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Back Pain Relief

Knee Pain Relief
Massage Therapy

By Mike Dixon RMT

There are many causes of Knee pain. This article will cover one of the more common causes of knee pain called Patella- femoral syndrome.
Patella (knee cap), Femoral (femur) syndrome (condition usually resulting in pain)
Patella-femoral Syndrome presents with a deep achy pain when the knee is bent for prolonged periods of time. This includes sitting in a chair or deep knee bending. Watching a movie at the theater can be a painful event.
The bone and cartilage on the underside of the knee cap and the groove in the femur where the knee cap (patella) glides can become irritated with  activities of daily living.

What can be done about this painful condition?

First and foremost, a thorough assessment of the biomechanics of the lower extremities is required.  This simple means checking alignments, measuring leg length, checking range of motion. Muscle testing and a neurological exam are also necessary for a proper diagnosis. Once the correct diagnosis is complete, your therapist should be able to give the best approach for correcting the condition.
Most likely it will involve some stretching and strengthening of involved muscles and fascia. Your therapist may also provide some physical therapy for example aligning the pelvis, joint manipulation to the sacroiliac, knee (patella-femoral, Tibiofemoral) joints. 

Here are some causative factors that can influence knee pain and joint biomechanics.

1. Work that requires kneeling, or deep squats, this could be carpet layers, painters, construction workers, and drivers of motor vehicles. These positions cause extra stress to the knee joints.
2. Excessive heavy lifting as this may throw out alignment of the lower extremity, back and pelvis
3. Age, as we age our muscles lose some of their strength, this could cause the knee to become compressed as normally the muscles attenuate some of the compressive loads.
4. Lack of stretching, if we sit a lot and we don’t stretch the muscles in the hips and legs can be shortened. With shortened muscles we have more compressive forces on the knee when we walk, run or jump.
5. Activities such as runners or racket sports like tennis can put a lot of stress on the knees, particularity with the weekend athlete, who exercises on the weekend or infrequently. Infrequent stressful activities which require running or ballistic activities are hard on all weight bearing joints.
6. Previous knee injuries for example ligament or cartilage tears.

Here are some questions to ask yourself?

1. Do my knees ache after an hour of sitting?
2. Does the pain keep me up at night?
3. Do my knees make cracking noises with rising from sitting?
4. Are my knees stiff in the morning when first getting up and does this stiffness last for more than 30 minutes?
5. Do my knees hurt during running or sporting activities?
6. Is there any visual swelling or does the knee just feel swollen?
7. Does your knees trick you sometimes by not supporting you while walking? Does the knee give way and not support you?
8. Do you knees feel unstable or wobbly.
If you answer to any of the above questions you should go for an assessment and I will provide you with a management plan to help in the resolution of the condition.

Here is a list of other common conditions that affect the knee and should be assessed and treated. (Listed in alphabetical order not order of occurrence)

1. Bursitis: Suprapatellar, Prepatellar, deep infrapatellar, subcutaneous infrapatellar, Pes Anserine, Baker’s Cyst
2. Compartment Syndromes
3. Hamstring strain or tear
4. Jumpers knee (tendonitis of the infrapatellar tendon)
5. Ligamentous injuries: ACL, PCL, Medial and Lateral Collaterals.
6. Meniscus injuries: Tears in the cartilage
7. Osteochondritis Dessicans
8. Osgood Schlatter’s Disease
9. Patella subluxations and dislocations
10. Synovial Plicas
11.Shin Splints
12. Tibial stress fractures

If you have any of the above conditions please book an appointment with Mike Dixon RMT at www.dixonmassagetherapy.com


Bibliography
Carolyn Kisner, M.S., PT, & Lynn Allen Colby, M.S., P.T.:  Therapeutic Exercise, Fourth Edition,  2002

Cynthia C. Norkin, EdD, PT & D. Joyce White, DSc, P.T.: Measurement of Joint Motion A Guide to Goniometry, Third Edition, 2003

Darlene Hertling, B.S., R.P.T., Randolph M. Kessler, M.D.: Management of Common Musculoskeletal Disorders, Physical Therapy, Principles and Methods, Second and Third Editions, 1996

David J. Magee, PhD., B.P.T.: Orthopedic Physical Assessment, Second and Third Editions, 1996

Frank H. Netter, M.D., Atlas of Human Anatomy 1993, The CIBA Collection of Medical Illustrations, 1991

Janet G. Travell, M..D., David G. Simons, M.D.: Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1 & 2, 1992

Nikita A. Vizniak, D.C. Clinical Consultant Physical Assessment, Second Edition, 2005.

Stanley Hoppenfeld, M.D.: Physical Examination of the Spine & Extremities, 1976

Steve Anderson, RMT, BSc.: Anatomy and Kinesiology lecture notes, 1992

Susan L. Edmond, M.P.H., P.T.:  Manipulation Mobilization and Spinal Techniques, 1993