3 Myths About Knee Pain (Have You Been Told These?)

3 Myths About Knee Pain (Have You Been Told These?)

3 Myths About Knee Pain (Have You Been Told These?)

Don’t Get Stuck On The Sidelines Because Of These Myths!

Knee pain is becoming a very common issue, especially with active adults who love to run, workout, or participate in their favorite boot camp classes.

Approximately 1 in 4 adults will experience knee pain that affects their ability to remain active, healthy, and fit. This can be a frustrating experience especially since many of the clients I work with tell me that they “just aren’t the same” if they miss out on their daily run or exercise routine.

Wouldn’t it be nice to go for that 5 mile run, participate in your favorite HIIT workout, or play your favorite sport without having to worry about your knee getting worse?

Having treated many fitness enthusiasts and runners I found that there were several myths that were floating around that actually were hindering their recovery. This often lead them to a delayed recovery and more time spent on the sideline.

By simply understanding these myths you can save time, money, and the FRUSTRATION of missing out on another 5k or enjoying a workout with your friends.

Myth # 1 Rest Is All You Need To Get Better (Hoping it Will JUST GO AWAY!)

Photo by Alexander Possingham on Unsplash

I know what your thinking…….don’t I need to rest to heal? Well the answer is YES! However it all depends on how you go about “resting”. While rest is needed for the body to heal naturally and correctly it is often done in an incorrect manner. Here’s  3 DO’s and Don’t about resting your injury.

  • Do’s

    • Rest in intervals. What does this mean? You may still be able to run 2x a week or workout 2x week but you will need to spend those other days in rest. Don’t keep aggravating the pain.
    • Shorten your exercise/run time. Run for shorter distances (before any pain is felt). Perform shorter workouts so you do not push into pain
    • Warm Up Before Don’t go into a workout or run COLD. Do some active warm ups. Maybe some high knees, butt kicks, Karaoke drill
  • Dont’s

    • Don’t rest for extended period of time (without taking any other action) hoping the pain will just go away. Usually pain occurs because there is some sort of strength, flexibility, or movement fault. Rest will not fix these issues
    • Don’t completely avoid activity. Sometimes it’s OK to feel a little sore in the knee after a run or workout out. It’s when this soreness turns into pain and lingers for 2+ days that it becomes an issue. Run 1 mile instead of 3. Squat 150Lb instead of 300Lb
    • Don’t take painkillers hoping it will go away. Painkillers only provide temporary relief and do not address the root cause of WHY you are experiencing your knee pain

Myth #2 Your MRI And Xray Tells You The Whole Story

Do you need an MRI for your low back pain or sciatica?

One of the most frustrating things for the clients I have worked with is that they have been led to believe (at no fault of their own) that whatever shows up on their MRI or Xray is the reason for their pain. Many times they are just given a diagnosis and no method of fixing their pain.

Here are some common statements I hear from people I have worked with:

  • “Nothing showed up on my MRI/XRAY but the pain is still there”
  • ” I was told I have chondromalacia and patella femoral pain syndrome”
  • “They just said I have a bone bruise and that it will go away”

The problem here is that these people were given a “diagnosis” just based off a picture. That fancy scan is just a picture that is STILL in time. It does not take into consideration different movements and activities that hurt your knee. So while the scan showed (or in some cases didn’t show) something it did not provide to reason as to WHY the pain is occurring.

This can lead to BIG problems when getting treatment because many clinicians will just treat based off what the MRI or XRAY shows and not take into effect the different deficits in muscle strength, flexibility, and faulty movement patterns.

In most cases of knee pain although the pain OCCURS in the knee it is not actually CAUSED by something in the knee. This is another reason why scans can be misleading because the cause of the pain often comes from the hip, pelvic ,and back region. The body needs to be “in balance” and when there is an area of the body that is “out of balance” it can then transfer excessive forces to the knee, thus causing pain.

Keep in mind that when I am speaking about knee pain and imaging I am referring to the type of knee pain that gradually occurs over the course of time (not the type of knee injury where something traumatic happens). The proper imaging is required if:

  • You hurt you knee during a sport or activity
  • You heard a pop or click in your knee when you injured it
  • There was swelling present in your knee after you injured it

Myth #3 Changing Your Shoes, Wearing A Brace , Getting Orthotics Will Fix the Problem

Photo by SJ Baren on Unsplash

One of the first “quick fixes” that people try is to change their shoes, wear a support, or get some orthotics/insert. This is often the quickest and cheapest way to go about trying to fix knee pain but often leads the user disappointed in the result.

This is not to say that shoes and orthotics/inserts AREN’T needed. It just means that there is more to the problem than just changing or adding to EXTERNAL factors. Now what do I mean by that? When dealing with knee pain there are usually internal factors that need to be addressed along with external factors.

