Defining Knee pain - by Brent Dodge

All too often, I hear patients tell me that the pain in their knee must be from arthritis. Then they explain what makes their pain worse, which often defines that their pain is not from arthritis but more likely from other causes. For example, I got a letter from my cousin, who was told her knee pain was from arthritis. After she explained her symptoms, it was clear she was dealing with the pain from a knee cap issue . . . and not solely from knee arthritis.

Here’s what my cousin emailed to me:

I was wondering if you can recommend something for my knee. I have been diagnosed with early stages of arthritis. It has been bugging me for over two years, and now it hurts to go down stairs. I have been doing a lot of hiking and have lost thirty pounds hoping that would help! Are there any exercises, supplements, or a brace that will help heal or prevent more issues?

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Here’s my reply:
From what you’re telling me about your symptoms, I get the feeling the issue isn’t arthritis but more likely a knee cap tracking issue (called Patellofemoral Tracking Dysfunction). This can be easily corrected with a special sleeve that you wear on your knee called a “patellofemoral brace.”

If I’m right, and you were able to get the right help (to include a knee brace like I mentioned), you’d likely be able to resume your activities without pain. From a clinical standpoint, the exercises are a bit complex to describe in an email. Let me point you in the direction of two documents. One is on knee cap problems. The other is on knee arthritis.

Read through them, and let me know which seems to fit your situation the best. The approaches are quite different for the two conditions.

1. Knee cap problems
2. Knee osteoarthritis

Once I know your answer as to which one fits the best, I will be better able to guide you.

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Her reply after reading these two articles made it clear that her pain was coming from problems with her knee cap. Along with having her increase fish oil intake to 2,000 mg per day, I advised her to purchase a Kuhl Shields knee brace.

​To order one online, Google Kuhl Knee Brace.” You’ll then need to measure the circumference of your knee by putting a dot on the middle of your knee cap. Wrap a soft tape measure all the way around your knee. If it’s 12 to 14 inches around, order a small. If it’s a 14 to 16 inches, you’ll need to order a medium. For 16 to 18 inches, you need a large. And for 18 to 20 inches, order an XL. You don’t need to specify left or right. They are interchangeable from left to right. Wear the brace during heavier activities, such as hiking, mowing the lawn, or doing any other form of climbing. It is also advisable that you work with physical therapist to gain instruction on specific exercises that can speed recovery from knee pain.