Talking Knee Pain with a Physical Therapist

"You have the knees of a 90 year old." That's what I heard after getting an MRI on my right knee. Great news, huh?! To be honest, I'm not really that surprised. I've been obese most of my life, which isn't easy on the knees, and I lost the majority of my 100+ pounds through high-impact activities like running.

I was at the gym and kept hurting my knee – sharp, shooting pains that would sometimes literally knock me on my butt. Like most people, I avoided seeing a doctor for much longer than I should have just because I didn't want to hear bad news. Well, I'm here to tell you that once you have a pain … please get it checked out. I honestly made things worse on myself by not starting physical therapy sooner and understanding the problem.

When I went to The Christ Hospital Joint & Spine Center, I met with Marc Schneider, MD, orthpaedic surgeon, and learned I had Stage 4 Runner's Knee (Chondromalacia Patellae). It was recommended that I do physical therapy for a month to see if I could find my own remedies to the problem and avoid surgery. I learned so much! They taught me special exercises that I could do on my own to strengthen the muscles around my knee so I could be physically active without hurting myself. When I met with Dr. Schneider again, I had gone almost a whole month without pain. Hooray! Physical therapy was the answer!

I had a chance to chat with Timothy Enwright, PT, the manager of The Christ Hospital Health Network Physical and Occupational Therapy Centers, about my knee issues, which I found out are actually pretty common. Here's what he suggested to fix it:

"This problem is successfully managed with targeted strengthening of the quadriceps, or thigh muscle, with focus on the innermost aspect of this muscle, specifically the vastus medialis oblique (VMO). With this condition, we often need to stretch the iliotibial band (ITB) to improve the alignment of the knee cap (patella). The best way to prevent these problems is to always warm up prior to exercise and progressively condition ourselves for the activities that we like to participate in, as opposed to jumping into a program at full intensity. And finally, to manage our weight properly. Here are two facts that I like to share with patients:  1 – For each pound of body weight loss, there is a four pound reduction in knee joint stress among overweight and obese people with osteoarthritis of the knee. 2 – Knees sustain three to five times our body weight when descending the stairs."

All these things sound like pretty good reasons to lose some of that extra weight to me! Knee pain is no joke. So, if my knee hurts, do I use ice or heat? Timothy says, "I always tell patients that you can put ice on almost any problem and not make it worse, but heat can irritate certain conditions (Raynaud's Phenomenon). Simply stated, ice reduces blood flow to an area, and heat increases blood flow. Therefore, you would use ice on any inflammatory condition where your goal is to reduce pain, inflammation, and swelling. Ice is especially encouraged when you have an acute, or "new" injury. The application of heat is not recommended with an acute injury, because there is already an increase in blood flow to the injury and the heat will increase the swelling and pain. Heat is beneficial when you have a chronic, or longstanding injury – a situation in which your goal should be to increase blood flow to the area. The increased blood flow can help with healing, as it brings oxygen to the area.  Also, heat helps to reduce stiffness, and allows muscles to be more pliable. So, when in doubt, use ice. Finally, it is always important to apply an adequate barrier between the heat/ ice, to reduce the potential of a burn to the skin."

With all this information in mind, I now ice up after doing an activity that stresses my knees. Additionally, I do my stretches so I can stay active and flexible! Actually, I'm an ambassador for the 2019 Flying Pig. But, I'm walking, not running. I'm choosing to stay active while still considering my knee health! If you're feeling any pains like I have, please get it checked out. Your knees will thank you for it! 

Learn how our experts at The Christ Hospital Joint & Spine Center can help you with a variety of orthopedic, spine and sports medicine injuries/conditions. 

​You may have heard radio personality, Amanda Valentine, on B-105's Afternoon Show on weekdays from 3-7 p.m. She also publishes a blog titled Pound This. Amanda has struggled with weight issues her entire life, but in 2012 she started her weight loss journey and now she's lost over 100 pounds. What started as a three-month New Year's resolution challenge with co-workers has evolved into a passion for healthy living. As a paid partner of The Christ Hospital Health Network, Amanda is excited to share her healthy living tips, tricks, and information with Healthspirations.