Getting To The Bottom Of Knee Pain
Have you noticed that knee pain can be difficult to treat? If you have chronic knee pain, then you may know this all too well. Why is knee pain so hard to manage? Medical technology and therapeutic treatments are as advanced as ever. Although there are injections of all kinds, myriads of physical therapy methods, and more highly advanced surgical procedures, these techniques do not always work for chronic knee pain. Many cases of chronic knee pain can be associated with conditions like:
1. Arthritis
2. Meniscal tears
3. Diminished knee cartilage
4. Injury of the knee ligaments, especially the ACL
5. Jumper’s knee
7. Bursitis
8. IT band syndrome
What do these conditions have in common? They may signify muscular, ligamentous, or joint adaptations in one or more body parts. These adaptations, or changes, aren’t necessarily bad. It’s the body’s way of responding and adjusting to the environment it is in. However, over time these adaptations can cause imbalanced stress on the knee. That is often why many procedures or medicines do not help knee pain long term; they aren’t addressing these changes within the body. Each person is unique and that’s why it is important to get evaluated. What if you’re struggling to understand why your knees hurt? There are two common locations of adaptation that may contribute to knee pain.
Adaptations at the hip
The complex musculature of the hips allows for both stability and movement of the femur. Broadly speaking, the hip has a 6 muscle rotator cuff, followed by layers of gluteal muscles and attachments by the hip flexors. When the balance between these muscles is disturbed, the femur may get “stuck” in either an internally or externally rotated position. Prolonged over-rotation of the femur creates counterbalancing actions of other bones and joints. For example, internal rotation of the femur can cause the tibia to externally rotate in compensation. These opposing rotational forces can create torque at the knee which may result in repetitive strain over time to the medial part of the knee. In other instances, weakness in the gluteal muscles causes the IT band and lateral knee to absorb greater force which may result in chronic IT band stiffness or lateral knee pain.
Adaptations at the foot
An integral part of healthy foot function are the foot’s arches. When the arch of the foot is compromised, either from excessive flattening (pronation) or too high of an arch (supination) function of the knee is altered. To be clear, pronation and supination are normal actions of the foot. Feet that spend too much time either pronated or supinated, though, can create uneven tension among the muscles of the lower leg which affects the knee. The knee may now receive imbalanced stress. For example, when the foot is flattened, more force is shunted to the medial knee, often resulting in dysfunction at the MCL and medial meniscus.
Finding options
By zooming out and viewing a wide variety of chronic knee ailments as bodily adaptations, whether from the hips, feet or elsewhere, we better understand why knee problems persist and, ultimately, how this sensitizes the nervous system into generating pain and causing disability. The good news is that there are many things that can be done to help the body adapt differently and decrease stress on the knee. At SPARC, our care team doesn’t look at knee pain as just a knee problem, but as a holistic issue that should be handled uniquely for each individual.