Knees Please!

So many people come to me with knee pain. They may have had the somewhat misleading diagnosis of "bone on bone". Why misleading? Because the bone isn't actually grinding on bone, there is always some cartilage left to cushion, and also the lubricating synovial fluid of the knee.

With a 'no way out' diagnosis like that, it feels like the only option is steroid injections and then inevitable joint replacement surgery. Steroid injections may help the pain; but they increase the destruction of cartilage! Also, masking the pain may lead to overuse which creates more inflammation. So, the familiar scenario of orthopedic diagnosis, then injections (to ostensibly see if it can be handled w/o surgery) actually accelerates the patient down the path to surgery. For some, it is the best path, but not all.

DId you know that many people have 'bone on bone' in their knees and are in utterly no pain or discomfort?

Why Knee Pain and Damage Do Not Always Match

• Lack of Swelling: Pain usually comes from inflammation (swelling and heat) in the soft tissues around the joint, not from the bones touching. If there is no inflammation, there may be no pain.

• Strong Muscles: Strong thigh and hip muscles act like shock absorbers. They keep the joint stable and lower the pressure on the bare bone.

• Partial Wear: The bone-on-bone label often applies to only one side or small part of the knee. Other parts of the joint may still have healthy cushioning.

• Brain and Stress Signals: The brain decides whether to create pain based on how safe it feels. If a person stays active and confident, the brain may not send pain signals.

• Bone Adaptation: Over time, the exposed bone can harden and smooth out (a process called eburnation), which sometimes stops sharp irritation.

Knees hurting but on the fence about surgery or want some gradual relief? Do these exercises daily. They work.

Swimming is also a good exercise for all of your load-bearing joints.

Try Lee Holden's qigong for the knees (video above) and let me know how it works for you in the comments...

Why do knee braces often fail to help?

• No structural fix: A brace provides external scaffolding, but it cannot regrow cartilage, repair joint surfaces, or reverse osteoarthritis. It often makes the weak muscles responsible for the knee instability even weaker.

• Muscle weakness: Relying too much on a brace can cause the surrounding leg muscles, like the quadriceps, to become weaker over time from a lack of active use.

• Increased stiffness: Heavy or rigid braces can restrict the natural bending of the joint, leading to tighter muscles and greater joint stiffness.

• Poor fit or discomfort: Bulky braces can slip, feel hot, cause skin rashes, or alter your natural walking pattern (gait), which may shift pain to other parts of the leg.

• Mixed study results: Medical reviews show limited, mixed proof that standard braces significantly improve long-term arthritis symptoms, as guidelines from groups like the Osteoarthritis Research Society International often debate their true effectiveness.

Where does your knee stress come from? You have heard that it is excess weight, and that is one cause...but it can also be weak thigh and calf muscles, or even issues lower on the kinetic chain:

How Foot Issues Cause Knee Pain

• Overpronation (Flat Feet): When your foot rolls too far inward or the arch collapses, it forces your lower leg to rotate inward. This twisting motion pulls the knee inward, causing the kneecap to track improperly and irritating the joint.

• Oversupination (High Arches): Rigid, high-arched feet lack natural shock absorption. Instead of the foot cushioning the impact of each step, the jarring force travels straight up the leg and crashes directly into the knee.

• Plantar Fasciitis: Pain in the bottom of your foot changes how you walk. This altered gait forces your knee muscles and surrounding tendons to absorb unusual compensatory strain.

  
  

Got a long 2nd toe? That's Morton's Toe and you know its attributed to chronic neck/shoulder tightness and pain...But it also affects your knees.

Connection Between Morton's Toe and Knee Pain

• Altered Biomechanics: When the big toe area cannot properly bear weight during push-off, the foot rolls inward too much (overpronation).

• Upstream Compensation: This inward rolling twists the shin bone (tibia) and femur, placing rotational stress and abnormal tracking on the knee joint.

• Chronic Overuse: Over time, this repetitive malalignment strains the supporting muscles, tendons, and ligaments around the knee, causing dull aches or sharp strain pain.

Management and Relief Options

• Supportive Orthotics: Custom orthotics or shoe inserts with metatarsal pads help redistribute pressure away from the second toe and stabilize your gait.

• Proper Footwear: Choose shoes with wide toe boxes and good arch support to reduce forefoot overload and minimize abnormal pronation.

• Physical Therapy: Targeted stretching and strengthening exercises for both the foot and lower leg can correct gait imbalances and reduce knee strain.

In conclusion: knee replacements are not always inevitable, according to recent research. It's a good time to explore your self-care options. Of course, one of them is massage. Massage can help!

How MASSAGE Helps Arthritic Knee Joints

• Relieves muscle tension: Massaging the quadriceps (thigh muscles) and surrounding tissue softens tight fibers that pull on and add pressure to the knee joint.

• Improves blood flow: Manipulation of the soft tissue increases local circulation, which helps warm up the area and nourish the joint.

• Increases flexibility: Loosening tight muscles and connective tissue allows the knee to move more freely, making it easier to walk, climb stairs, or rise from a chair.

• Reduces stiffness: Regular sessions help lessen morning stiffness, allowing for a better range of motion early in the day.

• 
  

What the Research Shows

According to studies highlighted by the National Center for Complementary and Integrative Health, patients who received regular massages (such as Swedish massage) experienced meaningful improvements in pain and mobility after eight weeks compared to standard care. The benefits are safe and provide a helpful non-drug option to manage daily symptoms

I hope this answers some questions and opens up new options for self care. Any questions? Please ask in the comments or text me. As usual, this is not medical advice or diagnosis, just information that may or may not be helpful. If it's an emergency, dial 911.

My knees need kneading! Book Here!