Many of our patients admit that knee pain has a big impact on their lives, making it hard to cope with the simplest day-to-day activities such as climbing stairs, walking the dog or even standing up from a sitting position.
Why do knee pain sufferers experience pain when performing these specific activities? What is the best way to cope with knee pain in the short- and long-run?
Two reasons we experience knee pain
We experience knee pain while performing simple day-to-day activities due to two main factors:
- Load on the joints – The weight of the body and forces of the muscles acting on and around the joints put pressure on areas that can get sensitive and painful either due to wear-and-tear or injury. When you engage in daily activities such as climbing the stairs or going for a walk, the knee has to support the weight of the body while moving through the different phases of each step. Additionally, the muscles moving and controlling the knee also increase the compression inside the joint.
- Poor neuromuscular control – When we talk about neuromuscular control, we’re talking about the brain’s ability to, one, sense the body and understand where each limb is and the movements it performs at any given moment and, two, orchestrate the muscles to control each part of the body in a coordinated manner. Obviously good neuromuscular control requires reasonable muscle strength and coordination.
Factors that can exacerbate knee pain
When you are going up or down the stairs or walking, each knee has to carry the full weight of the body as you move your other leg to the next step.
If the knee is malaligned (for example, if one has bowed knees or knock knees), there is an increased load on one part of the joint. As the knee alignment has been that way for a long time, the part of the knee that has the increased load is more likely to become degenerated and painful. The more that part of the knee becomes degenerated, the more severe the malalignment becomes. The more severe the malalignment, the greater the load that part of the knee has to put up with – and then, presto, more pain…
In addition to the above, when the knee starts hurting, the body becomes protective of it and—as an emergency protective measure—tells the muscles around it to brace. Long-term, this ‘bracing’ disrupts the neuromuscular control and also further increases the load on the knee.
Sounds terrible? There is actually a lot you can do to improve your pain.
Ways to cope with knee pain – short term
Here are a few things you can do to ease your knee pain that, although they probably won’t fix the problem, can help you get through the day a little better.
- Going up stairs – lead with your less painful knee.
- Going down stairs – lead with your more painful knee.
Note: There is a useful way to remember which leg to lead with: “good leg to heaven, bad leg to hell.” So when you’re going up, lead with the ‘good’ leg, when you go down ‘to hell,’ so to speak, lead with the ‘bad’ leg.
- Getting up from a chair – place the foot of the more painful knee slightly in front of the other. That way, the painful knee will have to handle less of the effort and load.
- Stay active – despite the pain. We don’t mean that you should go for a walk with tears in your eyes. However, if the pain is mild, studies have shown that activities with a reasonable amount of pain can help maintain better muscle strength and control over the knee. Perhaps even more importantly, studies show that physical activity and exercise can be AS EFFECTIVE as anti-inflammatory drugs. Obviously, exercise can have other “side effects” such as weight loss, reduced risks for diabetes and heart trouble, etc.
- Ice your knee for 10-15 minutes – if you have been active and your knee pain has increased. Make sure to use a thin towel between the ice and your skin. If you know you are going to be very active or are planning a vacation use a soft knee brace for the more demanding activities.
Treatment of knee pain – long-term
To find lasting pain relief, you need to address the two main factors which are causing it, joint overload and poor neuromuscular control (as described in the first part of the blog). Non-invasive ways of doing so include physical therapy and AposTherapy®.
Surgery is another option, and although it does not directly address both issues, can also be a major help for the right patient at the right time. However, in order to optimize the results of surgery, it can be a good idea to use non-invasive therapies such as physical therapy or AposTherapy®.