we you can talk on the phone to one of our providers. We can give you guidance on treatment options and how you can get your life back. Call us today at (864) 558-7346. We look forward to hearing from you!