Are you on a fitness journey in Tacoma and struggling with knee pain?
Then this knee pain blog post is for you.
Knee pain affects people of all ages. I've helped children as young as 5 years old with knee and leg pain with long-lasting results.
Here’s what you need to know.
Most people don’t know that exercise and knee pain go hand-in-hand. When we feel pain, we naturally think that rest is best, but pain is often caused by many things that exercise fixes.
Tacoma Personal Trainer explains personal training for knee pain evaluation
It can be scary to start or continue a fitness journey when you’re in pain. Which exercises are bad? Which are good? What’s too much? Too little? There is a lot to know, and an aggravated knee can be discouraging.
It’s counterintuitive to think that working out can improve joint pain, after all, it’s a joint, right? You’re not alone, if that’s how you feel. That’s why we offer personal training for knee pain. Sometimes you just need direction and the certainty of an organization that specializes in pain relief.
However, how do we know IF we should start?
Especially if we are in pain.
Whether you can squat without pain is NOT the evaluation we want to use to understand your knee pain.
Assessing Hip Range of Motion with Your Tacoma Personal Trainer - Foot Turning OUT= Hip Turning IN
Exercise helps knee pain, but not always. Before starting an exercise program for pain relief do the following:
Keep reading to understand why this is important for your personal trainer.
Most personal training clients that come to us have gotten X-rays, MRI’s, or been referred by doctors to try exercise to improve their knee joint condition.
If that’s the case you can skip this whole section.
If not, keep reading about your knee.
There are tests your Orthopedic Physician can do to make sure your knee isn’t moving too much.
If you have unexpected motion, your Doctor may determine you have a tear (usually accompanied by pain).
The ligaments around the knee, if torn, don’t regrow themselves.
If you have a tear, you can strengthen your muscles but you want to know WHERE the tear is.
This is called building “LIGAMENTOUS MUSCLE SUPPORT.”
Instability caused by the tear needs to be supported by the muscles around it and will have different tightness or weakness patterns.
Improper exercise or movements with a torn ligament or partially torn ligament can create more or greater knee pain.
The knee is a complex joint because it folds and straightens and also ROTATES. It rotates outward, called rotation out, and inward, called rotation in.
Watch the video to understand what that looks like:
INSERT LINK TO TACOMA PERSONAL TRAINER 2 SECRETS TO KNEE PAIN VIDEO
When the joint is missing rotation you can run into the following issues in your day-to-day life:
KNEE IS MISSING ROTATION OUT:
KNEE IS MISSING ROTATION IN:
EX: I helped a client whose knee would STICK after bending and trying to re-straighten.
He had pain/ locking in the outside of his hamstring.
By understanding what was locking the joint we were able to change the tension in the hamstring and he can bend the knee and unlock it without any challenges.
It’s important to understand where the pain is and what is happening AT the joint.
Your Private Personal Training program in Tacoma should focus on restoring the loss movement.
Pain itself comes from MANY different systems including:
Think of a trauma or injury as an X with a circle around it.
(Or watch the video on pain and compensations below)
TACOMA PERSONAL TRAINER EXPLAINS PAIN AND COMPENSATIONS
When an X changes a normal pattern, it stays there.
When another one occurs it overlays on top of the X.
It’s the same as having a kitchen counter and having ingredients on top of the counter.
EXAMPLE COMPENSATIONS CREATING STUCKNESS IN YOUR KITCHEN:
When you go to clean the counter it’s WEDGED.
It just feels “dirty”.
But it’s been a long history of muck.
Every old injury is like that.
Common list of old injuries we find pain and stiffness patterns with our Personal Training Clients :
Tracking and cleaning that out of the system can take some specialized intervention.
Having a comprehensive list helps your Tacoma Personal Trainer, therapist, or coach test and evaluate patterns and determine if something else is influencing the joint or perception of pain/ discomfort.
We will cover the big 3 of knee pain and how they affect your joints and muscles tissues below.
TAKING CONTROL OF KNEE PAIN BY UNDERSTANDING THE BIG 3
Understanding The Mechanical Part
If the main issue is the way the tissue is pulling on the body we could classify this as a “mechanical” issue.
Meaning the way the knee is moving itself is coming from a “physical” limitation.
