S E12: Ep 12 – Is your knee pain the problem or just a symptom?
Did you know that unless you have had a trip, fall, or some other trauma, there is a good chance that your knee pain is not due to a problem with your knee.
Welcome to the Pain Free Living Podcast with me, your host Bob Allen. I am an osteopath who has been successfully treating people’s pain problems since 2008.
In this episode, I cover the topic of knee pain, which is a problem that I treat almost as frequently as low back pain, especially with older clients.
While I will always be a huge fan of the NHS, the management of knee pain is generally not great. The options offered are generally anti-inflammatories, physiotherapy, steroid injections, an operation, or being told there is nothing that can be done, so live with the pain.
Typically, people come to see me as a last resort, but I have successfully helped the majority of them avoid injections or an operation with some hands-on treatment and targeted exercises.
I will discuss how ankle health is very closely linked to your knee function and how an ankle issue can often be the cause of a knee problem, especially where there has never been a direct knee injury.
Real-life cases of non-traumatic knee pain that I have treated include one caused by the poor rehab of an ankle sprain and a case caused by a fibula (outside of your shin bone) problem. I discuss these cases in more detail, covering how they were identified and resolved.
These examples highlight the importance of a holistic approach to treatment with a detailed diagnosis and effective rehab rather than just treating symptoms.
Takeaways:
- Knee pain can often happen without a previous injury, gradually developing with no apparent cause.
- Compensatory movements from an old ankle injury can lead to knee and/ or hip pain over time.
- Correct diagnosis is crucial; often, knee pain is a symptom of another issue.
- Rehabilitating ankle injuries properly is essential to prevent knee pain and other complications.
- Depending on the cause, balance and strength exercises targeting the ankle can effectively resolve knee pain
More about Bob
You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory
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Transcript
Hello and welcome to the Pain Free Living podcast with me, your host, Bob Allen.
Speaker A:treating people in pain since:Speaker A:What I'm going to talk to you today is all about knee pain.
Speaker A:Now, as an osteopath I see a wide range of injuries and issues and knee pain is one of those things that I see quite a lot.
Speaker A:The interesting thing about a lot of the cases of knee pain that I see, and the pain in the knee can be really, really acute, but the person has never had a trip, never had a fall, never had any kind of injury, but the knee hurts.
Speaker A:Now one of the things that I do as an osteopath is I take a really detailed case history and a lot of the time when I take that case history for people that have non traumatic knee injuries, in other words they haven't had a triple fall, is that there's no obvious reason for it.
Speaker A:They've had scans, they've had X rays and they've all come back clear.
Speaker A:Range of movement in the knee is fine.
Speaker A:So whenever that happens, the next thing I look at is either the feet and ankles or the hip.
Speaker A:Because one of the things about knee pain is it tends to occur because the knee joint either bends or straightens.
Speaker A:That's all it really does.
Speaker A:There's a little bit of rotation in there, but it's mainly what we call the hinge joint.
Speaker A:So bends and strains.
Speaker A:So what can happen is if you have an ankle issue, if you've had an ankle sprain in your history or you've had a trip or a fall where you've injured the ankle, then unless you rehab the ankle really, really well, it's never quite right.
Speaker A:So what tends to happen with an ankle injury is your weight goes from 50, 50 to on the injured side, you might put 40% of your weight through it, 60% on the, the non injured side.
Speaker A:So you limp for a little while.
Speaker A:And the thing about the ankle is that it's really, or the foot is that it's really important for balance.
Speaker A:So if you, as things heal and as things get better, the, the weight distribution shifts.
Speaker A:So it may be 52% on the good side and up to 48% on the side that was injured.
Speaker A:So when it gets back to full recovery and you can get back out and about and running and there's minimum pain in the ankle, you've still got that slight weight difference.
Speaker A:Now what can happen with that?
Speaker A:Unless you continue to rehab it to take it back to that 50, 50 is that you're putting a little bit more strain on potentially on either the side that was injured or the other side.
Speaker A:There's no real rhyme or reason to.
Speaker A:It depends on what your activities are.
Speaker A:But because there's that slight imbalance between left and right, you tend to put more stress through one of those knee joints and then that can transpire as knee pain.
Speaker A:Over time, it can transpire as really acute, sharp knee pain.
Speaker A:So a lot of, a lot of the problems I see where, like I said, where they've had no trip, injury or fall.
Speaker A:If there's knee pain, first place I look is the foot, foot and ankle.
Speaker A:And then I look at the balance, I assess the balance, and nine times out of ten, and I saw a client yesterday, they had exactly that, they were getting knee pain.
Speaker A:And it was, it wasn't the knee that was the issue, it was actually the feet.
Speaker A:I got them to do some really simple balance exercises.
Speaker A:They did the balance exercises and the balance was pretty terrible.
Speaker A:Interestingly, it was worse on the side where they'd.
Speaker A:Not the side that they had knee pain, but on the other side.
Speaker A:So what I've done is I've given them some knee exercises to correct that and I've given them some stretches as well, we'll review in a few weeks.
Speaker A:But I've seen a lot of knee pain like that and it always responds really, really well to working away from the knee.
Speaker A:So a little bit of treatment of the knee perhaps, but more work on improving balance and improving quad and hip strength and quad and hip mobility.
Speaker A:So there you have it.
Speaker A:Just because you have knee pain, it doesn't mean to say that the knee's the problem, the knee's the symptom.
Speaker A:So if you've never had a trip or fall or an injury, work away from the knee, have a look at the feet and ankles, have a look at what the hips are doing, potentially even have a look at the low back and then get that addressed.
Speaker A:And like I said, nine times out of ten, that is enough to resolve the problem.
Speaker A:So if you have knee pain, it's not always a knee.
Speaker A:And yeah, that's it for today.
Speaker A:If you thought that was useful information, tell all your friends, tell them that the Pain Free Living podcast is where you can go to find out the answers that you're not likely to get from the Internet.
Speaker A:Dr.
Speaker A:Google is not really aware of some of the problems that you can get that are not obvious.
Speaker A:Tell all your friends if you found this information useful, that the pain free Living podcast is a good place to go for finding out about injuries and issues that you may not find anywhere else on the net.
Speaker A:So that's Bob Allen signing off for now, and I'll see you at the next one.