If you have knee pain and go to your doctor, he or she might say your knee pain is caused by: osteoarthritis, a meniscus tear, patellofemoral pain syndrome, ACL tear, or that you might soon need a knee replacement. All these diagnoses explain what is damaged in your knee, but not why the damage occurred. Of course your doctor might have suggested treatments or surgeries, but most of these are aimed at the damage and not the cause of the damage. Epidural steroid injections might help relieve pain in the short term, but they do nothing about the cause of the pain and the FDA has issued warnings about the dangers of getting them. Having an arthroscopic partial meniscectomy might "clean up" the torn meniscus, but studies have shown results are no better than no surgery at all.
Cause or Symptom?
The key to becoming pain free is to find and address the underlying cause of the damage and pain - not just the symptoms. To find the cause of the pain we need start with a basic understanding of how the human body works:
- Pain is a signal from the body telling us that something is causing-or is going to cause-damage.
- The body breaks down for a specific reason (not merely age, genetics, bad luck, etc).
- Damage is caused by stress and strain coming in three different forms:
- Compression: forces applied in the same line and in the same direction
- Tension: forces applied in the same line, but in opposite directions.
- Shear: forces applied in parallel line, but in opposite directions.
- The human body is designed to have it's parts (bones, muscles, nerves, connective tissues, etc) arranged in a specific alignment relative to each other and gravity. (We call this Design Posture)
- The body works as a unit.
- Every cell in the body is responding to stimulus 24 hours a day every day of our lives. Changing the stimulus causes changes in cell structure and function all the way to the DNA level.
- The human body is a living organism and can and will heal itself if given a chance.
Position vs Condition
Knee pain is caused by the body losing postural alignment, which causes faulty movement mechanics and increased stress and strain on tissues of the body leading to damage and pain. An ACL tear is caused by dramatic shearing forces at the knee joint because of misalignment and instability of the knee. Surgery to repair the ACL might sound good, but the ACL can easily and often is re-torn because the postural mis-alignment is never corrected.
Patellofemoral pain syndrome is from excessive tension on the patellar tendon and ligament. This is caused by postural alignment imbalances up and down the body, especially in the ankle and hip. What is often forgotten is that the body works as a unit and the excessive tension can be because the opposite hip is weak thus increasing the load on the now painful side.
Osteoarthritis in the knee is caused by compression and shearing on the meniscus over time (often decades). Most people with an arthritic knee who are told they are "bone-on-bone" and need a knee replacement are told or think it's because of age, genetics, or overuse. The patient and the doctor often forget to ask the followup questions and think critically about the osteoarthritis.
- If the arthritis is because of my age, how old is my other knee?
- How can genetics be to blame if I only have arthritis in one knee?
- If running is to blame for my arthritis, how come every runner doesn't have arthritis?
- Why is the meniscus gone on the inside of my knee and not the outside?
Sciatica, a painful sensation that started in the lower back and runs down the back of one or both legs, is caused by postural mis-alignment also. The spine is designed to align vertically from the front on top of a level pelvis and below level shoulders. From the side the spine should be in a smooth and slight s-curve. Sciatica is usually caused by either the pinching of the sciatic nerve in the lower back or in the buttocks. The sciatic nerve can be compressed in the lower back by a herniated disc, degenerative disc, stenosis, or spondylolisthesis. All of these are caused by postural imbalances up and down the body including thoracic kyphosis, anterior or posterior pelvic tilt, hip elevation or rotation, and forward head posture.
The key to alleviating sciatica pain and knee pain is to identify and correct the postural alignment imbalances in the spine, shoulders, hips, knees, and ankles. If you would like help in figuring out what your posture imbalances are and what you can do to correct them, contact me for a free posture evaluation and consultation, and I'd be happy to help you.
Egoscue and low back pain
Spondylolisthesis and Egoscue
Low back pain video
How to fix chronic knee pain with posture exercises