Some examples of internal factors that needs to be addressed include:

  • Muscle Weakness
  • Lack of Flexibility/Mobility
  • Decreased stability

Some examples of external factors include:

  • Shoe wear
  • Shoe Inserts
  • Taping/brace

It’s important to know that external factors usually can bring about a temporary relief with knee pain as they do not address the underlying root cause. Permanent relief is achieved when the internal factors are addressed.

Treating and fixing knee pain usually involves addressing multiple components and multiple moving parts so be wary of any one product or device that promises to “fix” the issue permanently.

Right……So What Can You Do About Your Knee Pain?

The keys to treating and ending knee pain for GOOD involves these 3 steps:

  1. Proper assessment of how your body moves (i.e during walking, squat, jumping, running)
  2. Identify deficits in strength and flexibility in the body
  3. Modify your activity level so that the injured area is given proper rest (not JUST extended periods of rest though).

Worried and concerned about your knee pain? Are you unsure about how you will overcome this knee pain and return to your active lifestyle?

Ask about our FREE phone consultation. We’ll have simple discuss about your health and listen to how your knee problem is affecting your life. Then we’ll be able to help you come away with the best solution for you!

 

Fix Tight Hip Flexors (Without Stretching!)

Fix Tight Hip Flexors (Without Stretching!)

How To Fix Tight Hip Flexors (Without Stretching!)

Are you tired of stretching or rolling out tight hip flexors with no improvements? If you are a runner, weight lifter, or team sport athlete, chances are you have heard a teammate or friend complain about having “tight hip flexors”. Either that or you yourself have had to deal with the problem. The problem with these tight hip flexors is that people will stretch, stretch, and ……..stretch some more (until the cows come home) and get NO RELIEF. This keeps people in a perpetual cycle of ALWAYS stretching their tight hip flexor with no real permanent relief.  The cycle looks something like this:

  1. Roll/Mash a ball or foam roller into your hip flexor muscle until it “releases”
  2. Perform a hip flexor stretch that you found on YouTube or one that someone had shown you
  3. Repeated Step 1 and 2 with NO real results!

This leaves you frustrated and yes……….with consistently tight hip flexors.  A crucial step is often missed with trying to stretch away tightness or pain. Before anymore blame is placed on the hip flexor muscle, it needs to be properly assessed. Then after an assessment is performed you can determine what the right hip flexor exercise for you to do is.

Hip flexor anatomy

Let’s brush up on some hip flexor anatomy so that you can understand what exactly a hip flexor is and what it’s function is in the body. The Hip Flexors are actually a group of the following muscles: Hip tightness

  1. Iliopsoas (combination of psoas muscle and iliacus muscles)
  2. Rectus Femoris (part of your quadricep muscles)
  3. Tensor Fasciae Latae (sounds like a fancy drink)
  4. Note – There are other muscles that aid in hip flexion but for this article let’s focus on the main ones.

These muscles are all involved in the action of flexing the hip which is required during squatting, running, and playing sports. Something important to take note of here is that the psoas muscle (part of the iliopsoas) actually starts at the spine and runs down to the hip. It is considered to play a role in spinal stabilization. Common complaints include a pinch/sharp/tight sensation when getting down into a squat, pain in the front of the hip/thigh during running, or sensation of tightness when sitting for long periods of time.

How to test hip flexor flexibility

A simple and common test that can be used to determine whether or not you need to stretch your hip flexor is the Thomas Test. Follow the steps below:

  1. Lay at the edge of a table, mat or equivalent surface with your tailbone resting at the edge.
  2. Pull one knee to your chest and let the opposite leg hang down.
  3. See pictures below.

hip flexor

2. Leg parallel. No lack of flexibility. 

hip flexors

1. Leg in the air. There is lack of flexibility!

  Take note to see if the thigh rests down parallel to the ground (Picture 2) or if it stays up in the air (Picture 1) (You will need someone to be nearby to see what your leg does). Perform on both sides and compare. If the thigh does not stay raised up in the air then there is no true hip flexor tightness and stretching does not need to be performed. If one of the thigh/legs stays up noticeably higher than the other, then stretching will need to be performed. If your leg is able to hang down comfortably parallel to the ground or lower then you passed the test!

So what can cause hip flexor tightness if there’s no lack of flexibility?

As stated before, one of the primary hip flexor muscles is the psoas major. This muscle plays a role in core stabilization (something that is needed during running, squatting, and sitting) due to its attachment site at the spine. If there is a lack of core stability or poor movement patterns during these tasks then the hip flexor can become overworked/tired/fatigued (think what happens when your co workers or teammates don’t do their job, you have to pick up the slack and work harder, bringing you more stress and fatigue). It is when the hip flexor becomes fatigued that the sensation of tightness sets in. This is because the hip flexor has to “work harder” to compensate for other muscles not doing their job.

