Interconnected: Knee Pain

Knee pain is one of the most common diagnoses in physical therapy. The origins of symptoms can be numerous, and treatment is not always straight forward. The knee does not behave in isolation and keeping that in mind helps to make better decisions regarding the solution.

One very common way to treat knee pain in physical therapy is through interventions targeting the hips. There is ample evidence that this improves problems that arise at the knees. The interesting thing about the research looking at hip training for knee pain is that the investigations do not go any further.  There are few experiments looking at the effects of movement at the rib cage and knee pain, and even less looking at the effects of neck position on knee motion. The further away you get from the affected area, the magnitude of the effect most likely diminishes, i.e. neck position. That being said, this is a systemic behavior that must be treated as such.

All too often the knee is looked at myopically, when it requires an approach that encompasses the entirety of the patient. The activities the patient participates in, the speeds and forces required for those activities, the angles, and joint positions necessary to accomplish the task must all be taken into account. A patient’s symptoms are an outcome, the cause often lies elsewhere.

We all look locally when something hurts, it is only sensical. What often goes unappreciated is the accumulation of events that lead to the painful spot. The initial conditions, the rules of movement and time, all contribute to the outcome. To find a solution we must pay due diligence to each of these aspects and intervene in a way that allows for the system to create a new movement strategy.

Austin Ulrich, Physical Therapist