Knee pain is a common presentation at my clinic and it is my favourite part of the body to treat. The early years of my career were spent working exclusively with cyclists and triathletes. Endurance sports are highly repetitive and overuse injuries are common. A cyclist or runner exercising for just one hour will flex and extend each of their knees more than 5,000 times. An athlete competing in an long distance event like the Melbourne to Warnambool bike race will flex each knee around 40,000 times throughout the race, that's an awful lot of repetition if your knees are not running smoothly.
'Although the knee itself is may not be the cause of the problem, it is often the "weak link" in the lower limb where pain and discomfort comes to the fore.'
Patello-femoral pain syndrome and ITB friction syndrome are the common overuse knee complaints that I treat, both are often caused by dysfunction around the pelvis or lower back and are often associated with a muscular imbalance in the legs, leading to poor knee biomechanics and debilitating pain.
The prognosis for people with these sort of injuries is generally pretty good. Sometimes pain can be alleviated in a single session, other times more stubborn knees may treatment for a couple of months before the individual can resume a full training load.
'When it comes to treating elite athletes there are a few tricks that I can use to get training resumed as early as possible.'
I will often teach athletes to use a combination of knee strapping and specific corrective exercises which are used to help self-manage the problem. Strapping is generally not a long term fix for knee pain but sometimes it's all that is required to enable the athlete to start moving comfortably again.
I also deal with severe knee injuries like ACL tears and those requiring post-surgical rehabilitation. These acute injuries require a collaborative treatment plan combining consultations with physiotherapists, exercise physiologists and sports/myotherapists all playing their part in the rehab process. In these instances it's my job to do a lot of the manual soft-tissue work and monitor the patient's recovery process.
The final type of knee that I see regularly are those that require long-term, ongoing management. The patients are often in older age brackets or suffer from degenerative bone conditions such as arthritis.
'My goal when working with these type of knees is generally to make the best of a bad situation.'
Managing pain, increasing mobility and maintaining knee function to delay or prevent the need for serious orthopaedic surgeries like knee replacements and arthroscopy. Ultimately however, many of these patients will end up on the surgeon's table when pain and function become too painful or restrictive.
Modalities such as massage, joint mobilisation, exercise prescription, nutrition, and strapping can all play an important role in the management of knee pain. If you suffer from painful or uncomfortable knees during exercise, I recommend you pop in to one of my clinics for an initial assessment to discuss the best way forward for you to keep your knees healthy for longer.