What can be done to alleviate this hip flexor tightness?

The first step that needs to be taken is to determine if the tightness is due to a true lack of flexibility (perform the Thomas test above) or if it is because of weakness in the muscle itself. Once that is determined you need to focus on reducing the tension felt in the hip flexor and improving core control/stability so that the issue does not return. As with any condition, the root cause must be found (the root cause is not often at the site of pain) in order to get long lasting relief. This is why so many people unfortunately have to deal with this issue for several months or even years…..because the root cause was never found and they were just given generic information to “open up the hips” or “just stretch more”. Below are some common exercises I like to give to patient’s to start out with to help alleviate this condition. (Please keep in mind that every individual patient has different needs but these exercises tend to work in MOST cases.) The first hip flexor exercise involves actually strengthening the hip flexor while focusing on a neutral spine for core stability.

  1. Wrap a band around your feet and lay on your back.
  2. Bring both knees in the air so hips are at 90 degrees.
  3. Maintain a neutral spine by keeping your back flat against the mat. DO NOT let your back arch up in the air.
  4. Now slowly straighten out your leg, return, and repeat to other side.
  5. Perform to fatigue of 20-30 reps for 2-3 sets 3x a week. (You can also perform for 1-2 minutes 2-3 sets if you don’t like counting.)
  6.  You will likely feel fatigue in your lower abdominals and the front of your hips.

Working on gluteal muscle strength (buttock muscles) can be beneficial to reduce hip flexor tightness. Working the glute muscles pulls the hip into extension (the opposite of flexion which is what the hip flexor does) and improves muscle balance at the hip. Increasing the strength of your gluteal muscles can help calm the hip flexor down and reduce the feeling of “tightness”.

  1. Lay on your back.
  2. Press affected leg heel into the ground and slowly lift hips into the air.
  3. As you lift your hips into the air, kick the opposite leg out and hold.
  4. Hold each lift 5-10 seconds for 10 reps on each side to start at 2 sets each. Perform 3-4x a week.

If you’ve been dealing with tightness in the hip flexors or hip flexor pain for quite some time now and haven’t found the solution, then give these exercises a try. You may be pleasantly surprised with the results! Want more information on Hip Pain? Download our Free Report on Hip Pain “5 Secrets About Hip Pain That Will Surprise You….And Help Get Your Back To Exercising/Running Pain Free” Click Here to Download This Free Hip Pain Report

Is It Ok To Feel Pain When Exercising?

Is It Ok To Feel Pain When Exercising?

Is Pain Ok During Exercise When Rehabbing An Injury?

Is It Ok To Feel Pain When Exercising? When enough is enough and how to tell when.So you’ve had back pain for quite some time and aren’t sure what to do. You’ve been dealing with it for months, or maybe even years, and it has kept you from enjoying the activities you love. You may have tried several treatments to improve your condition, but at times it seems difficult to understand your body and know if what you are doing is safe and good for you. Your doctor may have said you need more exercise, but exercise hurts and you aren’t sure where to start. Many people will begin an exercise program but stop short of completing it due to the increase in pain they feel either during or after it. There are several approaches to managing our pain, but first, we must understand what our body is telling us before we get any relief. Knowledge is important to reduce pain and fear.

“No Pain No Gain”

Often times people will begin an exercise regiment with the concept of  “no pain no gain”, thinking that if they push through the pain that it will go away. In reality what they find out is that their body cannot tolerate the amount of stress and load they are placing on it. In this approach, the person will push through the pain barrier. This pain barrier is present to protect our bodies. With multiple tries at this approach to make their pain go away, they will become overwhelmed with the failure and give up on exercise altogether because “it didn’t work”.  This will lead to further avoidance of activity. Example: You begin a walking program in hopes to improve blood flow and decrease stress. However, you walk too long to begin with (depending on your tolerance it could be 5 minutes or 20 minutes).  You then experience immense pain when you come home and cannot do any of your regular household chores. To no avail, you try again but with the same result, each time flaring up your condition with no improvement.

“If It Hurts Don’t Do It”

This approach will do more harm than good and can be characterized by avoiding any meaningful activity or exercise that can be beneficial to the body. It is often accompanied by fear, anxiety, and uncertainty about what might happen if “too much” activity occurs. You will become hypersensitive about any movements you perform and in turn, avoid the very movements that can help reduce your pain. Tolerance to activity and movements will decrease, limiting exercise and movement. But the key is that the body and tissues need to be stressed a little so they can adapt over time, which will allow for high tolerance for certain activities. Example: Having experienced pain during walking you decide that this exercise is bad for you and you may be fearful that it will continue to harm you.  However, this will not improve your body’s ability to perform certain activities and will decondition it further.

