As the only Holistic Orthopedic and Sports Medicine Physical Therapist in Long Beach, I marvel at the simplicity of our knee design. The knee architecture is deceiving in my journey of helping people stay active when dealing with arthritis in knee. This article will summarize my favorite 3 knee arthritis exercises that I prescribe to many who are successfully avoiding or delaying a total knee replacement at my clinic.
Although the knee is simple in design it relies on your whole body to capture the functionality of the knee. What I mean to say is that the knee is a victim of how you use your whole body: ankle/foot, hips, pelvis, spine, shoulder, head/neck, and inner ear system.
Here are three quick examples to help you see the big picture.
There are more options and hope to counteract the stress to your knee. We understand that when you have been told to have an unchangeable fact of having knee arthritis, mensicus tear or bad alignment, it is very hard to believe that you can still function and stay active. Here is a list of people that we have helped over and over again.
- If you cannot feel the ground well, how can you expect your knee to know how to help you to walk, navigate stairs or run?
- If we put you on a rocky raft where you definitely will have balance issues (many do not know they have this until tested), you will automatically try to stay low to the ground to stay safe. Your knee muscles are compressing your meniscus and arthritic knee joint to protect you from stumbling.
- Did you know that there is a sensory nerve called the saphenous nerve that gets tugged and tensed when you have digestive disorder? This nerve mimics medial (inside) knee pain.
Consumer Report recently wrote an article that says having knee surgery is too risky. There is a recent research article that demonstrated having knee meniscus clean-up has the same result as a sham surgery? Sham surgery is where they open up to portal incision and stitch them back up without doing anything inside.
The article supports what the recent Orthopedic and Physical Therapy research have been talking about for the past 10 years, but not publicized enough. A top surgeon can fix a knee design but it is the whole body that drives how you make of your “surgically-fixed” knee. You can improve your chances of having less knee pain, even when diagnosed with arthritis or meniscus injury if you read along.
I have been a Sports Physical Therapist and Fitness Performance Specialist for 13+ years and clinical frustrations came when I use to chase after all the fancy exercises and therapy techniques. When I would ask the gurus of knee surgery and rehab, I would get a sense that everyone talked a nice game but had the same struggles as me. Reassuring for me but didn’t help me solve the difficulties of helping a small portion of people in pain.
Where am I going with this?
Where am I going with this? I came to the conclusion that focusing on the basics and to stop chasing after fancy exercises dramatically improved my results. The article “When an Expert is Not an Expert“, I emphasized this point in why there are many people are still in pain. In order to appreciate this article, understand there are hundreds of high evidence research studies showing that people with knee pain have weak quadriceps, hip weakness and stiff knee joint, however, the exercises you see on social media channels focus on the advance version of these issues. The take-home message is that you should emphasize 50-60% of your energy mastering the 3 tips below first.
Here are two key concepts that I preach in every knee articles: hinge and pulley system.
The knee joint is broken down into 2 simple design that models the functionality of a hinge with a pulley system. A hinge is designed to open and close a door many times without fail. This is made up of the two long bones: thigh (femur) and shin (tibia/fibula). In my Knee Pain Series in the past, I go into great details in regards to what makes a knee (hinge joint) fail. The short answer is that a knee hinge is a dependant on our hips, ankle, and how you use it. Use a knee like a hinge i.e. run, walk, squat, and your knee will not get “damaged”.
A pulley joint is represented by the kneecap joint, which I explained in more details in this article. A pulley is designed to help us have better leverage not to give us power. In the past article referenced above, I wrote about the influencer of this kneecap (pulley) system. A summary of that article is that glute reflexive control and strength, kneecap mobility and the direction of pull matters tremendously in getting the most out of your kneecap joint.
If you understand this concept, there are many things you can modify here and there to fine tune a good to a great rehab or fitness knee program.
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3 TIPS FOR LASTING KNEE CARE WITHOUT MEDICATION OR SURGERY
1.Get Your Quadriceps (Front Thigh Muscle) to Work Better. When I write the phrase “work better”, I am specifically writing about its neuroreflexive capacity. The Quadricep needs to turn on when you need it to as you walk, step down, step up, perform a lunge or squat. Research has proven that chronic knee pain sufferers and after knee surgery subjects have issues with the neuroreflexive component of their quadriceps muscle.
The Quadriceps muscle is important for all knee disorder including arthritis. The reason for this is that it helps the knee to work like the natural hinge that is talked about and relies on your hip to have a good kneecap (pulley) system.
WHAT TO DO? CLICK ON PICTURE TO WATCH VIDEO. Take a pillow and place it along the length of your femur. Contract your front thigh muscle as tight as you can and focus on lowering your knee into the pillow. Hold this for 60 seconds. If you feel your front thigh about to cramp, tremble, or burn, then you are on the right track.
IF THIS DOES NOT WORK? You most likely would need a Physical Therapist to manipulate the fascial tension in your quadriceps muscle and its connecting joints. It takes 2 weeks for most people to achieve this, but in my experience, getting an expert to intervene will save you lots of headache and time.
2. Get Your Hip Abductors and Glutes Working Better.
The hips neuroreflexive capacity is crucial in making sure this joint region takes most of the dynamic load and stress instead of the hinge and pulley system. Research has demonstrated that the hip control and strength are important to address in arthritic knees, meniscus and ACL rehab.
WHAT TO DO? Lay on your side with the bottom knee bent. Raise your top leg at an up and back angle. Your leg needs to be straight and should get harder to maintain this the higher you raise it. Hold this lift position for 30 seconds while placing a pillow behind your thigh.
IF THIS DOES NOT WORK? You most likely would need a Physical Therapist to free up the muscle and joint tension to your low back spine, pelvis, tailbone, and hip joint. The concept of the hinge can be widened to imply that the hinge is impacted higher up the kinetic chain like your pelvis and low back spine.
3. Get the knee and kneecap joint stiffness “rust” by a trained Physical Therapist. There are self-treatment techniques for the knee joint, but I find it hard to do it correctly. I am constantly having to correct clients after showing them that I don’t feel comfortable instructing them in this article. A trained Sports Physical Therapist can address this in a matter of 1-3 sessions. These techniques are designed to free up your knee motion so you become more flexibility to bend and straighten out the knee.
An important concept is that a knee that cannot be locked out straight can never have a good Quadricep neuro-reflexive capacity!
IF THIS DOES NOT WORK? There are techniques that address the subtle motion of helping your knee joint move efficiently. If you have a desk drawer that did not close completely, force does not mean it will solve this problem. It may break the track for the drawer to close properly. The magic is feeling where the track has less resistance and jiggle it as you close the drawer.
Please share this article with anyone having knee pain. If you would like to get a second opinion with your knee pain issues, click on the button below. ReVITALize Rehab Club has helped many knee pain sufferers like meniscus and knee arthritis conditions avoid surgery using these principles.
You can run, jog, walk, squat again as long as you focus on the basics more than the fancy stuff =)
One LOVE,
Danh Ngo PT, DPT, OCS, SCS
Long Beach’s Holistic Knee Expert
Board Certified Orthopedic and Sports Medicine Specialist
Mind Body Health Results Coach
Owner of ReVITALize Rehab Club
Long Beach, CA
Call or Text @ 562-548-0876