Freedom From Knee Pain Chicago: Physical Therapy as a Permanent Solution
The human knee is one of the most impressive pieces of living machinery in the human body. Designed to absorb impact, provide balance, and generate motion, we use our knees from the day we start crawling until the day that we die. This level of ongoing use can lead to accumulated wear and tear on the joints and cartilage, or even direct damage through injuries.
DIFFERENT TYPES OF KNEE PAIN
Knee pain can range from moderately uncomfortable to severe and debilitating. Sometimes it is an acute issue, perhaps caused by an injury, but other times it is a chronic problem that will continue to degenerate over time. At its worst this type of joint pain can prevent you from spending time with your friends or loved ones, engaging in the activities that you most enjoy, or maintaining a healthy lifestyle. In a city like Chicago, knee pain can make getting around exceptionally challenging, and simple things like navigating stairs or sitting in a cab can become excruciatingly painful. A course of physical therapy, performed by one of our licensed medical specialists, can be the most effective treatment method for finding relief from the agony of chronic knee pain and helping you get back to living your normal life.
WHAT IS RUNNER’S KNEE OR RUNNER’S KNEE PAIN?
Runner’s knee is a common umbrella term used to describe a variety of injuries to the structure of the knee known to cause pain while impairing flexibility and mobility. Read more on Runner’s Knee and Runner’s Knee Pain on our blog here.
Other injuries in this category can include Patellofemoral Pain Syndrome (PFMS), more commonly known as jumper’s knee, and the two most frequent fascia related knee injuries: iliotibial band syndrome and plica syndrome. With all of these types of injuries a physical therapist can be an extremely effective component of a treatment plan that provides relief without the need for orthopedic surgery, especially when coupled with nutritional intervention and targeted stretching routines.
DO I NEED TO SEE A PHYSICAL THERAPIST FOR MY KNEE PAIN?
A visit to a physical therapist specializing in the treatment of knee pain is the best course of action for treating your painful knees.
A knee pain specialist understands the physical structures that make up the joints and how they interact with the surrounding soft tissues: quadriceps femoris, VMO (vastus medials oblique), iliotibial band (IT Band), gluteus maximus and gluteus medius. The comprehensive view better determines the source of your pain and focuses on a long-term solution rather than just a temporary quick fix.
It is important to understand the physical structures that make up the joints. This allows you to better determine the source of your pain and focus on a long-term solution rather than just a temporary quick fix.
The skeletal structure of the knee is composed of three bones, the tibia (shin bone), the patella (kneecap), and the femur (thigh bone). Rather than a simple intersection between two bones, the knee joint is made up of three different connections: the patellofemoral joint which operates by sliding, and the two tibiofemoral joints that operate like hinges. Two fibrocartilage discs known as articular menisci work to fill the gaps between the bones and are critical to shock absorption and the circulation of synovial fluid. The knee joint is capable of a wider range of motion than many other joints in the body, including both outward (lateral) and inward (medial) rotation as well as bending (flexion) and straightening (extension). A series of muscle tendons, capsular fibers, and ligaments provide support to the joint, with the two most commonly injured being the anterior and posterior cruciate ligaments. These cruciate ligaments can become severely damaged during a fall that causes the knees to twist. If any of these structures become irritated or damaged through injury or long-term use a Chicago physical therapist can offer a pathway to permanent pain relief.
REASONS FOR KNEE PAIN
It’s not just the athletes of Chicago that are susceptible to these types of injuries, there are several risk factors that can lead to knee pain in the general population. As people lead increasingly sedentary lifestyles there is a rising number of employees spending the bulk of their days in the seated position and people who may be above their ideal weight. Without appropriate stretching and exercise, this factors can lead to poor muscle control as the muscles surrounding the knee and hip become weakened over time and can no longer function properly, allowing the kneecap to shift to an improper position. This issue is especially prominent in women, likely due to the wider pelvis creating an increased Q angle at the point where the bones of the knee joint come together.
