Knee pain



Lessons to learn

Quite some time ago, I’d been treating a person, with a knee problem. I was using the approach taught to me at college and things weren’t improving. I rarely go beyond 2 or 3 sessions without any improvement, and for the life of me, I couldn’t figure out how to help this mans knee, so on the third session I discharged him asked him to let me know how he’d got on. To his credit, and despite my failure, he actually did get in touch sometime later.


Talented Physiotherapist

It turned out he’d gone to see a local private physiotherapist and got quite a dramatic improvement. I expressed my delight whilst hiding a sense of envy and impotence in the light of this obviously talented healer. I asked for the physios' name and when I put the phone down  immediately made an appointment with him. It turned out he was an enthusiastic and interesting man who was delighted to talk to me about his approach to knees and healing generally, he was also very inquisitive about the philosophies I’d learnt at college. The brief time I spent with him gave me more insight into the knee.


Lessons learned 

Since then I’ve studied, practised and enhanced my skill with knees to the point where it's rare for me to not be able to remove or improve someones knee pain. (see testimonials)


Damage or dysfunction?

As with all joints, the pain you are experiencing in your knee can come from damaged or worn joint components, (including ligaments), or from dysfunctional muscle action upon that joint. (see Why do I have pain) The important thing to remember is that either damage or dysfunction can cause huge amounts of pain, but only damage may need rest, repair or surgery.
Soft tissue dysfunction quite simply needs to be fixed through treatment, and your pain will begin to immediately ease.



I believe it is possible to distinguish dysfunction from damage in the knee with a 95% success rate, using relatively simple tests. If I can determine that your knee pain is due to soft tissue dysfunction, then it is almost certainly fixable, no matter how long you’ve had it or what activities seem to aggravate it.


Knee pain

Classic examples of knee problems include pain when going up or down the stairs, or both. Pain when you run or jog, pain only when you drive, or sit with your legs crossed, maybe only pain when you perform a particular activity such as golf or dancing. You may find that a support helps with your symptoms, but this is a somewhat controversial solution.

If I can determine that your pain is due to soft tissue dysfunction, then the next step is to figure out why you’ve developed that condition. Discovering causative factors here can involve assessment of the feet, the hips, low back and pelvis.



Having established these possible causative factors, my approach is to then deal with the immediate symptoms, ie the knee pain itself.
I want to remove your pain as quickly as possible, so I will start by improving the local factors, around the knee and thigh using specialised massage techniques, I may also start working on the causative factors, especially if I feel they may inhibit progress with the knee itself. Improvement is often immediate, or within the 2-4 days that the body takes to fully respond to treatment, or it may not begin to resolve until after the 2nd or 3rd session.
If I can determine that your pain is due to some damage within the joint components, then we will discuss the options available to you.
I will usually still treat your knee, for two reasons:-


1. Your body has the capacity to heal any damage, so even though there may be physical wear or tear, the body is much better equipped to deal with it if we can remove any obstruction to that healing process.


2. Sometimes I am pleasantly surprised to find that the 5% margin for error in assessing what is wrong with your knee has come into play, and contrary to appearences of damage, your knee responds well to treatment, suggesting that joint damage is either not there at all, or much more minimal than the test results suggest.


Exercise therapy:

We are all conditioned to believe that we must ‘strengthen’ our thigh muscles in order to ‘protect’ painful knees. I believe this reasoning is flawed in a number of ways and so never recommend it. (see why strengthening and stretching doesn’t work) Also see Five Knee Myths


With the knee in particular, the ‘leg extension’ exercise is usually given on a machine that isolates and strengthens the quadriceps (Front thigh muscles) in the mistaken belief that this will ‘support’ the joint more effectively. Since this is a completely ‘non-functional’ exercise, i.e. there is no aspect of our lifestyle that this exercise is representative of, then the strength gained will begin to be lost almost as soon as the exercise is stopped. Also, it won't support the knee, it will create further muscular imbalance between the hamstrings (muscles on the back of the thigh) and the quadriceps. Then there is the question of, if the thigh is weak, why is it weak? This is rarely asked. The fact is, all muscles in the body retain their natural strength unless there is nerve damage, forced immobility or muscle imbalance.  Muscle imbalance is the primary cause of knee pain, and if resolved any weakness in the quadriceps will resolve itself spontaneously. 


This treatment is very effective but often very uncomfortable. However, remember you are in charge of the discomfort and therefore it will never be more than you can bear.