We have seen several clients in our office lately with knee pain that has NOT resolved doing treatments such as cortisone injections, stem cell injections, other physical therapy, acupuncture and surgery.
We really try to get the message out there to help people get answers, so they do not have to go down these expensive pathways and frustrations of not getting better after spending so much time and money other treatments such as stem cell, cortisone injections, and worse surgery.
If the doctors tell you that you need to do a “clean out” of your knee as conservative treatment, run! The research on this is not great and actually because they are messing with your knee it is creating more arthritis. Especially if you are 40 and over!
How do you Avoid Surgery and Injections and get Knee Pain Resolution?
At mPower Phyiscal Therepy in Dallas, these are my top 4 tips to avoid surgery and injections.. You much go in this order, if you skip a step you will not get resolution..
1. You must have Full Mobility of the Knee, Ankle, Hip and Back to avoid Knee Surgery and Injections
What does that mean? Your knee must move fully into extension and flexion. The same goes for your ankle, hip, and back.. Remember everything is connected. If one area does not move, another area has to take the load.
We recently had a knee pain patient who was fed up with pain. She was doing yoga and strengthening but she was not getting better. She was fearful that she would never be able to walk long distances to be able to travel…
She clearly did not have full range of motion of the knee. Lying on her back, her knee could not fully extend. After asking lots of questions and doing a through evaluation. We found out that her hip was not moving very well in a bend and extended position. She could not rotate her hip to sit in a criss cross position.
We started to improve her hip mobility with joint stretches and releasing tightness in her hips as we are stretching the joint, her knee range of motion improved. We did not touch her knee.
What happens when you miss this step and go straight into strengthening? Your muscles will not fire or contract properly or at all. You keep on trying to strengthen but after 1-2 months you are in the same pain and not any stronger. We see this all the time.
We had another client who had tried physical therapy at several places after having a knee scope. Remember the one that I talked about, the “clean up surgery.” Well, this client was worse after surgery. Not able to be active at all. So frustrated that they would never be able to aerobically workout again.
They had been doing strengthening, but they were not getting stronger and still hurting without any progress. Everyone else skipped this step.
This client’s hip was moving pretty well, but their knee was not moving very well at all. We showed this client how to do knee mobilizations. After doing the mobilizations, this client had improved their knee range of motion and squatting no longer bothered them like it had before.
If you skip this step, you will not get better.
2. Strengthening the hips and core individually is the next Step in avoiding Surgery and Injections
Once you check or have fully resolved their mobility issue above and below the joint, then you have to check the individual muscle strength. If you cannot get all your muscles to fire individually then you will not be able to get them to work functionally with running, climbing stairs, or just walking!
For example, we can test the strength of a client’s hips and the will automatically recruit their quads because they are stronger. Our body will take the path of least resistance. We have to get your body in a position to recruit your muscles that are weak so that other muscles will not take over.
Common weakness we find in our clients who have knee pain are hip abductors, deep hip rotators, and hip extensors. Usually, our clients like to recruit their quad and IT band for stability creating problems in the knee. We find some of these recruitment patterns also create tightness and mobility issues in the hip.
I like to say, we have to “jump start” the muscles to knowing how to fire again. Once the muscles know how to work individually, then you have to put it together in our next step or top tip!
3. Improve poor movement patterns or compensations to avoid knee surgeries and injections.
Now we have to put the movements together with a focus on the weak muscles. Starting out for example with lunge slides and doing it in a way to activate the muscles that are weak more than the other muscles.
We have to adjust the way you move so take out the poor movement patterns that your body is used to doing with your everyday activities and correcting them making sure your muscles that are weak are firing correctly. Sometimes we have to use props to make the movement easier and then progress the exercise to add balance, speed, endurance to the exercise.
How we chose and dose the exercise is based on your goals of what you want to get back to doing.
4. Get back to your Activities safely to avoid knee surgeries and Injections
The final step is then to progress you back to doing the activities that you love. For example, if you are going on a trip and have to walk 3 hours a day. You can not just start walking 3 hours you will hurt yourself again. We have to set you up with a program to train you to get back to what you love to do.
If it is a sport like soccer or tennis. We will set you up with a program to see how your body responds. We want to know what happens during, after and the next day. How your body responds guides us in how to get you back to your activities safely.
If you miss any of these steps could be the reason you are not getting better. This will lead you down a path of frustration with injections that do not work, surgeries that could have been prevented. We see it all the time..
Want to learn more? We have create our Top Tips to Resolve Knee pain ebook. These are the top tips we share with our clients who come into our office. If you would like to get that ebook just CLICK HERE and you will recieve this ebook into your inbox today! You will not be disappointed!