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Stop Hurting Part IV: Knees

November 10, 2014[email protected]Fitness

The knees are one of the more common areas of pain and dysfunction. The number one reason for pain, dysfunction, or injury in the knees stems from repetitive poor mechanics over time wearing the joints down and putting them at risk. I have covered this topic extensively in previous blogs and in the book Do This, Eat That. This article pertains specifically to short term treatment of the symptoms so that you are able to get more out of your training long term.
When discussing pain or dysfunction in a joint, proper mechanics and getting stronger are the most important things you can do long term to fix the problem. However, sometimes the pain can be so intense that it can limit your training and inhibit you from correcting imbalances and weaknesses. There is some immediate corrective work you can do to try and limit symptoms and avoid getting medical treatment such as injections, or surgical treatment such as a knee replacement. It is pivotal to understand that medical injections or surgical joint replacements are still SHORT TERM treatments of symptoms, and that you still need training long term to fix the real problems.
Initially with the knee I check for soreness around the knee joint itself. Many times there is a trigger point at the pes anserinus that can be attributing to symptoms. This is a point where 3 muscles (gracilis, sartorius, and semitendinosus) come together on the anteromedial area just below the knee cap. I will work this spot with vigorous deep friction massage looking to rush blood into the area. If there is a palpable “knot” I will work to try and release it. If the Sartorius muscle is specifically the problem additional soft tissue work directly on the greater trochanter (located around where your front pockets are,) along with soft tissue massage and stretching to the IT Bands can help to relieve symptoms.
The second place I look to is the fatty pad directly below the knee cap. This is a point where some of the ligaments of the knee attach, and is often a trigger point for some pain and dysfunction. A trigger point in this area usually stems from an individual who has improper knee protrusion where the knee tracks inwards and/or forwards during functional movements. A trigger point can also form in this area in an individual who has issues with hyper-extension of the knees. This area is not extremely vascular so any massage to help promote blood flow to the area can help to reduce symptoms.
Lastly I check another very common area that can cause pain referring down into the knee, the sciatic region. There is a muscle located in with your glutes called the piriformis. The sciatic nerve runs right next to, and in some case right through the piriformis muscle. Any inflammation, knot or adhesion at this location can cause irritation to the sciatic nerve which can run right down into the knee. Direct massage and stretching to the piriformis can work to relieve pressure on the sciatic nerve and reduce symptoms down into the knee.

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