EXAMPLES OF MECHANICAL KNEE PAIN IRRITATORS:
Hardware Installed In The Body
Metal or other material hardware installed in the body can pull and tether tissues causing inflammation, restriction, and sensitivity. These kinds of pulls can influence the rest of the body in a specific vector.
Spinal fusions, dental implants, breast tissue implants, stents, and gastric bypass bands are all examples of hardware installed in the body.
By inhibiting (changing a communication signal) of how the body speaks to the hardware location a practitioner can determine the impact of that area on the knee.
EX: A metal plate and screws installed in an ankle can pull and tighten tissues elsewhere in the body.
Rigidity causes stiffness and is a coping mechanism for false stability.
This inability to turn off a stiff structure in the body is known as “ hypertonicity”
A constantly “hypertonic” part of the body will experience overuse and pull the body into a constant direction to compensate.
If the plate was in the left leg the person could experience a right knee problem from the pulling of the left tension.
The hardware could create a bind or a tether.
The bind would stress tissues above and further away from it.
It’s important when addressing the human body and knee pain that we inspect hardware as they are “abnormal” the setup of the body.
Understanding how that is affecting the whole body as well as the knee joint is key to understanding which patterns, movements, or exercises are pulling on the connective tissue.
Bone Growths ( Calfications and/or Other)
Flexibility + Blood Supply
Overuse of a Joint
Bone Bending and Impact On Tissue
Bones have flexiblity and blood supply.
They are living, breathing pieces of tissue.
Without any give in the bones, they would actually shatter.
A gymnast is able to flip, spin and land because the bones can flex and return to “normal” without breaking.
Often when we think of bones, we think of them adapting to stress as in “wolf’s law”.
Which states the body will adapt to a stress given to it.
Many people associate that with thicker bone mass and calcification.
However that isn’t the only way the bones can adapt.
If you look at someone’s shin bones, you’ll realize they turn in, out, twist and swell.
Any ladies have a hard time fitting into “ boots’.
These aren’t increased calfications these are actually demands to pressure and stress.
Many times these have no obvious symptoms in those areas.
When we think about mechanical issues we want to look at how the “joint coupling” works.
In the fascial world, these kind of bone strains are known as “peristeum” strains, and the connective tissue being treated is a “deep bone” artery.
Easiest way to think of this is a person who does too many curls.
They may lose the ability to straighten their elbow because their bicep is “tight”.
However, they had full bone range of motion, yet no one can press their arm down now.
Did they “calcify” from curls?
No they exhausted the arteries feeding the bicep muscles and then had to create demands from the deeper arteries.
This cause the bone to bend to protect itself, however not a ‘permanent” bend at this point.
If the connective tissue is treated the bone will move back to its original state out of spasm.
When it comes to knee issues, long habits of bone twisting can not only cause the bones to go into spasm but the “joint coupling” to become very poor and can contribute to pain in the knee.
Bones spasm are high on this list because a flexed bone torques all tissue that connects to it.
Think about the body of an airplane and how it being bent would influence the window, wing angles, and the engines attached to the vessel.
Areas of Body Connective Tissue
Axis, Pathways and Neurovascular Reflex Arcs
Clearing Layers of Spasm Influences
This classification I refer to as any structure that is not the bone pulling it. The “rails” aren’t the issue but the items attached to the rail.
Body Connective Tissue :
To name a few.
You can check our Tacoma Massage Therapy Page for a detailed list and explanation of these different structures.
Any of these connective tissue structures can influence the mechanics of a joint.
These connective tissue types would require a different evaluation and different treatment.
As your body runs as a single organism, meaning that all the living tissues communicate with each other inside itself through what’s known as an “axis”.
They also communicate locally within themselves.
EX: If your knee has fluid stuck in it, you could experience “neurovascular” symptoms in the joint, because the inability for the vein to do it’s job correctly pressures the nerve.
If the space is reduced the pressure to the artery would also be modified.
Understanding how the different systems of the body interact with each other to produce function is vital for helping your knee.
It can be an “axis” issue or a local issue caused by a structure in the body not directly related to your symptoms.
It can also be multilayered ( remember the dirty kitchen counter top from earlier).
When looking for exercises and solutions for knee pain, we have to consider the layers of how the body operates instead of just looking at 1 joint.
Extensive research on scar tissue shows that it lays down in a random and chaotic way.
