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Episode 124: Knee Pain Reduction and Relief

Video Highlights

- Why knee pain may indicate other problems in the body.
- A combined soft-tissue and mobility approach.
- One pain-free repetition is the goal.

Today we’re going to be looking at 3 simple tools and ideas that you can use to improve the function of your knees and also reduce pain.

When it comes to talking about knees, there is so much information that I’d love to share with you but we’re going to try to make this very fast and concise.

Number one, what I want you to understand is that in most cases I consider knees to be the shock absorbers of the body and often if you having chronic or issues with your knee either from a performance perspective or pain perspective it often means that you have foot problems or hip problems or back issues that also need to be addressed.

I do not assume that what I’m showing you in this particular video is going to fix everyone’s knee problem, but there are some really critical things that I want you to understand. We’re going to look at some soft tissue things with the knee and then also a few movement exercises all of which can be incredibly beneficial.

That’s number one. It may not be your knee, it may be other stuff.

Number two, whenever we start working on this, it’s really important that you also understand that our goal is, if you’re having knee pain, one pain-free rep.

What I mean by that is most people with knee pain, it hurts every time they bend the knee or every time they straighten the knee.

What we’re looking for is a set of exercises or tools working together that helps you do one pain-free rep because your brain needs to understand that it’s possible to move your knee without pain.

With that said, what we’re going to start off with is a little bit of self-massage. All right? To do this, you’re going to have to identify 2 specific areas on your knee. I’m going to ask you to do the same thing, just follow along with me. You can do this in a chair. I’m going to do it standing obviously.

I need to kneel down and the first thing in this position is we need to look at the skin. I want you to get your pants out of the way. We’re going to look at 2 specific spots on the knee.

The first one that I’m interested in is what’s called the adductor tunnel and it’s where a nerve called the saphenous nerve comes down out of the back and through the hip and then feeds the inner surface of your knee and lower leg.

This spot is pretty easy to find.

You’re going to find the top of your kneecap. This is your kneecap. You’re going to slide over to the middle of the inner surface of your leg and then start working your way up. Now you’re going to feel some meaty tissue but as you work your way up usually 2-3 inches you’re going to find a hole.

If you push into that hole a little bit you’re going to find in most cases, if this the side that you have knee pain issues on, you’re going to find it’s quite tender.

Also if you have some weakness in the knee, you have a difficult time doing strengthening exercises, you may also find it to be quite tender. It’s often tender just to light touch.

Once you find that, what I want you to do is understand you put your fingers on it, make some small circles, maybe 5-6 times. Try to reduce the intensity of the discomfort if you’re feeling any but don’t press into it really hard.

It’s a nerve so take it really easy, nice and comfortable. I want you to spend again maybe 30 seconds just lightly massaging that area.

The next thing that I want you to do is I’m going to have you straighten your leg out just a little bit and I want you to just simply grab the skin underneath the patella. The patella is your kneecap and there should be a little bit of flexibility in the skin here.

I’m going to have you basically take a light pinch of that skin, hold it, and then I just want you to lightly bend and straighten your knee. I’m not asking you to bend it fully or to straighten it fully, but I just want you to hold that and maybe do 10-15 light flexions and extensions.

We’re just bending and straightening the knee while you’re holding on to that tissue. What you may find as you do that is you have to use both hands. You may have to change your grip a little bit.

This is really, really important as a lot of knee pain actually comes from small what we call nerve entrapments of what are called cutaneous or skin nerves as they come around underneath the knee. We massage a little bit here. We mobilize the skin under the knee.

That should prepare us now to do a little bit of mobility work.

To do the mobility work, I’m going to come up to a standing position and the first thing that we’re going to do is just what we call hanging knee circles, which are very, very light comfortable exercises.

In most cases, you’re going to want to hold on to a chair, hold on to a wall. You’re simply going to bring the knee up to a comfortable position. Just lift it off the floor.

I’m going to have you start by making this little side-to-side pendulum motion and you’re trying to relax your knee when you do this. Once you can relax and do a side-to-side pendulum, now I just want you to lightly let the knee go back and forth.

If this causes you any discomfort, reduce the range. You want to always be working into this pain-free range.

If we can do side to side and we can do front to back, we’re then going to try to create a very, very small comfortable circular motion. Nice and light. Again, you’re not trying to fully flex or extend the knee. You’re just making this light circle trying to let the lower leg be really heavy and create some space within the joint.

Do maybe 10-15 repetitions each side, just whatever is comfortable for you. Now I want you to just come up to a standing position. Once you’ve done that, we’re now going to go into some different forms of knee circles.

To keep this really simple, I’m going to have you put the leg that you’re working on in front of you. I’m going to have you fully lock the knee at a comfortable level, not a hard lock but a light lock of the knee.

Then we’re just going to start doing some small circles, almost like you used to do in gym class years and years and years ago. You start, you turn the kneecap out, you come around, come to the inside and then lock the knee. Notice that we’re not exaggerating this motion.

We’re just making a simple circle.

I want you to go in both directions. If you can do, again, 5-10 comfortable repetitions, that’s what we’re aiming at. Once you’ve done that version with the foot in neutral, we’re going to repeat this first by turning the foot to the outside.

Turn the foot out lightly. You’re going to repeat the same circles. Once you go slowly and comfortably with these and keep the range really, really small in the beginning. As your knee mobility improves and your leg strength improves, you can increase the size of the circle.

Once again, you’re aiming for 5-10 repetitions. From here, we’re going to turn the foot in. We’re going to repeat the same set of circles.

What we’re doing with these 3 different positions is we are mobilizing different areas of the knee, trying to hit all the different spots in various bits and pieces that can cause tension to build up as you’re moving.

Good.

Once you’ve done those knee circles, hopefully your knee is feeling better. It should feel like it’s been mobilized. It should feel like it’s a little bit warmed up. If you were having knee pain, re-test it; see if it’s better.

Last step in all of this now is if you got some improvement from the mobility drills and you also got a little bit of improvement from the soft tissue work, we want to combine them.

Sometimes this requires someone to help you, particularly if you’re working on the skin underneath the kneecap.

To demonstrate, what I’m going to do now is I’m going to get into the same position with my foot in neutral and when I find that little tender spot on the inside of my leg here again.

I’m simply going to press into it lightly and I usually need to pull that area up toward my hip. If I hold that now and go through the same knee circles, very often if the knee circle is uncomfortable or felt uncoordinated before it will feel much more secure and much less difficult while you’re holding this particular area.

We like to combine the soft tissue contacts with the knee work because very often by adding in a little bit of information from our hands touching the skin it makes the knee feel a lot more secure. As a result lowers the overall threat to that area so if you’re having pain it will usually reduce it and if you’re having any kind of functional deficit with strength it will usually improve that as well.

There is a basic approach to deal with some of the issues that come up.

If you have any questions about this, please let us know.

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