– Dr. Peter Chiang DC, CCSP

My knee problem started on the high school football fields. During one of the plays, I was involved in a tackle that caused one of the other players to fall on my knee. The injury was diagnosed as a bone bruise by the trainer at hand, I thought nothing of it and continued to push through the pain. Ever since that time, my knee has given me trouble. Years later, when I felt the discomfort, I just needed a good stretch and would “walk it off” to make it feel better. Other times it was not so easy. Now twenty years later, I am very conscious and fearful of my knee giving out, as it has happened before. The worst is when I jump, plant, and try to rotate/pivot my foot; it just seems like when my foot turns, my knee does not want to. This action is a guarantee that I’ll be hurting and that I won’t be able to walk normally for a while. It has happened too many times in the past.  Besides the pain, when the injury happens my knee region swells up, becomes tender to the touch, causes limited range of motion, and the surrounding muscles become extremely tight.

Back in the day, I would rest, take an insane amount of anti-inflammatories, and avoid putting weight on the affected side. Today, when this injury happens, I try to get ice and/or therapeutic ultrasound on it as soon as possible. The purpose of the therapeutic ultrasound is to increase local blood flow, and reduce local swelling. Then, I will wear a brace on the affected knee for few hours a day, and remove it for another few hours. The brace helps support the area when it is on, and I try to get some active range of motion when it is off.

Once I can tolerate it, I get some sort of soft tissue mobilization done such as Active Release Technique and/or Graston. This will ensure that the muscles surrounding the area stay loose, and prevent fibrous/scar tissue from forming.  Kinesio taping has been great in controlling the swelling after the treatment session, and I still take anti-inflammatories as needed.

peter1I have also made changes to maintain an anti-inflammatory diet and take daily supplements. Omega 3 has been my daily supplement staple for a very long time now, since it is better to take it daily than it is to take massive amounts when injury happens. This helps control the frequency and intensity of the knee pain flare ups. I also make sure that my pelvic and lumbar muscles are not compensating for my injury. In order to get those areas treated, I use the foam roller. Another area to be mindful of while doing this therapy is the posterior side of the knee, as it can also harbor some edema and cause discomfort.  It still takes time for the knee to heal, but the combination has lessened my down time, and improve my recovery time.

Since the damage to my knee had already been done, I focus on form and function during my workout sessions. I used to think that leg extensions were the only way to strengthen the quadricep muscles and rehab the knee, but that’s boring to me.  Now, I focus on dynamic movement in the lower body to strengthen my knee. By incorporating functional movements and performing body weight programs, my knee hasn’t “given out” on me in a few years.  Some doubt and fear still crosses my mind when I’m jumping off a 30” box, but I won’t let that stop me.  The whole “work out smarter, not harder” will be a mantra that sticks with me.

peter2That single event in high school, coupled with many years of neglect, improper technique, and inadequate knowledge, undoubtedly some structural damage was done to my medial collateral ligament and medial meniscus. Scar tissue formed as well, causing some occasional discomfort. All these issues make it likely that surgery will be in my future.  It is my own personal mission to avoid that surgery. When I became injured, I was young and naive, and I had that “tough it out” mentality . I have learned my lesson, and although my knee still has occasional flare ups, it no longer affects my daily activities as much as before.  I attribute my progress to proper resistance training techniques, functional exercises, an anti-inflammatory diet, and occasional treatments with soft tissue mobilization and ultrasound.  However, I don’t think that I will be comfortable jumping, planting, and rotating for a very long time.

Of course, if you are suffering from knee pain, it is recommended to get a proper assessment of the injury. Although some knee conditions can be self treated or rehabilitated using conservative methods, surgical intervention may be necessary depending on the severity of the injury. Whether it is an acute sprain/strain or a chronic condition, an evaluation from a knowledgeable healthcare provider is a necessary step to figure out your next course of action.