1/13/2017 0 Comments
It’s not just any knee. It’s your knee. And when it hurts, you are not the YOU that you are meant to be.
Wouldn’t it be great to be like Clark Kent where you could step into a phone booth and immediately transform into Superman? Knee pain? What knee pain? When your knee is feeling great, you are unstoppable! You are once again the hero in your story.
Let’s get you pointed in the right direction and put a halt to your knee pain. Let’s get you back in your game and get you in shape to take on the world as only you can!
Allow me to be your guide. I’ve been a physical therapist for 25 years. And more importantly, I’ve had times when I too had knee pain that kept me out of the game. I used the tips I’ve outlined here for you, and they worked. Now I want to share with you the top 7 tips that put a halt to my knee pain and enabled me to get going again.
Ice is by far the best way to ease knee pain, especially within the first 3 days of an injury or onset of pain. If you miss that window immediately after the initial injury and now have a more chronic overuse injury, such as tendinitis, ice is really only helpful if you use it immediately after you re-aggravate the area. Apply the ice right after a run, practice, or especially active afternoon when your knee is aching or painful. If it’s a small area, use an ice massage. It’s as easy as grabbing an ice cube with a moist washcloth and rubbing the painful spot till its numb, usually within 3 to 5 minutes. For more general and diffuse knee pain, consider wrapping a cold pack on it for about 10 to 15 minutes. With an acute injury, you can ice as needed through the day with applications spaced an hour or two apart. With a more chronic injury, ice is only beneficial immediately after you re-aggravate that area, so you won’t ice as often throughout the day.
Even minimal knee swelling can be a problem. If it looks swollen, it is swollen. The knee joint is especially good at hiding swelling. If a third of the knee joint has swelling in it, it may not even be noticeable. So if swelling is visible, it’s really swollen! To offset swelling, spend time with your leg elevated by lying on your back with your leg propped on a stack of pillows. This coaxes swelling back into circulation to be drained out of your system. To aid this, pump your ankle back and forth, as though you are pushing and releasing the accelerator on your car. This activates the calf muscle to help pump out some of the extra fluid. You can also activate your thigh and butt muscles by contracting them and holding the contraction for 5 seconds. Repeat a few times here and there while you rest with your leg elevated for 10 to 15 minutes at a time. If the swelling continues, consider going online or to your local running or sport shop and purchase a knee-high compression running sock. This type of sock works much better than an ACE wrap, as the tensile strength of elastic fibers in the sock are such that they are in a uniform gradient, tighter at the bottom that the top, to keep swelling from settling in your lower leg.
Rest it Right
Isn’t rest . . . rest? Not these days. A sports approach to rest is what we call “specific rest.” It’s giving your knee time to heal, without taking a prolonged vacation from activity. Respect your knee symptoms, but don’t fear them. If it hurts or feels loose when you pivot in one direction, avoid that for a few days, but try biking, swimming, or walking on more even paths. Focus on getting out and doing your normal activities as best you can. If golfing, hiking, and workouts seem over the top right now, that’s okay. But don’t plant yourself on the couch and throw up your hands. Instead, choose some of the items on this list to reduce inflammation, get moving, and keep your muscles activated. As symptoms ease, begin to add in the higher level activities you enjoy. Think of this step in the process as an “active recovery,” where you are an active participant in your life. Activity helps with circulation and the release of anti-stress hormones into your system which will speed up the healing process.
Get it Moving
Now is the time to start regaining movement in your knee. When it’s swollen, you’ll likely feel tight when you try to fully bend your knee. Don’t force it. Instead, do some gentle heel slides: Wear a sock and lie on your back on a smooth surface, such as on your bed or couch. Begin to draw your heel along the surface toward you as you allow your knee to bend. Now slide your foot away from you until your knee straightens. Repeat 20 to 30 times and do this several times a day. You can also do this with your legs elevated on an exercise ball, moving the ball back and forth. Another important structure to keep loose is the knee cap: Just hold on to it and move it up, down, and from side to side. Do a few of these before or after doing your heel slide exercise. You can also try riding a stationary bike to loosen the knee joint. If you cannot get all the way around, just go in a half-moon motion from front to back, giving it a little stretch at both ends of the movement.
Activate Key Muscles
When the hurt is on, muscles that support the knee joint may stop working right. Some of these key muscles can actually shut off and start to shrink, known as atrophy, in as little as 24 hours. Knowing this, it’s vital to keep these nearby muscles active while you heal up. One is the inside thigh muscle, the VMO (Vastus Medialis Oblique). While seated and with your leg out in front of you, put a hand toward the end of your thigh. Now slide your head downward along the inside of your thigh until you are just above the knee. With your hand there, gradually make the muscle tighten so you feel it under your hand. You want to feel the inside quad muscle (VMO) tighten at about the same time as the rest of the muscle at the top and outer thigh. To help it work even better, imagine lifting your foot off the ground, while keeping the knee on the ground, or put a rolled up washcloth under the knee and press the back of the knee down into it. Hold 5 to 10 seconds, and repeat 5 times. Do this often during the day. The gluteals can sometimes shut off too. Try tightening your buttocks and holding the contraction similar to what you did with the quad. You can do this in any position throughout the day.
Knee Joint Connected to the . . .
Knee pain often is related to nearby joints being too weak or stiff, particularly the hip and the ankle joints. It’s important early on to do exercises that target these nearby joints to help strengthen the muscles crossing the knee. With any exercise you do, be sure to keep your limbs lined up. Put equal weight on the ball and heel as well as both edges of your foot. Align your knee over your second toe. Practice this as you do a bridge exercise. Here’s how. Lie on your back with your knees bent and with everything lined up. Keep your pelvis square and strong as you begin to raise your hips off the mat. Hold for 5 seconds. Then slowly lower your hips back to the mat. Do 5 or 10 at a time. The bridge exercise helps activate your gluteals, quadriceps, hamstrings, and core muscles. You can place a ball between your inner thighs if you are having trouble staying lined up. When you can do this without pain, try a supported wall squat. All you need to do is lean back against the wall. Again, get everything lined up, and slowly slide your back down the wall as far as you can comfortably while holding good alignment. Hold for 5 seconds, then stand back up and repeat.
Get the Right Help
Sometimes even superheroes need a power source outside themselves. At Alpine Physical Therapy, we know that. We’ve helped thousands of them, just like you. We have a core team of physical therapists who know what it takes to help resolve knee pain. But we don’t stop there. Instead, as your pain eases, we’ll work with you to ramp up your knee function to an entirely new level. Whether it’s getting you back to where you can reach down and lift up your kids, resume a workout program, hit the ski slopes, or get you back to competitive sport, we’re here to help.
There really isn’t a faster way to end knee pain than by working with a knowledgeable, hands-on physical therapist. Doing so means you get the fastest access to care that will soothe and relax your knee, while also maximizing your strength so you can get back to saving the world . . . or to whatever else a hero like you needs to accomplish.
Combine these 7 tips with a visit to one of our expert hands-on physical therapists, and you’ll see and feel the difference. It’s your knee. You are the hero. Let Alpine release your inner hero and get you back in the game!
Call us at 406-251-2323 for more information, to set up a free 15-minute consultation with one of our physical therapists, or to schedule your evaluation by one of our sport specialist physical therapists. And visit our website for more information by clicking here.
Brent Dodge is the founding owner of Alpine Physical Therapy and is a board certified orthopedic specialist. He holds additional certifications in Functional Dry Needling, Manual Physical Therapy, and Strength and Conditioning.
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