“Tease It, Touch It, Nudge It”

What does this entail you might ask? This approach is the happy medium between the prior two approaches. “No pain no gain” is too aggressive and “If it hurts don’t do it” is too passive. “Tease it, touch it, nudge it” lies in the middle of the prior approaches. It entails performing a specific exercise or certain tasks into a little discomfort. There will be some soreness and maybe an ache here or there, but this is necessary for the body to adapt to new thresholds of activity. Over time, as the task or exercise is performed, the body adapts to new activity levels. This will allow you to perform the exercise for longer periods of time or at heavier loads. You have successfully gradually improved your ability to perform tasks with less pain and at longer durations. Example: You decide to begin a walking regiment. Your first walk can last 6 minutes or whenever you start to feel some aching/soreness in your low back. You decide to not push through into further pain. That afternoon you have a noticeable soreness in your back as if “you have definitely worked it a little bit” but it doesn’t keep you from carrying on your chores and work for the day. This soreness or slight increase in pain would be a normal response to an appropriate amount of exercise. So do not fret if this is what you feel. You progressively add a minute to your walk and slowly build up your activity tolerance so that you can now walk 15 minutes without any pain. When dealing with pain it can be difficult to know what will benefit you and what will keep you in a state of persistent pain. Some important ideas to remember include: “hurt does not always equal harm” and “soreness is ok”.  In other words, you want to exercise, but not in the “no pain no gain” range and not in the “if it hurts don’t do it” range. Instead, your body will need a certain dosing of exercise all the while respecting the body and your pain. This will allow for you to begin tolerating other activities in your life that are normally painful. So the next time someone tells you “You just need to exercise”, they better have a good suggestion on what type of exercise will benefit you most!

Does Stretching Help Your Pain?

Does Stretching Help Your Pain?

Should You Stretch to Get Rid of Your Pain?   

  

Just keep “stretching”…….does that sound familiar? Often times it’s a phrase used when you have been seeing a medical professional for some kind of musculoskeletal pain and you haven’t seen the results that you’d like. You may have come across an article on the Internet or been given advice from a friend that tells you to “stretch” whatever body part is painful. There lies the problem though. Most of the time “stretching” just isn’t enough to solve your problem. Sure, it is a part of the solution (but most of the time its <10% of the solution!). Think about it for a second. When is the last time you had persistent pain and was able to “stretch out” the pain for it to go away (without it coming back).  That clinically doesn’t happen very often. I see it on the faces of frustrated individuals who are still in pain despite their persistent stretching. While stretching can help improve the flexibility of your muscles, it does not address underlying deficits in muscle strength, endurance, stability, and motor control (the ability of your muscles to move efficiently within a certain range).  Deficiencies in these areas are more likely the cause of your musculoskeletal pain and stretching does not help improve those deficiencies. For instance, those tight muscles you are “stretching” are often muscles that are tensing up because they are being “overworked” due to weakness in other surrounding muscles.                 Should You Stretch to Get Rid of Your Pain?    Let’s use an example of the “low back”. When you have muscles that constantly tighten up in your low back and you experience a “stiff” feeling, then that is likely due to weakness in the stability muscles of your back. Those stability muscles are not performing their job very well causing the muscles around them to work overtime. What happens when you yourself work overtime? You become tired, maybe a little irritable, and not pleasant (think about what your muscles go through!). Same goes for the neck. This day and age, with computers, the amount of people with neck pain has definitely spiked in numbers! One of the most common occurrences with neck pain is a feeling of tightness in the neck down into the shoulder area. Stretching won’t help this condition, at least not unless you address the weak muscles that aren’t doing their job of supporting the spine and other joints.

Does Stretching Work?

Now, by no means am I saying that stretching is bad for you or that you shouldn’t stretch. I am just discussing how stretching alone is often not the solution to your musculoskeletal pain. Many people who have come to see me say they have been through a “stretching” program and it hasn’t worked.  People often think of exercises as being a series of stretches, and while stretching is considered a form of exercise, it is certainly not the only form. There can be much confusion out there on what form of exercise can help decrease pain and get the body to move pain-free again. This is usually done with a combination of tactics including hands-on techniques to help relieve pain followed by strength and stability work on the muscles. Research supports comprehensive programs when it comes to addressing our pain. While stretching can be a component of these programs, it by no means should be the only form of exercise used to address your pain. It is important to be able to target the specific muscles, nerves, or tendons that may be causing your pain. This can be done with a proper assessment of the area where your discomfort is to determine the source. Then by figuring out what the source of the pain is you will be able to understand what type of exercise will be most appropriate for that specific problem. So if you have been in pain lately (maybe even for quite a while) I would ask, “has just ‘stretching’ been able to help solve your problem?”