Knee Pain in Happy Valley

Why does my knee hurt?

Knee pain can be the result of many possible factors including fractures, sprains, strains, tears, and degenerative changes. Symptoms will vary based on the underlying reason but may include swelling, tenderness, limited motion or stiffness, weakness, and reduced ability to bear weight on that leg.

Mechanisms of knee injuries can be from a sudden or longstanding mechanical overload. Sudden mechanical stress would include events such as: twisting while moving, falling, impact in sport/recreation, or car accidents. Gradual overload injuries are typically associated with changes in your physical activity level/demands without adequate recovery time such as: a new training program, starting a new sport, changes in running volume/intensity, or going on a long/vigorous hike.

Many knee injuries can be boiled down to a common denominator of abnormal knee mechanics as a result of functionally weak hips placing unnatural stress through your knee.

How abnormal mechanics can create problems –

When your knee becomes symptomatic, your body will attempt to minimize the symptoms through compensation patterns. In the short term, these can be advantageous for preventing further damage, but can cause overuse injuries to the compensating muscles and joints. With the prolonged change in motor pattern, you will see an overdevelopment of strength in the compensating leg and atrophy in the injured leg. An increasing asymmetry of mechanics can be difficult to correct once the injured leg stops hurting. This is when nagging injuries begin to creep up and a pain cycle is formed.

If you’re standing, try turning your knee side to side. This motion is all driven from your hips! You can place your hands on your hips to feel the muscles working. Functional weakness of the hips can be observed if your knees move inward (toward each other) during squatting. This movement pattern can leave you at a much higher risk of general knee injuries but particularly for ACL tears and arthritis. This is sometimes referred to as “genu valgus” or “knee valgus”.

How can I find out what’s causing my pain?

Many times, our patients have seen their primary care provider already and have a working diagnosis. During your examination by one of our therapists, we will still perform a thorough examination to assist in confirming or offering an alternative mechanism.

Information used to determine what is causing your knee pain may include:

  • Where on your knee does it hurt?
  • When does your pain occur?
  • Did you experience a tearing or popping?
  • Does your knee get stuck or click, like hitting a speed bump, when moving?
  • Does going up or down stairs increase your knee pain?
  • Does sitting for an extended period of time increase your knee pain?
  • Did you have any diagnostic imaging completed, such as, X-rays or MRI?

In addition to the prior information, your physical therapist will also assess physical parameters:

  • Range of motion / flexibility
  • Strength
  • Body mechanics
  • Palpation of knee structures
  • Stability

Can Physical Therapy help?

Physical therapy can assist in most cases of knee pain. However, some situations will call for a surgical intervention to regain full prior function –

  • ACL tear
  • PCL tear
  • Moderate to severe meniscus tear

In these unfortunate situations, seeing one of our doctors of physical therapy for pre-operative range of motion and strength improvements can facilitate faster recoveries after your surgery. Sometimes surgery is not necessary for these situations, depending on your long-term goals. If your planning on returning to an active lifestyle including sport participation – you’re going to want to have your ACL reconstructed – but if you just like to go for walks and don’t have any sensations of “giving out” or “buckling” you would be categorized as a “coper”. Similarly, with mild meniscus tears or damage, physical therapy has been shown to be just as effective in long term outcomes as surgery and without the risks.

Aside from the aforementioned situations, we will be able to assist you in correcting the underlying dysfunction that has been causing your knee pain and restore your prior ability levels.

Knee Pain Prevention

We’ve compiled an overview of strategies we use at Ascent Physical Therapy to prevent knee pain from starting and/or returning.

Glutes!

Working on increasing your strength and control of your butt can give your knees some serious TLC. The muscles around the hip control the twisting motion that is experienced at the knee. Twisting under load is one of the most common mechanisms for knee injury. A good starting point for exercises would be: bridges, squats, and step-ups.

Mobility & Flexibility!

Tight and stiff muscles through your hips to your ankles can contribute to unusual strain at your knee, increasing likelihood of injury. Participating in calisthenics can ensure your muscles stay balanced and supple. Just be sure to perform dynamic warmups before an activity and static stretching after your activity.

Core Control!

Your core refers to the muscles between your ribs and pelvis which dictate trunk motion and positioning. What does that have to do with my knees though? Great question! Our bodies are incredibly integrated biomechanically. We’ve already discussed how your hips control a large portion of twisting motion through your knee. Try standing up and take note how your posture is and where your knees are. Now round your back with poor posture and notice how your knees will drift inward, and then correct when you stand back up! Being in a ‘neutral’ spine during activities can help reduce any extra strain in your knees (and back) to prevent injuries. Front and side planks are excellent exercises to help with this!

Size Matters!

Having a sedentary lifestyle can lead to gains in weight. The growth in our size leads to disproportionate increases in strain through your knees. While BMI is not always an accurate reflection of health, it is a good indicator of plain size. Having a higher BMI increases likelihood of developing arthritis. And contrary to some old-school beliefs, running and resistance training actually decrease your risk of developing knee arthritis! Talk to your primary care provider or physical therapist if you are struggling to reach or maintain a healthy weight!

What’re Those On Your Feet?

High heels, while fashionable, place an incredible burden on your knees, ankles, and feet. They can increase pressure within your knees by up to 23%! Aim for shoes with a lower heel profile if possible, especially for prolonged wear. It’s also a good idea to replace your shoes if they are beginning to get worn out and less supportive. You may read advice suggesting to replace your shoes every 300-500 miles but the bottom line is how YOU feel while using them. Here are some quick tips on when to switch out your kicks:

  • Damage on the exterior of your shoe such as holes
  • Tread is bald or very worn down, patchy
  • You begin noticing increasingly more aches and pains without changes to your workouts
  • Go to a shoe store and try on a new pair of the same shoes. If they feel noticeably better, it’s probably time.

Sometimes replacing the insole of your shoe is enough to make them feel new again!
If knee pain has been interfering with your life, call us today to get started on a plan of care that works for you. Ascent Physical Therapy is conveniently located off Sunnyside Road in Happy Valley. We also love treating our neighboring communities of Damascus, Gresham, Clackamas, and Sandy at our top rated physical therapy clinic!