Aged 15, I ran hard and did a lot of plyometrics because my dream was to be the next Michael Jordan! That was, until one day I felt throbbing pain in my knee. I had succumbed to my first non-traumatic injury. I had rolled my ankle multiple times up to that point (the most common basketball injury) but this experience was different. The pain would be there one moment, and disappear the next. It would flare up and prevent me from running but didn't show up when I played basketball. It was puzzling to say the least.
At this point in massage career, I now realize that I had a bad case of patella tendinitis. The typical cause for this injury is (1) growth and maturation (I was in puberty) and (2) excessive running and jumping activities (my life as a 15-year old was to eat, sleep and play basketball. Then wash and repeat.)
Today's focus is more specific to my present age group - being in your forties. Now age is interesting. Someone reading this article (I'm thinking of my 16-year old) may think "man, he's old being in his forties". Someone else in their seventies may think "oh, to be young." My perspective on age is simple. It's going to happen, stop focusing on it and instead refocus on HOW you arrive into that new age bracket.
I've used this analogy before and it's the best one. Imagine you buy a brand new vehicle. You could skip a couple of oil changes and not have the tires rotated and it will be okay. Now travel forward in time and that same vehicle has 150,000 km's on the odometer. It will not tolerate those skipped oil changes and tire rotations, as it did when it was younger.
The solution I'm proposing for your body is to maintain your wellness through your 4 Health Controls - body, mind, food and recovery - on a regular, consistent basis. The older you get, the more important this becomes.
Knee Pain vs. Knee Stiffness
There can be a correlation between these two aspects of knee symptoms. For example, when I tore my meniscus several years ago, there was no pain or stiffness, just a distinct 'clunking' noise for several months. It was only through an MRI that it was correctly diagnosed as a meniscal tear. As I didn't have any pain associated with the injury, I was given the all clear. Since that time I have skied several winters, played basketball and competed in five CrossFit Open's. Upon seeing an orthopedic surgeon his comment was prophetic "it's better the meniscus in the knee, than out the knee." Surgery should be a last resort. I've seen many patient's who've had surgery but it didn't solve their real problem and the original symptoms returned, and in some cases, it worsened.
Knee pain arises typically through a repeated stress similar to my earlier example or some form of physical trauma such as torquing the knee whilst skiing (I've had that experience too!)
Repeated Stress - It's common to see this in someone beginning to run or who has been running extensively for a prolonged period of time. The easiest solutions for these (well, easy for me to recommend) - is to stop doing what hurts. Modify your workouts, switch to an alternative activity such as cycling or swimming, and give the knee the opportunity to heal. We naturally have all the pharmaceuticals we need to heal our body. However, when we expect that pharmacy to remain open 24-hours under high demand, we are not allowing our body the opportunity to replenish it's shelves!
Trauma - It's inevitable that we will have had several 'owies' from when we were kids. The pain was unbearable, for a few minutes. After mom had kissed it better and given us a band-aid, we felt like we had a new, bionic leg and we'd be back out playing immediately. Until later that night and we jumped in the bath or laid down to sleep and we'd get that rude awakening of pain. Knee trauma injuries are common among sports and - living in Canada - it's common when winter hits and we are taking on icy pathways.
Knee stiffness arises through both of these channels - repeated stress and trauma. Stiffness is triggered by inflammation within the knee joint. As soon as fluid begins accumulating, it restricts the mobility of the knee to fully bend. In an ideal world, regardless of age, we should have the flexibility to kneel on the ground and have our butt touching our heels, as I illustrate below.
"You Can Mess With The Gods But Don't Mess With Your Knees!"
This was the repeated message from my yoga instructor in the past. It stands true, that when we have any kind of impairment in our knee, it affects anything we do each day involving movement.
In a similar way to dealing with pain, the first priority in dealing with inflammation is to mitigate the response as best we can. Inflammation is a natural and necessary process within the body to help heal a problem. However, unless you have the luxury to lay low and do very little - we have to perform our daily duties and carry on, regardless. And so this is why I recommend cryotherapy (icing) to my patients.
One of my golden rules applies here. You know your body better than anybody else. I've used ice countless times for my own injuries. It has worked every time! The best measure is to just do it and see how your body responds.
For the knee specifically, I recommend the following: - Place 1 or 2 ice packs around the front of the knee (avoid the back of the knee as you have a superficial nerve/blood vessel that can be sensitive).
- Apply a snug bandage wrap over the ice packs and around the knee to apply mild-moderate compression.
- Elevate the knee and rest it for 10-20 minutes, 4-6 times per day until the pain, inflammation and symptoms lessen.
- Minimize or stop the movements that make it worse. Find pain-free alternatives.
#1 Trick to Overcome and Prevent Future Knee Stiffness
This is arguably my favorite movement and I shared it in my instructional video earlier this week. It's called a Breathing Squat and it has a positive, therapeutic effect on our spine, posture, digestion, bowel regularity and hip, knee and ankle strength, stability and mobility. I class it as a big-bang exercise for its vast benefits. For a complete illustration of how to perform, watch my video below.
When we perform this exercise regularly, we are moving our slowing down the againg process of our body. Do you remember how easy this exercise used to be when you were a child?
In many cultures, particularly Asian and indigenous people, this exercise is a common sitting posture used for socializing, eating and going to the bathroom. It's simple, if you don't use it, you will lose it.
To overcome knee stiffness, I suggest to perform this exercise PAIN-FREE, in the variations that I share in my video, until you feel your knees (and hips and ankles) are improving their range of motion. Start with five repetitions, two or three times per day and focusing on getting PAIN-FREE depth. Remember your feet must remain flat and your arches raised. When you are performing these for thirty repetitions, once a day, for a couple of weeks, you are ready to shift into maintenance gear. For this, I suggest to use your squat pattern whenever you have chance in your daily tasks such as gardening, cleaning or watching TV for a few minutes.
The Gods will be happy and so will your knees!
Any questions, you can reach me at my clinic by phone: 403 589 4645 or email: firstname.lastname@example.org
Please help me on my mission to relieve stress, tension and pain. Share this anyone you know that would benefit from this blog :)
Yours In Muscle Health,
Jason Barlow, RMT