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If you have knee pain and are wondering what your actual diagnosis is, you ought to know that not all knee pains are the same; when your pain has increased over time without an initial injury arthritis is not always to blame and if you think arthritis is for old people, think again!

You see, the most common type of arthritis, degenerative joint disease or osteoarthritis, is a by-product of misalignment and not age. Imagine a door hanging on a frame crooked; after a while, the edges wear out not because it is old but because it was not hanging properly. A dysfunctional joint wears out faster and the dysfunction we are talking about is now happening at a much younger age because of our sedentary lifestyles with or without increase activity such as playing a sport is not going to solve the issue.

This blog will cover:

  • How the knee joint works
  • What causes pain in the knee 
  • Different knee pain diagnosis
  • Pain under the knee cap 
  • Pain below the knee 
  • Back of the knee pain and more!

How Does the Knee Joint Work?

The knee is a complex weight-bearing structure. It is composed of 3 bones: the femur (thigh), tibia (leg), and patella (knee cap). This joint functions as a hinge joint meaning its primary movements are flexion (bending your knee) and the opposite which is extension. There is also a small degree of medial and lateral rotation (rotation). 

Because the knee is weight-bearing, it requires a little more cushion and stability than some of the other joints in your body. These structures are:

  • Anterior Cruciate Ligament (ACL)
  • Posterior Cruciate Ligament (PCL)
  • Lateral Collateral Ligament (LCL)
  • Medial Collateral Ligament (MCL)
  • Lateral Meniscus 
  • Medial Meniscus 

Of course, there are muscles such as the quads on the front of your thigh and  hamstrings in the back that work together to perform the movement of the knee, but then they also have to work in conjunction with the surrounding joints such as the hip and ankle when it comes to performing movement such as walking.

With every joint, complex or simple, what matters is how they perform their job, functionally or dysfunctionally. Let’s put it this way, knee pain can be bad but it is not terminal. When there is pain, there is a modification in the movement to accommodate the painful body part. Over time, this modification from the natural design of movement becomes the norm so the function becomes the dysfunction and the dysfunction becomes the new norm.

How to Get a Knee Pain Diagnosis? 

Knee pain, like with all musculoskeletal injuries, can either be chronic or acute. Acute injuries are those that occur as a result of direct injury or insult to the knee. An example of this would be a sports injury in which there is torsion of the knee resulting in a torn meniscus. 

An acute injury in which there is potential structural damage should be confirmed by a scan such as X-rays to rule out a fracture of the bone or MRI to see the degree of soft tissue damage, if any. If you’re dealing with an acute injury, it is best to see your doctor (Medical or Chiropractic Doctor) who can then order scans if necessary. Do not simply use pain as your gauge of the degree of injury; I say this because I have seen plenty of cases where the pain was mild but the degree of damage was far from subtle.

Knee pain varies depending on the structure that is involved The video below shows how to quickly assess your knee to determine what structure(s) are involved.

Unfortunately, in the case of surgery, the type of physical therapy that is done is the bare minimum. You see, it is not just about the range of motion or strength of the muscles that make the joint functional. If movement is a concert, the body parts are the musicians. If let’s say the pianist has not played their part, the other musicians have had to improvise to make the concert go on. Just because the pianist is there does not mean that the piano is going to sound good; when the pianist chimes in or phases out matters quite a bit and THAT is the most ignored part of the therapy when it comes to rehabilitating the knee joint. 

The Most Common Cause of Knee Pain No One Tells You About 

If arthritis is inevitable and just comes with old age, why is it that so many people only have arthritis in one knee? Is one knee older than the other? If arthritis is age-related why are we seeing arthritic changes in people as young as late 20s?

What you are not being told about is that the root cause of your knee pain is the imbalance due to a dysfunctional joint. Let’s be real, prevention is not what most people think about and the whole saying of ‘don’t fix it if it is not broken’ is on top of the minds of most people. Then we have experts who are only experts in one section of your health: You are broken into pieces and each piece is given to one specialist to treat! I suggest you read my blog Functional Movement Disorder to learn about this secret to most functional movements and disorders.

While the treatment for acute knee pain may vary and modalities such as bracing and taping may be used, when it comes to chronic pain, the key ingredient to the correct treatment protocol requires deep investigation to the history and examination.

The most ignored duo approach to all musculoskeletal-skeletal issues that is almost always missed is the rehab treatment involving Dynamic Neuromuscular Stabilization (DNS) and Postural Neurology to assess the problem now and reverse engineer the path to the map of movement in the brain called Homunculus. DNS is functional movement exercise and rehab based on the natural developmental movement pattern that every baby around the world develops starting at around 3 months of age all the way through the first 2-4 years of life. Postural neurology allows us to map the brain in regards to movement and posture so we can see which parts of the brain are performing sub-optimally and leading to the modification of the map of movement (blue-print of movement).

I know that was a lot of information to take in and probably not what you’re used to or were expecting to hear. If you want to learn more about functional movement, DNS, or postural neurology explore my website.

When it comes to knee pain the most common question that I am asked is to brace or to not brace!

Should I Wear a Knee Brace? 

Unless you have a broken bone or just had surgery, I am not a big fan of bracing. It takes away the mobility of too many areas which comes with a price: DYSFUNCTIONAL movement.

Aside from the fact that braces do not do anything to actually fix the problem and serve as more of a bandaid, they can actually cause more problems! Braces, especially the long and thick ones, restrict your movement and since you don’t plan on putting your life on pause, this will impact the blueprint of your movement quite a bit. While that part of your body rests, you plant the seed for future issues. Watch this video to see how!

The alternative to bracing is taping but don’t look at taping a joint as stabilizing it. Taping simply provides sensory stimulation to the brain so it pays closer attention to what it is we try to bring its focus on. I am a big fan of Proprioceptive Taping to reinforce the function back to the joint.

To be pain free in the knee joint requires rehabilitating the injured soft tissue and not just be content with increasing the range of motion and being pain-free. Follow the rehab process all the way to the brain and its map of movement. Use Developmental Kinesiology moves such as DNS to assure ‘it’ knows how to ‘play’ with the rest of the body. Make sure to visit my Youtube Channel and check out the playlist for everything Knee related. If you still have questions, contact me.