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5 Things Your PT Wants You to Know About Knee Pain

At Therapydia Denver, knee pain accounts for 30 to 35 percent of patient complaints. Here are five things physical therapists want you to know about this often-injured joint.

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When it comes to knee pain, active Coloradans pretty much corner the market. In fact, at Therapydia Denver, knee pain makes up approximately 30 to 35 percent of the complaints that therapists hear. Even if you’ve never injured your own knees (count yourself lucky), the physical therapists at Therapydia have a few things they’d like you, and every other knee pain sufferer, to know about this complex and easy-to-injure joint:

1. The problem may not be your knee.

A lot of times what actually starts out as a weakness in your hip muscles may force you to walk funny, or cause tightness from your hip or upper leg, which manifests itself at the knee joint. “The problem may not be at your knee, but that’s where you’re feeling the pain, because that’s where the issue is coming to a head,” says Dr. Josh Hardy, PT, DPT. “The other thing we see a lot of in our clinic, in runners especially, is minor errors in running form or running gauge, which is something that can be fixed or modified to prevent knee injuries.”

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2. Treating knee pain with knee exercises might make it worse.

Patients with knee pain who attempt to ease the problem themselves with certain exercises or stretches may actually end up making the problem worse. “The problem usually can be improved with core strengthening or hip stabilizing and strengthening,” says clinic director Casey McNitt, PT, MSPT, “but that’s where [a physical therapist or doctor] can come in and modify those exercises that people may have pulled off the Internet” to make them work for you, not against you.

3. Some knee pain can be avoided with a little training.

Sometimes, the best treatment is to simply slow down. The knee is especially susceptible to what therapists call “weekend warrior injuries”—in other words, a person who has spent a couple months relaxing without much physical activity who then decides to go run four miles, or hike a 14er. “It’s not surprising someone like that would end up with knee pain,” says Dr. Hardy. “People should ease into exercise if they’ve been out of the game for awhile. If you try to do a big run or hike without the flexibility or strength to back it up, the next thing you know your knee is irritated, and you have to play catch up even more.”

So how do you know if you’re mountain ready? Diagnostic testing can help you figure out your level of fitness. “We have tools here that measure if people are at-risk before they go out and do something,” Dr. Hardy adds. “It doesn’t hurt to have someone take a look at your functional movement and strength to find out if you’re at-risk before going out and hurting yourself.” (Speaking of training—with ski and snowboard season coming up, now’s the time to do some strength training for injury prevention for those particular activities.)

4. Avoid the quick fixes.

It’s frustrating to have to take extended time off from doing an activity you love, but attempting to work through the pain or come up with a quick fix instead of taking the proper time to heal will most likely set you back even more. “We see this a lot in runners who take a couple days off and then go back out and run six miles,” says McNitt. There’s a gradual progression that your doctor or physical therapist will come up with to help ease you back into those activities so there isn’t more damage done.

5. The answer isn’t always surgery.

For non-traumatic injuries it stands to reason that, for the most part, they can be treated without invasive interventions, but even some more serious injuries can be treated with therapy first (depending on the patient) to try to avoid surgery. “For people who aren’t elite athletes, some can rehabilitate their muscles in such a way—with direction—that they don’t even need their ACL,” said Dr. Hardy. “If you can get functional strength back in your hamstrings, they can do the same job.”

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(Read 5280‘s special report on pain)

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