As we age the cumulative strain of a lifetime of impacts combines with declining muscle strength and flexibility to increase the risk of osteo-arthritis, creating a negative feedback cycle where pain and inflammation makes exercise and stretching more difficult, leading to further pain and eventually immobility. The good news is that there are gentle and pain-free options available to help end this cycle of physical pain and get patients back on the path to life, vitality and activity.
HOW PHYSICAL THERAPY CAN HELP KNEE PAIN
One of the most beneficial ways to deal with structural issues that affect the knees is a program of physical therapy treatments created by a rigorously trained, friendly, licensed specialist in Chicago. A regular doctor may be inclined to dismiss your knee pain as a natural occurrence related to the aging process, or alternatively to recommend costly surgical interventions that may leave you permanently restricted in your movements.
A caring physical therapist will take your painful joints seriously and provide you with a full range of non-surgical options as they build a treatment plan customized to your specific needs. Through the use of focused adjustments, stretches, nutritional intervention, and soft tissue therapy, a physical therapist can improve tracking of the kneecap while offering increased motor control. By employing a strategy that focuses on the whole body, our orthopedic experts provide relief by targeting the source of your pain rather than just trying to manage your symptoms.
CAREERS ASSOCIATED WITH KNEE PAIN
Over the past four decades the average percentage of aging Americans that report chronic knee pain has tripled. With a rapidly aging population and an obesity epidemic sweeping the country the potential for physical therapists to provide customized relief for the average person is greater than ever before. Certain types of jobs are much more likely to be a common source of pain for those living and working in Chicago. Aside from the more obvious physically strenuous professions like construction, roofing, bricklaying, and railroad work there are several jobs that can be an unexpected source of knee pain. Nurses and other healthcare workers who spend extended hours standing or walking on hard surfaces can be prone to knee and hip pain. Gardeners, landscapers, and preachers all spend a lot of time kneeling, which can lead to inflammation of the bursa of the knees, also known as bursitis or ‘Preacher’s Knee’.
Bursitis is defined as the inflammation and irritation of the bursa, a fluid filled sac that works as a cushion to reduce friction on joints throughout the body. This reduction occurs because the bursa actually absorbs the friction as it happens, which is why repetitive strain can be so harmful. Bursitis of the knee can be extremely painful and either come on slowly or suddenly, with symptoms similar to those of tendonitis.
Once a joint is affected by bursitis it can take months to heal and has a high risk of complications that can extend that time to years. Ultrasound therapy can be an effective way to decrease inflammation in the early stages of bursitis, allowing for a licensed specialist to manipulate the joint and break up any accumulated scar tissue. From there a course of physical therapy can be developed, including multiple interventions on the soft tissue and the joints to relieve the pressure and friction on the affected bursa, restoring flexibility and reducing knee pain.
The rise of desk jobs and personal computing has led more Americans than ever before to live an extremely sedentary lifestyle. Working 40 or more hours a week in a seated position can actually alter the mechanics of your joints and change the relationships between muscle length and tension. Coupled with bad posture this can lead to an ongoing cycle of cumulative injury and pain that can be difficult to overcome.
If you or a loved one are suffering from a cumulative pain cycle it’s important to remember that you have options. An adjustment or a course of physical therapy performed by one of our caring doctors can help correct the alignment issues that may develop in your knees or other joints, but unless you make the necessary adjustments to your personal and work routines it may not be enough to maintain a pain free life.
DEALING WITH THE ROOT CAUSE, NOT JUST ALLEVIATING SYMPTOMS
There are a few critical steps to take in order to correct the root causes of the injury cycle. First and foremost you have to correct any bad posture. Left unchecked, bad posture can push parts of your body like your hips or knees out of alignment. As a result, every movement causes further cumulative damage and leads to development of muscle imbalances. Time and repetition combine with these imbalances to put your joints under stress and play a key role in changing the way you move, keeping you in a perpetual state of pain.
