Can Physiotherapy Help Knee Pain?
Spring has (finally!) sprung! Yahoo!
With the change in weather, at our clinic MOMENTUM Physical Therapy in Okotoks, we are hearing stories of people returning to the running trails, hiking in the mountains, and getting back to the outdoor sports that we love like baseball and soccer. This is truly the best time of year!
With the return of spring, we also tend to find ourselves entering into “knee pain” season.
Yes - that is right - we are into knee pain season.
At this time of year, we often seen an influx of people seeking physiotherapy for knee pain or knee injuries. So today, I wanted to take moment to connect about what usually causes knee pain, what the symptoms of knee problems are, and four simple physio techniques that you can do today to reduce your knee pain.
Before we get started, let me introduce myself. My name is Stephen Uhrbach and I am a physical therapist at MOMENTUM Physical Therapy in Okotoks, Alberta. I lead a team of talented physio therapists who treat people with knee pain and knee injuries everyday. Today we are going to review what we see in the clinic so you can learn about knee pain and knee injuries, and hopefully if needed, start to reduce your knee pain today!
First of all, knee pain is a common problem that affects millions of people worldwide. It can be caused by a variety of factors, including injury, overuse, or arthritis. When knee pain strikes, it often can have a significant impact on your quality of life; making it difficult to perform daily activities, exercise, and even walk comfortably.
Does this sound like you? If so, you are going to want to keep reading!
Before we start tackling knee pain and how physio can help, it is important for us (and you!) to understand what the cause of your knee pain is.
Here are 5 common reasons why we see people in our physio clinic in Okotoks for knee pain:
Contact Knee Injuries:
Contact knee injuries are one of the most common causes of knee pain. Have you seen a bad tackle in soccer? Maybe you have seen someone slip off a curb while wearing flip flops? These forceful falls or twists can lead to tears of the stabilizers in the knee. When injuries like this occur, we often see knee ligament sprains (ACL tears and MCL tears are the most common), muscle tears (such as quadriceps strains and hamstring strains), and cartilage (or meniscus) tears. Often these knees are sore, swollen, stiff, and come with a very descriptive story of what happened.
2. Knee Osteoarthritis (OA)
Knee osteoarthritis is the next most common reason we see people for knee pain. Osteoarthritis is the gradual breakdown of a joint where the smooth surfaces of the joint slowly wears away and gets replaced with small bony bumps (think like sandpaper). Knee osteoarthritis often sets in slowly, and usually slowly worsens with time. This type of knee pain is often accompanied with a history that the knee has slowly gotten more sore over the last few months or years to a point where it now is too sore to ignore. (Hey - if you want to learn more about Osteoarthritis - check out this blog on Osteoarthritis HERE)
3. Knee Overuse Injuries:
Lots of sports (such as cycling, jogging, swimming, or soccer) involve repetitive movements (such running, jumping, sprinting, or kicking). Sometimes, these high repetitions lead to tissues rubbing against each other. We often seen this with our clients who present with IT Band Friction Syndrome (pain on the outside edge of the knee) or with pain through the knee cap (pain directly on the front of the knee). These types of knee injuries often come with stories of high repetition in a specific sport or action.
4. Knee Tendonitis
Like overuse injuries, we also see knee pain that is associated with quadriceps or hamstring muscle and tendon breakdown. If the muscles around the knee is overused, they can fray like a worn rope and cause tendonitis. Tendinitis is a painful inflammation that requires both short term rest followed by proper strengthening.
5. Knee Bursitis
Knee Bursitis is the final common knee injury we see. Bursae sacs are fluid filled sacs cushion joints and tendons. The knee has number of bursae sacs that can become inflamed and irritated due to injury, overuse, or by bumping them wrong. Bursitis is often accompanied by pain and swelling in the knee.
At the end of the day, most knee injuries are one of these 5 injury types (or a combination of them). Each of these types of injuries can be successfully treated and relieved with exercise and physiotherapy (which we will get to below!), but before we do that, I want to review what knee pain feels like.
5 Knee Symptoms That You CANNOT Ignore:
… and why our physiotherapists at MOMENTUM Physical Therapy are the best suited to help you out!
1. Knee Pain:
Pain in the knee is usually the first sign that something is not moving correctly. If your knee begins to feel pain, stop and get it evaluated. Pain is the first warning sign that something is not working properly (like a muscle, ligament, meniscus, or joint). Pain can range from mild to severe and can be felt in different areas of the knee. Getting the knee evaluated by a physical therapist early in the pain process can prevent the injury from worsening and dramatically reduce the amount of time required to heal the knee.
At MOMENTUM Physical Therapy, we strive to teach you about your condition so you know the true implications of your arthritis. Understanding what is going on (and how you can tackle it) is the first step in successfully treating your knee pain.
