How to Manage Knee Pain

Knee pain is a common issue. As a large supportive joint of the body it takes a great deal of strain in all movement activities, including the inactivity of sitting.  Due to its complexity as explained in our Exploring the Knee Joint blog post, we always suggest a professional consultation to diagnose the issue before taking action to reduce the pain. The suggestions in this blog post cover general knee health to prevent pain arising. So, make sure that you get the problem diagnosed.


Common Anatomical Problems

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Knee problems are often the cartilage or ligaments of the joint.

Ligament problems:

  • Anterior Cruciate Ligament is responsible for knee stability so frequently becomes injured and is the sensation of ‘giving way’.

  • Medial Collateral Ligament can take the strain on the inside of the knee which can cause pain. Retraining alignment can help this type.

  • Posterior Cruciate Ligament is the least common and best suits physical retraining.

Meniscal tears - the cushioning discs in the knee are torn during a twisting motion that pulls the femur in the opposite direction to the tibia. Tears can cause the knee to lock out.

Tendonitis - inflammation from repeated activity of tendon between the knee cap and tibia Subluxation - patella slides along the femur. May be called a dislocation.

Meniscal tear - often happens during twisting and the cushioning cartilage is torn.

Bursitis - pain and swelling often from overuse.

Effusion (fluid inflammation in the knee) - may relate to arthritis.

Osteoarthritis - wear and tear of the joint that leads to pain, stiffness and inflammation.

Forms of arthritis - common symptoms are redness, warmth, pain and swelling. The key is to keep mobilising the joint gentle and strength building the muscles of the thigh and lower body.  

Cysts - Fluid collects in the back of the knee and may arise in relation to arthritis.  


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Fascia causes

The most common ‘fascia’ injury that is felt in the knee is a ‘tight’ iliotibial band (IT Band). This band extends from the hip past the knee and can become inflamed when overstrained. This is called IT syndrome. This is felt on the outside of the knee and can be challenging to treat. Often there are weak hip abductors that need retraining to take the strain off the IT Band, in particular gluteus medius.

However, this is a simple explanation and with three fascia lines that cross the knee joint the root of knee pain could be somewhere else in the body. Here are three examples of origins elsewhere in the fascia meridian that can cause knee pain:

Excessive and prolonged pronation in the ankle can cause strain into the IT Band and then the pain in the knee. But the ankle is what needs to be addressed to heal the pain.

Genum varum or ‘bow’ leggedness from the Deep Front Line where the outer legs are short or knock-kneed where the inner legs are short.

Short hamstrings can pull on the knee in SPL tracking and result in strain of the IT Band.

See a myofascial specialist to uncover where in these whole body chains the release and retraining may be required before solely focusing on a knee rehab program.


Energetic causes

As explained in the Exploring the Knee Joint post, the knees are part of the root chakra system - the connection to living and being a part of the human tribe. Where there is no yield in the knees or a buckling of them, there is poor communication with the root of the ego to the higher self. This may arise in low self-esteem.

The complexity of the knee in musculoskeletal and fascia is also mirrored in Chinese Medicine. Depending on where stability or pain issues arise will impact what aspect is an energetic concern.

Lateral side of the knee is the Gallbladder and liver meridians. These are yang energy (doing energy) and often connected to stressed and anxious emotional states with unclear thinking and decision making ability. Physical signs will be pain in quadriceps above the knee and inner thighs (sartorius muscle). There may be weak and poor circulation that can lead to conditions like forms of arthritis. The emotions to address here are irritation and frustration.

Posterior side of the knee is the yin meridians of bladder and kidney. These are gentler and tend to show up as nervous system issues of restlessness and the inability to completely relax because there is a sense  of urgency. Work needs to be done on appreciating the use of resources and creativity already existent in one’s life.

At the front of the knee is the spleen meridian another yin and vital meridian. The spleen nourishes the organs, muscles and blood. Often depleted in modern society due to worry and the need to seek approval from others. The spleen point at the knee (S9) becomes congested and can cause pain in the inside knee. Congestion of this meridian will direct towards diet changes of less processed food and reducing worry in daily life.


Holistic Training

If you suffer with knee pain, then always get a diagnosis due to the complexity of the joint. The below provides holistic guidance for preventing knee pain. Yoga asanas really support the healing for the knee when undertaken with care, try the sequence below for some knee pain prevention.  

Movement Sequence

DFL - rotated triangle to stabilise knee whilst lengthening

SBL

Forward fold

Doward facing dog

Plow

Release the hamstring specifically tightening (there are 4)

Tennis ball rolling under foot

Calf stretches to lengthen

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Hyperextension in the knees - soften them to take the load out and begin to strengthen the joints at either end (hip and feet/ankles

SPL - rebalance spiral activation and massage outer hip and thigh.

Plies are great for this as they train the neutral spine for the pelvis on top of the ankles.

Ankle raises with knee bends will improve the ankle stability whilst tracking the knee.

Energy Work

The movements included in the sequence that support energy work of the knee chakras are: Warrior asanas, downward facing dog to lengthen the calves and hamstrings, low lunge for lengthening the quadriceps. In addition, try some diet changes and massage the inner knee (S9 acupressure point - see image).

Diet changes = avoid greasy, fried, processed and creamy foods. Try to eat vegetables all the colours of the rainbow.

Emotional work

Take some calming resonant breaths to soothe the nervous system from the worrying thoughts.

Become aware of actions and thoughts that seek approval from others, rather than being for your own sense of self-worth. Can your actions be for your own pure pleasure and sharing of gifts, rather than requiring another’s response to validate your action?

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Want more?

If you enjoy our explorations of conditions and the body, then get in touch. We love to hear your requests and will try to write about what you want to learn.

If you have something more specific, or are post-rehabilitation of an injury then get in touch as our team of experts can support you with yoga, Pilates and fascia movement.

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ACKNOWLEDGEMENTS

Fascia information from ‘Anatomy Trains’ by Tom Myers and ‘Fascia in Sport and Movement’ by Robert Schleip

Energy from Energy Medicine by Donna Eden