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Natural Ways to Address Chronic Knee Pain
Posted by Dr. Ben Kim on Jan 22, 2006
Chronic knee pain comes in three main varieties. The following is a look at common causes of pain and discomfort in and around the knee joint and some points to consider in addressing each of them:
1. Chronic, superficial pain along the inner portion of the knee joint
Superficial pain that persists in the inner regions of the knee joints can be caused by wearing high heels on a regular basis. Wearing high heels does not allow one's body weight to be evenly distributed throughout the entire foot and ankle complex, which can result in compensatory pressure on the medial collateral ligament that lines the inner portion of the knee joint.
How to find relief: wear flat, comfortable shoes.
This type of pain can also be caused by being overweight. Excess weight can cause one's feet to roll inwards more than is considered normal with every step that is taken, which can also put excessive stress on the medial collateral ligament.
How to find relief: strive to reach and maintain optimal weight.
Finally, inner, superficial knee pain can be caused by joint dysfunction in the hip region, which can alter gait in a way that contribute to unnecessary wear and tear of the medial collateral ligament. Joint dysfunction in the hip region may be due to tight muscles that surround the hip joint, or an actual problem with the bones and joint surfaces that make up the hip joint.
How to find relief: visit a health care practitioner to have your hip joint evaluated. If there is nothing wrong with the bones or joint surfaces, begin a program of stretching the muscles that line the inner and outer regions of your hip.
Good stretch for the inner hip region - use your elbows to apply gentle downward pressure on your knees.
Good stretch for the outer hip region - be sure to stretch both sides
2. Pain underneath or around the knee cap (patella)
Pain underneath and around the knee cap region can be caused by improper tracking of the knee cap on the knee joint. The knee cap is imbedded in a large tendon that represents the end of the quadriceps muscle, a large muscle that originates from the hip region and runs along the front of the thigh to eventually insert into a bone in the front, upper calf region as the patellar tendon. The quadriceps muscle is actually a group of four individual muscle bellies that share common origin and insertion points.
In a healthy leg, the four bellies of the quadriceps muscle pull on the patella in a way that allows the patella to move properly along the front of the knee joint.
Sometimes, a wide hip angle (genetically predetermined) and/or muscle imbalances in the hip and thigh can cause the quadriceps muscle to pull on the knee cap in a way that causes it to move out of line with respect to the knee joint. In this case, the knee cap has a tendency to move towards the outer half of the knee joint, which can create inflammation of the tissues between the back of the knee cap and the knee joint. In children and young adults, this condition is often called chondromalacia patella. In adults, it is usually called patellofemoral syndrome or patellofemoral tracking dysfunction.
How to find relief: first, stretch your hamstrings and quadriceps on a regular basis. Stretching these muscle groups will help to ensure that they do not put unnecessary stress on the patellar tendon.
Next, begin training the quadriceps muscle to pull evenly on the knee cap, so that it doesn't move towards the outer region of the knee joint.
Here's how you can do this:
- Lie comfortably on your back and put a rolled up towel underneath the knee that you want to work on - it should be rolled up in a way that allows your knee to be about 6 inches off the surface that you are lying on.
- Keep your thigh still while you're doing this exercise. You should aim to keep the back of your knee steady on the rolled up towel - you shouldn't lift your knee off of it, nor should you allow your knee to sink into the towel.
- With your thigh and knee in this position, slowly lift your foot up until your lower extremity is straight, from your hip to your foot. As you do this, you should feel your quadriceps muscle (the front of your thigh) contract. The key is to focus on contracting the inner muscle belly of your quadriceps muscle - it's called your vastus medialis, and is the muscle that looks like a big tear drop on cartoon super heros. If you place your hand right on top of your knee, you can identify this muscle - it sits right above your knee joint, towards your inner thigh.
- Once your lower extremity is completely straight, slowly lower your foot, keeping your knee and thigh still, as described in step 2.
- Right before your heel hits the surface you are lying on, start raising your foot again and repeat steps 1-4.
Remember: the key is to focus on squeezing the inner part of your quadriceps muscle throughout this exercise. When you first try this exercise, it's possible that you might be able to do 1 or 2 repetitions. Shaking and jiggling is quite common, especially if you do it slowly. Over time, you can work your way up to doing 10 repetitions with each leg every day. Most people find that their knees feel much stronger after about 3 months of consistently doing this exercise. Pointing your foot outwards - towards 1-2 o'clock - while performing this exercise can facilitate optimal training of the vastus medialis muscle.
3. Pain deep inside the knee joint
Chronic pain that occurs deep inside the knee joint is usually caused by one of two main categories of arthritis:
- Degenerative joint disease (osteoarthritis) - can be caused by a number of factors that lead to erosion of cartilage that acts like a shock absorber between the two surfaces that comprise the knee joint. Sometimes, the cartilage can get eroded to a point where both bony surfaces of the knee joint rub against one another during movement, which can lead to excruciating pain and intermittent bouts of stiffness. Bone-on-bone grinding can also lead to the development of bony spurs, which can further increase pain and stiffness.
- Rheumatoid arthritis and other metabolic or immunologic-type arthridites - are often related to dysfunction of the immune system, a poor diet, and emotional stress.
How to find relief: although each case of arthritis is best addressed by taking into account each person's unique circumstances, both categories of arthritis tend to respond positively to the following actions:
- Regular intake of cod liver oil
- Avoiding large amounts of cooked animal protein
- Decreasing or avoiding intake of sugar and other refined carbohydrates
- Reaching and maintaining one's optimal weight
- Avoiding activities that put repetitive stress on the knee joint, such as jogging, basketball, and volleyball
- Identifying and addressing major emotional stressors
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