"A point that pivots by degree
is how one best describes the knee,
but the more we look, the more we'll see
the simplest form's complexity!"
Knees are tricky things. But you wouldn't know it to look at them. I mean, on the outside, they look like nothing more than just a big hinge. But when there's a problem with that 'hinge', your whole life can change. Stair climbing, walking outdoors, even getting up out of a chair becomes a chore, and an uncomfortable one at that!
So let's talk about your knee ... shall we?
For those of you with an appreciation for mechanics, your knee is your basic class C lever.
In the case of your knee, the hinge is where your femur (your thigh bone) meets the two bones just below it (the tibia and the fibula). This hinge is protected in the front by the knee cap (your patella). And the whole assembly is cushioned by a 'shock absorber' (your meniscus) and held together by a series of ligaments, which criss-cross and wrap around the juncture so as to be able to accept force from any number of directions.
And powering this lever... this hinge... are your body's most powerful muscle groups: the 'Quads' (vastus lateralis, medialis, longissimus and rectus femoris) and the 'Hamstrings' (biceps femoris).
You Don't Need to Know That for the Test!
But the reason I point all this out, is because if you have knee pain, it can be caused by a lot of things. Yes, you could have a torn meniscus, or a strained ACL or PCL (ligaments inside the knee joint), which are very serious injuries that should be looked at by those much more knowledgeable and qualified than yours truly. BUT ...
...sometimes it's a problem with the two muscle groups previously mentioned. Sometimes (but not always) the ache you are feeling in and around the knee cap is the result of trigger-points in either the quads or the hamstrings.
This is because the attachment sites for the muscles that bend your lower leg are all in the knee area. Even the IT-band (powered by the small muscle- tensor fascia latte) attaches down at the knee. So any tightness in these muscles will transfer right to the knee, sometimes mimicking a much worse condition.
Some Things to Look For
f you have an injury to the meniscus or any of the ligaments (the ACL, the PCL, the LCL, etc.) you'll almost always experience swelling. That's the first clue for you to bypass me and go straight to your friendly neighborhood doctor's office, where you will then be guided to the department of the x-ray and MRI department. (Really, these are great tools, and it's worth knowing exactly what you're dealing with!)
Another good indicator is if it feels worse the more you use it. Like, if you rest it for a while, and it starts to feel better, but then, as soon as you attempt to put weight on it, it sends a sharp signal to your brain which, being interpreted, means "No Friggin' Way, Jose'!". Again, make an appointment with your doctor and have it checked out. Even if it's NOT a serious injury, it's always best to rule that out before trying alternative treatments. And if it IS a serious injury, well ... as much as I'm not a huge fan of surgery ... sometimes it's all you can do, especially in the case of torn soft-tissue(s) within the knee.
When a Negative is a Positive
The best scenario is when someone comes to me and says, "Well, they ran all the tests, and everything came back negative! There's no tears in the meniscus, there's no tears in the ligaments, everything showed up 'fine'! So now what?"
"Now," says I, "we explore the quads, the hamstrings and the IT band ... which is the easiest way to repair knee pain." Usually the problem isn't scar tissue as much as it is trigger-points. First, we'll locate the offending fibres within the belly of the muscle. Then, by using STR (soft tissue release) techniques, we'll work on opening the trigger-point(s), thereby reducing the amount of tension on the attachment site of the muscle (which also happens to be where the nociceptor, or specialized-pain-nerve is), thus restoring full range of motion to the 'hinge'.
Tada! It's that simple!
Well ... sometimes it's that simple. Other times it takes three to five sessions to get everything opened up, depending on the severity of the condition, and how long it's been like that. For example, a problem that just started showing up last week will be much easier to remedy than one that's been there for ... oh ... say 'since Hector was a pup'!
Success is sweet!
I've had athletes, especially runners, come to me with knee pain, fearing the worse. "Am I gonna need surgery? Am I going to be able to run in the 5k next month? Am I gonna die?!" My answer to those questions is, respectively ... "Probably not. Hopefully. And definitely... but hopefully no time soon!"
I'm thinking of three cases in particular, all within the past year, where the clients (two males, one female) experienced full recovery simply by releasing the trigger points in the quads and biceps. No pain meds. No injections. No surgery. Just good old fashioned logic and body work. (Man, I love my job!)
"So if there's pain down in your knee
the cause may not be plain to see.
Don't wait 'til you're in agony-
bring your troubled knee to me!"