The medical term for this in the knee or other parts of the body is “cicatricial” tissue.
Scars can occur in different ways but the key is the “collagen” ( found in tendons, bones, ligaments, skin, and even hair follicles ) is thick and stops the needed regeneration of tissues.
When we have an injury the body is trying to plaque a hole as fast as possible.
It doesn’t lay down connective tissue in an orderly way.
The easiest way to think about this is if you have a home from the 1960s.
When you have old heavy, galvanized plumbing, the issue with changing the piping is the original weight and pressure of the system is set that way.
If it starts to erode, break, or have issues, just slapping a new piece in could imbalance the system.
Then you have to start replacing parts of your plumbing every year, or when there’s more pressure on the system.
When you have scar tissue it’s like your cells losing a highway that ran smoothly, quickly, and efficiently.
It can create lld fluid stuck in an area unable to drain
In primarily “mechanical” issues I refer to these as “hardware” problems.
Think like the beams, pillars, and physical parts of your house.
However, these don’t need to be “replaced”.
They can often be repaired or improved to help someone with knee pain.
SIGNALS
The nervous system is split into the Central Nervous System and the Peripheral Nervous System.
Think about these as brain-to-body functions like “breathing” and other unconscious functions.
Whether we realize it or not we are always processing ENORMOUS amounts of data at one time.
Your knee joint is impacted by these central engines that allow you to make decisions.
To be more specific in how we work with these, you can think about these as different processing engines of how the nervous system works and they keep a storage of how your knee should be functioning.
It’s easy to see how often we use these intricate systems to use something as “far away” as our knee joint.
During pain, trauma, or just day-to-day overuse we can overload these brain sections and the circuits causing dysregulated signaling.
Ensuring these circuits are running well with the knee is important to keeping the body and the knee joint running in proper order.
This brings us to the next step of nervous system automation which is the glands.
Chinese medicine and other research has found what’s called “ associated muscles”.
That means in neurological reflex testing these muscles have been found to respond to stimuli that organs do as well.
EX:
Constantly organ dysregulation can feed not only weakness, hypertonicity, but inflammation to the area.
As a Tacoma massage therapist, I used to be amazed at the hard areas of the body that never responded no matter how deep the pressure was or the techniques we would use.
You can’t massage out a glandular organ dysfunction related to a brain signal.
If you have re-occuring muscular issues, weakness, instability, or pain you may be dealing with a signal issue between the gland and the related muscle area..
Glands also relate to specific levels of the spine, a dysregulated gland can make a spinal segment unstable and recreate issues resulting in continued correction.
Diet can also play a role in the state of the gland and nutrition should be considered if a gland is found to be dysregulated.
Think about the Central as a TOP DOWN issue and the Peripheral as a “bottom down” issue.
EX CENTRAL - Head injury causing motor control issues in walking and problems with the knee joint
EX PERIPHERAL - Side Impact to the knee causing pain and stress on the joint causing continued knee pain.
These will store both centrally and peripherally in the brain but it’s important to be able to TEST for the difference in the two.
Reflexes like the “deep tendon reflex” pass up through the “sensory fibers” of the cord and are then translated to the brain.
However, it’s important to note that the body starts reacting to these signals before they reach the brain.
Think about how a Taser works.
A Taser is able to disable the communication system of the body BEFORE it even reaches the brain, working effectively to dysregulate the entire nervous system.
A reflex spinal pathway is the same way.
The body has reflex arcs built in to save itself from dealing with large amounts of data processing.
EX: If you are about to step on a rusty nail, the time it would take for your brain to process that pain through all the brain engines and pull your leg away would be too immense.
The body uses fast and slow pain reflex pathways known as “ nociceptive pathways”.
It’s interesting to note that the “slow pain” pathways are found in “chronic” pain situations, these are called “paleospinothalamic tracts.”
These negate with PRESSURE, which is 1 of the reasons why applying pressure, tape, or other tools helps with pain and is commonly used to help treat tendonitis or other overuse chronic injuries.
However, these reflex arcs can become dysregulated and stored permanently in the signals of the system.
This is especially common in knee pain situations that manifest with temperature changes like cold or hot as these are on specific pain pathways of the reflex arc.
Temperature: heat/ cold stimulus that creates pain in the knee
The signals of the body are deep, complex, and often misunderstood.