If you work at a desk on a regular basis it is important to be aware of the primary posture mistakes that cause tissue trauma, including: hunched shoulders, crossed legs, having to strain your neck to look at an improperly placed computer monitor, slouching in your chair and rounding your back, or performing repetitive motions like moving your mouse or typing. A Chicago physical therapy specialist can provide you with necessary adjustments alongside a series of stretches and an exercise routine that you can perform to help break the cumulative pain cycle and live a pain free life.
TYPES OF TECHNIQUES USED TO TREAT KNEE PAIN AND RUNNER’S KNEE
Typical knee pain treatment involves the same pattern. You are instructed by your primary care physician to take prescribe NSAIDs or stronger anti-inflammatory medications. Physical therapy may also be recommended during this initial phase. These drug treatment regimens usually range in time from 2 to 4 weeks. If no progress or minimal progress is made with either method, the primary care physician will typically refer you to an orthopedic doctor. Orthopedic physicians will take x-rays to rule out any bone related problems and recommend additional therapy or cortisone injections.
Cortisone injections may create the illusion of a solution but have been shown to lead to greater problems and worse long-term outcomes in published medical studies. There are many negative side effects to cortisone injections due to the invasive nature of the procedure and the effects of the steroids on both bone and soft tissue. Cortisone injections are presented as “no big deal” but in a blog post on our page (https://www.myajs.com/cortisone-injections-better-now-worse-later/) we show how it’s very much a serious decision. If, and often when, the cortisone injection wears off, another injection may be recommended. Due to the risks associated with cortisone injections, it is only medically advisable to receive 3 injections into the same joint as they can also lead to bone loss and osteoporosis after only just one injection.
In instances where a degenerative meniscal tear is present, orthopedic surgeons commonly recommend an arthroscopic procedure. Degenerative changes in the meniscus are very common with people who have been lifetime runners, people who may be a little or even a lot overweight or people who have been on their feet for extended periods of time over the lives. Unfortunately, in a study published in the New England Journal of Medicine in 2013, it was found that surgery in these cases was no better than physical therapy alone. This same study also indicated that progression of osteoarthritis was more common in people who had undergone a partial meniscectomy (surgery to “clean up” the meniscus). These same individuals were also at higher risk for knee replacement surgeries as they aged.
The most effective course of action for knee pain is to start with a kinetic chain evaluation to identify all contributing factors for your nee pain. Kinetic chain evaluations check both the structural and muscular integrity of your lower back, hips, knees and feet. These evaluations investigate both soft tissue (patellar tendon, IT band, surround musculature) and the bony support structure (knee joint, hip joint, sacrum and lumbar spine). Both components in the system, soft tissue and bone, are responsible for proper function. Failure to perform a kinetic chain evaluation which is an extremely comprehensive and highly specific evaluation make it even less likely all the causes of your knee pain will be identified. Therapies not including a kinetic chain evaluation will only create symptomatic relief while the real cause of your problem continues to cause damage to the knee and surrounding structures which may be permanent and irreversible.
FINDING THE BEST PHYSICAL THERAPIST FOR YOU IN CHICAGO
There are a few different things to focus on when trying to determine if a specific doctor best suits your physical therapy needs. Asking if they perform a kinetic chain evaluation which includes analysis of not just the soft tissue structures but of the hips and pelvis utilizing digital x-ray analysis. Any evaluation not covering all possible causes of knee pain will be doomed to failure in the long run.
Other helpful questions to ask are how long the physical therapist has been practicing and if they have ever provided treatment to other patients for issues that are similar to yours. If a physical therapist is claiming that they can cure a variety of conditions with their treatment, or that they are the only one trained in a special new technique you should exercise caution, particularly if they are recommending a long-term schedule with no end-point. The best physical therapists in Chicago can diagnose the source of your pain, perform appropriate adjustments that move towards a healthy resolution, and help construct a long-term strategy that provides you with the relief that you need to live your life however you choose.