2. Knee Swelling:
Knee swelling is a common sign that something is injured in the knee. Sometimes the swelling will be localized to one area, and sometimes the knee will look swollen like a small melon. Generally speaking, the more swelling (and bruising!) that you see, the more serious the knee injury is. Swelling (or sometimes known as water on the knee) is not normal for a knee and should be evaluated.
At MOMENTUM Physical Therapy, we will ensure that you receive the hands on treatment that you need to maximize your joint health and minimize your swelling. We provide you with at-home swelling management strategies and also use state of the art equipment, such as the GameReady Cryocuff System that works to manage swelling of the knee.
3. Knee Stiffness:
Stiffness is a common symptom we often see with a knee injury. If any part of the knee is injured, the body will go into a “self splinting” mode that will cause the knee to stiffen up. You may find it difficult to move the knee joint. In serious instances, the knee might even lock up. Regardless, any loss of knee movement is a sign that something it the knee is not functioning properly.
Connecting with a physical therapist, like those here at MOMENTUM Physical Therapy, can show you the specific exercises that you need to increase your joint movement, strength, and endurance. These specific exercises will become foundational to you managing your osteoarthritis and preventing symptom progression. Getting the right exercises is a HUGE component to your success.
4. Knee Instability:
Instability, or “giving way” is a common symptom when you have a ligament tear in the knee. The ligaments in the knee are the guide wires and supports in the knee. If a ligament is torn, you will effectively lose some of the stability of the knee. There are different healing pathways required for different types of knee instabilities, so if you feel like your knee is giving way, a physical therapist can evaluate the ligaments of knee to determine your best recovery pathway and timeline.
At MOMENTUM Physical Therapy, your physical therapist will be able to test ligaments and structures in the knee to determine exactly what the cause of your knee instability is.
5. Knee Clicking or Popping:
Knee clicking or popping is something that we often see in the clinic. Generally speaking, if the click or pop is not painful, usually the knee problem is not serious. These audible sounds from the knee usually occur when a muscle group is tight or weak and the knee cap is not tracking normally through the groove that it slides in. This often settles with some hands on physical therapy.
Our team of award-winning physical therapists at MOMENTUM Physical Therapy, located in Okotoks, would be thrilled to partner with you to set a recovery plan in motion and get you back to doing what you love to do.
Treatment Options for Knee Pain
When knee pain strikes, there are things that you can do at home to try and reduce your knee pain. Things to try include:
P.R.I.C.E IT!
What does PRICE stand for?
P stands for Protect. Remove yourself for the activity that caused the injury to prevent a further aggravation. If necessary, toss a brace on the knee (please see a physical therapist to determine if a brace is needed) or grab a pair of crutches. We want to make sure that the knee injury doesn’t get worse!
R stands for Rest. After you injure your knee, you will need to give you body rest in order to heal. Although healing times for different knee injuries vary, complete rest for an injured knee can last anyway from 24 hours to a few days. Again, consulting a trained physical therapist is the best way to get an accurate idea of how long you should rest your knee, but taking some time to let the knee heal is necessary.
I stands for Ice. Icing a sore knee will help reduce the swelling and soreness that a knee feels. With ice, we recommend using crushed ice (or frozen peas!) that can conform to the contours of the knee. Square ice packs don’t get the contact we want. Make sure you have a damp towel between the ice and the skin and leave the ice on for ~20 minutes.
C stands for Compress. A tensor bandage or compressive knee sleeve is a great way to further reduce knee swelling, provide some minor stability, and reduce some knee pain. Please note - you should never sleep with a compressive garnet (like a sleeve or tensor) on your knee.
E stands for Elevate. Elevation (or having the knee above the heart) is another great way to help reduce knee swelling.
We follow the PRICE principle for new knee injuries that occur when the knee is sore, hot, and swollen. Now, we don’t continue with PRICE for weeks on end. Research has shown that prolonged “PRICE”ing can actually can slow the healing process. For the first 5-10 days after a new injury, “PRICE”ing the knee is a great way to settle the initial pain, reduce the initial wave of swelling, and then set your knee up for healing and recovery.
2. Physio Exercises to Loosen The Knee Muscles
Whenever a knee gets injured, you can expect to have some muscle guarding or stiffness around the knee. This protective muscle spasm, although helpful when the knee is initially healing, will limit proper movement and can actually make the knee more sore with time. We often find that loosening some of these tightened muscles is the best way to get the knee moving and reduce some pain.
HOW TO LOOSEN THE KNEE WITH MUSCLE ROLLING
In order to loosen the muscles that cross the knee, we are going to use a foam roller and a myofascial ball (or lacrosse ball). Grab a large foam roller and a hard myofascial ball to get started.
Step 1: Place the roller and lacrosse ball on the ground.
Step 2: Carefully lower your body onto the ground beside the foam roller. Position yourself over the foam roller so that the fronts of both thighs are perpendicular to the foam roller.
Step 3: Slowly roll up and down the foam roller on the front of the thighs looking for any sore or tender spots. Hold each sore spot for ~30 seconds. If you can’t seem to find any sore spots, try stacking your legs on top of each other so you are only rolling the front of one thigh. Do not roll above the hip or over the knee cap. Each thigh should take 4-5 minutes.
