Knee Pain

You’ve probably used the RICE acronym before for your joint pain. While this may have felt good in the short-term, it probably wasn’t the best option for your pain. Why? Because there are little to no musculoskeletal disorders where rest is recommended. And NSAIDs or a steroid injection may help in the case of acute inflammation, but the underlying cause of your knee pain was not actually addressed. Instead, try the conveniently named MOVE acronym (Movement, Options for cross-training, Vary rehabilitation with strength, balance, and agility, and Ease back into activity for emotional strength). Get back to doing the things you love by easing back into them.

Not necessarily. Unless you had a direct injury to the knee, then the knee is often not the culprit. The regional interdependence model (when used in the evaluation of a physical therapy patient) helps determine a cause of pain in one location of the body due to dysfunction in another (often non-painful) part of the body. That’s why our Doctors of Physical Therapy not only examine your knee but also examine your foot, ankle, hip, and even lumbar spine. There is a relationship between lack of hip strength and knee pain. Will we treat your knee if you have knee pain? Of course. But we’ll also improve the strength or mobility at other areas of your body so your knee stops taking the brunt of it all.

In short…NO! While there is an increased “stress” on the patellofemoral joint as the knee bends, the tensile strength of the patellar tendon far exceeds what studies have shown the stress of squatting up to 2.5 times your body weight places on the joint. In fact, if you “force” your body to squat while keeping your knees behind your toes, you’re actually going to place more stress on your spine than anywhere else (where you don’t have large muscles like your quadriceps, hamstrings, and glutes to help stabilize). Yes, everyone is built differently, and sometimes modifications need to be made to accommodate specific body types, but in general, it’s safe to let your knees pass your toes when you squat and lunge. Otherwise, how else are you going to do down stairs?

You do NOT need surgery for a meniscus tear, especially for “chronic, degenerative” meniscus tears. Studies have compared “sham surgery” (going under anesthesia but not actually having surgery) and actual meniscectomy and showed no significant difference in pain in the short term and NO evidence for use of surgery in the long term (2 years). So why undergo the surgery? Even if you have what are called, “mechanical symptoms” (your knee catching or locking), there is still no support for having surgery. And here’s a dirty little secret: a high majority of studies that “support” surgery compared to conservative treatment don’t actually include physical therapy as conservative treatment. Now, there is some evidence to support surgery in the case of an acute, LARGE meniscus tear. But for “chronic, degenerative” tears that even have “mechanical symptoms?” Physical therapy is the answer.

Not exactly. Does a total knee replacement change the biomechanics of your knee? Yes. But can you return to your “sporting days?” It is well within the realm of possibility. Research shows that some people can get back to playing tennis 3 days per week after total knee replacement. But there are a few hurdles (no pun intended) you need to overcome. Generally speaking, the advice of no “impact” activities after total knee replacement has been more of a surgical precaution based on theory rather than any evidence. The main factors in returning to sports after total knee replacement are a significant decrease in pain, obtaining full range of motion, demonstrating no loss in balance, and your experience level in that sport before the surgery. Aren’t so sure? Check out this story about returning to CrossFit after a total knee replacement…and then schedule an appointment with our Doctors of Physical Therapy who are also certified USA Weightlifting Coaches.