I've often said that barring direct injury, arthritis, or an old injury/surgery, that knee pain doesn't come from the knee. It is often from either problems with the foot/ankle, or the hip/pelvis. Problems or dysfunction in those areas can create an altered gait, tight/over-active muscles, weak muscles, and trigger points responsible for referring pain to the knee directly.

The muscles originating from the pelvis include the hamstrings, quads, adductors (inside of the thigh/groin), and the muscles joining at the illiotibial band (or IT band) on the outside of the thigh. Together these muscles work to both move the knee, and stabilize it as guide wires on a circus tent pole. Any dysfunction of movement at the hip or pelvis will alter the balance of these muscles, and therefore the function/stability of the knee itself. This can create pain and needless wear and tear on the knee.

As for the foot/ankle, it is literally the base for what the rest of our body stands on. Whatever dysfunction is present there will be translated through the kinetic chain up the leg and into the rest of our bodies.

So what can you do at home to relieve knee pain? There are two things that you can do on your own: roll and stretch.

Foam rollers have gained popularity in recent years and for good reason, they are extremely effective at breaking up muscle knots, trigger point, and other dysfunctional tissue. They are easy to use, and you can target any area of the body on your own. Typically, you sit on the roller perpendicularly and with your hands on the ground as support, roll across the ground so that the roller massages the tissues.

Following a workout, or later in the day (you want to allow the muscles to warm up prior to rolling) roll out the quads, hamstrings, glutes, calves, muscles of the shins, and every other area you can roll over that feels tight or sore. This is not a comfortable process. In fact, when you find a spot that especially hurts, hover over that area for 15-30 seconds. This helps break up those sore spots and they will begin to resolve.

Following the rolling, make sure that you stretch each area rolled for 15-30 seconds. The rolling process breaks up tissue in the areas targeted, and to ensure proper remodeling of new tissue, the stretching is critically important. Otherwise, the problems may persist.

If after 3-7 days of repeating this process every other day, the problems still persist, it is time to visit a sports medicine physician. We can diagnose the problem to target the proper tissues and joints, and enact a plan to resolve the problem.

For cyclists and runners, you may be tempted to get a professional bike fit or shoe fit. I would strongly recommend against this prior to having the problem evaluated and addressed by a sports physician. Fits are necessary, but if you do not correct the body's dysfunction, then you are fitting to a body that is not functioning ideally. You do not want a bike or shoe that encourages your dysfunction!

Try these at-home steps first as long as the pain is not severe. Hopefully we will not have to see you in the office, but if we do, knee pain is something that we successfully treat regularly at Evergreen Spine & Sports Medicine.   

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