By sharing these teachings and training I’ve collected from doctors, neurosurgeons, physical therapists, chiropractors, osteopaths, acupuncturists, personal trainers, and researchers from around the world you’re likely starting to understand the layers to your knee pain and discomfort.
I hope this guide helps you understand the many layers of pain and dysfunction that could be causing your knee pain and how not only mechanical but signal-based pain from different systems and engines could be causing improper signaling to your knee.
Many times when hiring a personal trainer people think about getting STRONGER. However, the reality is that your knee pain could be caused by DIFFERENT KINDS OF WEAKNESS.
To understand that correctly we have to understand if all strength is appropriate, what a weakness signals to us, and think about how the muscles around your knee use strength to contact and interact with the floor.
Ex: If your quad muscles ( commonly thought of as knee extensors) can’t relax, they will squeeze your knee too tight all day. This can cause discomfort from walking or standing all day at work or during other activities.
We want the muscles surrounding your knee to be strong in the correct relationship, that relationship is how your neurological system should be using the muscles as well as the relationship required to walk, stand, and do normal functions.
THE 3 DIFFERENT KINDS OF STRENGTH AND WEAKNESS FOR YOUR KNEE
List of muscles that attach to your knee:
Quadriceps Muscle Group:
Hamstring Muscles:
Gastrocnemius:
Popliteus:
Iliotibial (IT) Band:
Sartorius:
Gracilis:
Popliteus:
Each of these muscles can be tested in a normal position to see if they are strong with no input.
This would help us rule out general muscle action strength or weakness to determine what function is or isn’t available.
If the muscle is weak, we would want to run through our earlier teachings:
After the video, you have an understanding that a test is just a signal and the pairing of tests give you the information you need to understand how knee pain is being influenced in your body.
Each of the standard tests can be done in 2 different ways.
1. Starting with increased length at the top of the body
2. Starting with increased length at the bottom of the body
You can watch the video for examples.
A muscle may test “ strong” in the middle position but when the signal is tested then show weak.
Some signal or issue with the connective tissue in the way it is pulled would be an indicator of needing to further investigate.
Once again using the following techniques but adding another:
Think of a movie studio motion capturing how people walk.
Slowing down every movement that creates the unique walking pattern a person has.
That is GAIT.
Hundreds of actions happen in a second so GAIT can be complex as well as hard to coach.
When we test a muscle for knee pain, we want to make sure that the muscle can be strong as well as turn off or the joint can’t move in the way it needs to for walking.
The way we can test this is 2 ways:
If a muscle can’t process a shut-off signal correctly it’s problematic for creating rotation.
Lack of rotation and turning off muscles impacts the body’s ability to move through walking.
SEE THE VIDEO TO UNDERSTAND HOW THIS WORKS
If this is the case, we need to figure out what is happening with the body holding that tissue in a state where it can’t relax.
In summary, looking at local muscle actions to determine how the knee joint is doing in a pain or stiffness situation as well as testing the lengthened position and normal brain functions can tell us a lot about what is happening in the knee.
Before moving into exercises and strengthening it is beneficial to understand how the nervous system is processing its relationship to using the knee.
We often find that when this isn’t taken into account, exercise programs or exercises are unsuccessful because the way the body uses the knee isn’t being taken into account.
The exercise can then cause increased dysfunction or stress to the knee rather than becoming a knee pain solution.
WRAPPING UP THE QUESTION: Should you start exercising with a Tacoma Personal Trainer for Knee pain?
If you’re looking at having a Tacoma personal trainer help you with your knee pain then you’re probably in 1 of 2 groups:
We have personal training clients in both categories and we get it.
You have a free license to use your body however you choose.
To have a high quality of life, use your joints the way they were meant to be used, and stay as injury-free as possible keep 3 things in mind.
OUR CHEAT SHEET KNEE PAIN CHECKLIST:
Get Fit. Stay Fit. Encourage Others.
Tacoma Personal Trainer + Tacoma Massage Therapist Isaac
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DO YOU WANT TO TALK MORE ABOUT YOUR HEALTH AND FITNESS GOALS?
Enter your name and contact information below and a team member will reach out to you.
DO YOU WANT TO TALK MORE ABOUT YOUR HEALTH AND FITNESS GOALS?
Enter your name and contact information below and a team member will reach out to you.
