There are two common causes of knee pain: trauma, a fall where you have landed on the knee or run into something; and overuse. Trauma could be caused by sports-related injuries or stepping wrong or twisting the leg, then a ligament goes pop and may need to be surgically repaired. When overuse is the cause it is due to mechanics. If tightness is present in another joint, either the hip above or the ankle below, that generally leads to overworking or more pressure on the knee itself.
Anatomy of the Knee
The knee is a hinge joint similar to the elbow. When you fully straighten your knee, it goes into a slight rotation to lock it in place. Then when you bend your knee, it has to slowly un-rotate to allow the bend to happen. There are other unique components of the knee. The knee is formed by the thigh bone, femur, shin bone, and tibia. Those bones, as they are touching one another have a connection where the tibia has crevices that hold the menisci, which provide a cushion for the end of the thigh bone of the femur. This allows for shock absorption as force comes up the leg when you land from a jump or even step and put weight on one leg to the other.
The challenge that happens is when the knee itself is being forced to do more work than what it is prepared to do, or you have movement mechanics. For instance, if you sit down in a chair and every single time you sit your knees go forward. It is okay for your knees to move forward, but they should not stay forward. When the knees come forward it causes more pressure on the thigh bone into the back of the kneecap. The kneecap is present in the knee to provide some tension ratio for the thigh muscle and the quadricep to have a place to move up and against.
There are little complexities in the full bend and the full straightening, but it is subject to what happens above in the hips and what happens below in the ankle. If something is tight above or below, the mechanics of the knee will change. Many times when a patient comes in for physical therapy the physical therapist is evaluating above and below to make sure that everything is moving appropriately, and nothing is tight or holding things.
When a Patient Comes in with Knee Pain
When a patient first comes in for physical therapy we evaluate their pain level. We first look at improving pain levels before we begin the hard work of therapy. After the first phase of pain control, we want to know which motions and movements are pain-free. Next, our physical therapists work to have our patients gain strength, and then finally their overall function.
When knee trauma occurs and a patient has had surgery there are other factors to consider. Once the surgery is done there has been a disruption within the knee joint to repair something. Tissues heal at different rates and looking at how quickly that tissue is healing and being able to improve its function is part of the process of therapy.
Occasionally a patient comes in with knee pain seeking relief through physical therapy. Many times, they have already seen a physician and have been told surgery is necessary. The patient could request a physical therapy evaluation. During this evaluation, the therapist performs a series of special tests to assess the contractile and non-contractile tissues of the knee. Along with the doctor’s assessment, if a tear in the knee is mild, physical therapy may be enough to counteract the knee pain and move forward to healing the knee. However, if surgery is recommended and confirmed by the evaluation, research shows that having physical therapy before, “prehab,” helps patients get their strength and function back more quickly.
Everybody heals differently and by giving the body time it can heal better given the right information. If it is a simple cause of knee pain or knee problems, resting and over-the-counter pain medication can help reduce pain and swelling. At ProHealth the physical therapists provide customized manual therapy treatment for each patient so their body can heal and feel better.
How Can Pilates Help?
One of our regular clients had been coming in for Pilates and used this as part of his repertoire and found it to be helpful with his back issues. However, during jiu-jitsu, he injured his knee badly enough that it required surgery. The fact that he was active before the surgery was helpful in his recovery. Now he is doing amazing. Just a few months post-surgery, he’s almost back to full function. He’s about to graduate from PT and start his Pilates again.
Incorporating Pilates into a rehabilitation program helps allow patients to start moving their limbs and have support. Joseph Pilates created the Pilates equipment for people to move their bodies and have some resistance. The springs provide more or less resistance and over time the patient can move more easily with less pain. Using Pilates speeds up the process of strengthening more than the traditional methods.
Some patients come in after seeing their physician and they get referred for therapy. The doctor may say there is a minor tear or something else mild and therapy is started and within four to six weeks the patient is back to their day-to-day activities. An athletic person is usually back to normal and enjoying their athletic endeavors. The rehabilitation is not super complicated. The main factor is that the patient does what is recommended to strengthen their body. Given the right amount of rest and input of exercise and activities, and four to six weeks, patients can get back to their typical routine.
Knee pain can be elusive for some people because it could be knee arthritis. When arthritis happens in the knee the challenge is people change their movements. They avoid movements and stop moving in certain ways because it hurts. The challenge then is to pull back and change the quality of the movement and see what the body likes to do and change it to move it in a way that it likes, which allows for improved support for the body and proper mechanics.
If you are experiencing knee pain and you live within easy driving distance of Peachtree City,
Georgia, consider calling ProHealth Physical Therapy and Pilates Studio for a PT appointment. Our PTs are experts, and appointments fill fast, so call today at 770-487-1931.