Step 4: Sit up with your legs straight out in front of you. Grab the lacrosse ball.
Step 5: Place the lacrosse ball below the back of the thigh (against the hamstrings!) of the straight out legs. Slowly roll up and down on the lacrosse ball looking for any sore or tender spots. Hold each sore spot for ~30 seconds. Do not roll below the knee joint. Each leg should take 4-5 minutes.
3. Physio Exercises to Get The Knee Moving
After you have loosened the muscles of the knee, it is time to get the knee moving again. We often find that injured knees NEED to move, but individuals are apprehensive to let their knee bend and straighten. In order to regain confidence in the knee and let the knee start to heal, we begin with an exercise called “Ball To Bum”. For this exercise, you will need one of those large exercise balls.
HOW TO GET THE KNEE MOVING AGAIN WITH "BALL TO BUM”
Step 1: Place the exercise ball on the ground.
Step 2: Carefully lower your body to the ground beside the ball. Lift the legs up and place the ball below the heels.
Step 3: Gently push your heels into the ball and pull the ball in towards your buttocks. Only go as far as you feel comfortable. Pause at your limit.
Step 4: Gently straighten your legs out allowing the ball to roll away from your buttocks. Only go as far as you feel comfortable. Pause at your limit.
Step 5: Repeat this 25-30 times.
4. Physio Exercises to Strengthen the Knee
After you have loosened the knee and then got the knee bending and straightening better, we need to start working on regaining strength and confidence in the knee. Although there are MANY exercises we teach to help strengthen knee injuries, the best exercise to help a knee recover we have is called “The Bridge”. With bridges, we teach the body how to properly align the knee so that the knee never gets put into dangerous positions that cause pain and injury. With bridges, you will need a looped elastic exercise band.
HOW TO START STRENGTHENING THE LEGS WITH BRIDGES
Step 1: Grab your looped exercise band. Put it around your legs so the band is around the outside of both knees.
Step 2: Lay down on the ground with your feet hip width apart and gently pressing your knees out against the resistance band.
Step 3: Tighten your core and squeeze your buttocks muscles together. Lift the hips up off the ground until your shoulders, hips and knees are in a straight line. While doing this, keep constant pressure out against the band.
Step 4: After a count of 1, slowly lower your hips to the ground. Repeat 20-30 times always focusing on engaging the core and glutes.
When Is It Time To Get Help With Knee Pain?
Knee injuries happen. Very often in-fact.
If you have recently injured your knee (or your knee has been sore for a while), and you have tried the quick physio tips above without success, it is now time to see a physical therapist.
Our physiotherapists at MOMENTUM Physical Therapy in Okotoks deal with knee injuries every day. At our clinic in Okotoks, we will perform a comprehensive evaluation of your knee in order to determine your best path to recovery.
From this evaluation, you can expect to leave with:
An understanding of what is actually hurt in the knee
A timeline on how long it may take for the knee injury to recover
Some hands on treatment to bring you some knee pain relief
A plan on how to get you back to your normal self
At the end of the day, our physical therapists strive to help people like you overcome their pain and injuries and get back to the life you want to live. If you are dealing with any form of knee pain, call us at MOMENTUM to connect with one of our talented physical therapists who will get your knee back on track. Knee pain can feel debilitating, but getting the right plan can put you back in the right direction quickly.
Our award-winning team here at MOMENTUM Physical Therapy- in Okotoks, is ready to help! Give us a call today at 403-982-5600 to get booked in with one of our awesome physiotherapists, massage therapists, or trainers. Or feel free to book online HERE!
We’re here for you!
Frequently Asked Questions
Can physiotherapy fix Knee Pain?
Yes! Physical therapy that involves hands on treatment and specific exercises has been shown highly effective to reduce and eliminate most sources of knee pain.
Is walking good for knee pain?
Generally speaking, staying active is important for managing knee pain. Walking is often a safe exercise that you can do to help maintain the strength and mobility of your knee. A physiotherapist can help make a plan that considers how far you should be walking and if any assistance (ie. a brace, cane, or crutches) will help.
Should I exercise if my knee hurts?
Exercise is an important part of knee recovery. The important thing is to make sure that you are doing exercises that loosen the knee, decrease pain, and increase knee stability. High impact exercises, or exercises that are done incorrectly, can damage the knee. A physio can help make an exercise plan that meets your specific needs.
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Momentum Physical Therapy, located in Okotoks, Alberta, is ‘Here for YOU’.
If you are experiencing shoulder pain, have a back injury, or you just want to learn more about how massage therapy and physiotherapy can help heal your pain, don’t delay and call MOMENTUM Physical Therapy today. You can reach registered physiotherapists and massage therapists at MOMENTUM, located in Okotoks, by calling 403-982-5600. We look forward to helping you feel you best again.