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Never Trust Dr. Google to Diagnose Your Knee Pain

  • Posted by Covent Garden Physio
  • On 27th February 2019
  • 0 Comments
  • Knee pain, Knees, PFPS, Runner’s knee

People who suffer knee pain following an acute injury usually won’t hesitate to seek medical advice and treatment. However, when people suffer from chronic knee pain – which develops gradually and may only present intermittent symptoms – they’re more inclined to forego treatment and attempt to self-diagnose via Dr. Google.

Much of the advice you’ll find online for treating knee pain focuses on strength and strength alone, and I’ve even known of some health professionals to have this one-dimensional approach.

But knee pain is a multifaceted issue, caused or aggravated by the interaction of multiple structures from your hips down to your feet. Simply trying to strengthen your knees without understanding the structures at play is more likely to cause further irritation than resolve your symptoms.

 

How yours knees work, and what happens when they don’t

Your knees consist of two joints: one between your thigh bone (femur) and shinbone (tibia), called the tibiofemoral joint, and another between your thigh bone and your kneecap (patella), called the patellofemoral joint.

When you extend or bend your knees, your kneecap slides up and down through a groove at the base of your thigh bone. If your kneecap is not tracking correctly, movement through this groove is impeded, resulting in dysfunctional joint mechanics and pain.

There are a number of painful conditions caused by a misaligned kneecap:

  • Patellofemoral pain syndrome (PFPS): also known as runner’s knee, this condition refers to misalignment of the kneecap resulting in friction between the kneecap and the thigh bone, which may become painful.
  • Winking patella: a type of PFPS where rotation in the femur causes the kneecap to face inwards, which can lead to tension in the structures that pull the kneecap outwards and painful contact between the kneecap and the thigh bone.
  • Patella alta: where the kneecap sits too high on the knee and points outwards, putting stress on the patella tendon which connects the kneecap to the shinbone and increasing risk of dislocation.
  • Tipping patella: a downwards-pointing kneecap which can put pressure on the fatty pad which sits beneath your patella tendon, leading to aggravation and inflammation.
  • Chondromalacial patella: if PFPS goes untreated, friction between the kneecap and thigh bone can start to damage the bones themselves, resulting in severe pain and potentially months of rehab.

There are also a number of painful conditions which can develop in the ligaments, cartilage, tendons and muscles in and around the knee joints – but there are simply too many too discuss here!

 

The delicate tug of war keeping your knee in position

A useful analogy to understand why your kneecap might become misaligned is to think of a tug of war between the structures pulling your knee towards the inside of your leg versus those pulling it to the outside.

If the structures on one side are weaker or tighter or slow to activate, they start to lose this tug of war and your kneecap gradually starts to shift into the wrong position.

For example, one of the structures which pulls your knee outwards is the iliotibial band, connective tissue which runs all the way from your hip to your knee, where it provides stability during movement. This tissue often becomes inflamed or tight through overuse, which you may have heard of as iliotibial band syndrome (ITBS).

On the other side, a structure pulling your knee inwards in the vastus medialis (VMO), one of your quadriceps muscles. If this muscle becomes weak or fatigued, your kneecap can lose stability and get tugged over by structures on the other side.

These are just two examples of the many structures involved in keeping your knee joints properly aligned. There are many, many more, extending all the way from your hips to your feet.

Weak glutes, a tilting pelvis, tight hamstrings, poor ankle balance, overpronating feet and more have all contributed to knee pain in patients that I’ve seen. Equally, these factors have been present without contributing to the pain at all.

This demonstrates why it’s impossible to self-diagnose knee pain or treat it with a simple prescription of “strengthening”. There are simply too many potential factors involved, many of which can overlap, to trust anything but a professional diagnosis.

 

Treating knee pain with strengthening alone can be more irritable than helpful

If you Google your symptoms, diagnose yourself with PFPS and start a tough regimen of leg exercises, you’re more likely to cause further damage to the knee than resolve your pain.

For example, squatting with a misaligned kneecap will only increase friction between the kneecap and the femur and accelerate the onset of a chondromalacial patella, turning what could have been a rehab of a few weeks into one that lasts for months.

Treating knee pain properly is a bit of a catch 22, as many of the strengthening exercises which will reduce the likelihood of pain reoccurring also aggravate the knee.

Rehabilitation is a delicate, two-part process where we first focus on restoring stability and alignment to the knee before moving on to strengthening exercises to lock everything in place.

Using techniques such as taping can help to provide additional stability during rehabilitation, while foam rollers can directly work on tight muscles without putting load on the knee.

Whatever it takes to restore pain-free movement to your knees, it’s far beyond the scope of what you can do yourself. No amount of online advice, including this blog, is a replacement for safe and effective physiotherapy.

If you’re feeling knee pain, get in touch with the clinic now at info@coventgardenphysio.com, 0207 497 8974, or book online.

Anthony Vidis

BEx Sci MPhty MCSP Physiotherapist

 

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Alex Pitt
Alex Pitt
18:05 19 Oct 21
An excellent experience. Both Kevin and Anthony are superb, I can't recommend them enough.
Joseph N’Guessan
Joseph N’Guessan
09:45 29 Apr 21
Highly recommend Anthony. Great service - understanding and knowledgable.
Geoff L
Geoff L
14:05 17 Mar 21
Kevin Kong at Covent Garden Physio is outstanding ! I have seen a lot of physios in my time but Kevin is by far and away the best ! He has taken me from long term back problems which were casuing me huge issues to fully functional again and sorted my knees out too. Don't waste your time and money on random physios.... go see Kevin and get great results !read more
Holly Lazarev
Holly Lazarev
05:35 26 Aug 20
I recently found myself suffering from a lower back and leg injury that brought with it very bad pain, numbness in my leg and also weakness. Seeing as I have a history of having herniated discs in my lower back, I just assumed that I was having another issue related to the discs in my back and I began to get concerned. Not sure what to do, I spoke to my GP who recommended trying Physiotherapy first to see if that would alleviate my issues and I did an online search and came across Covent Garden Physiotherapy & Sports Injury Clinic. Not only were they conveniently located to where I live, but their reviews were wonderful so I decided to give them a call. My first point of contact was Victoria, the office manager and she was so incredibly kind, helpful and accomodating. She got me in for an initial visit right away and she recommended that I see Scott Branny for my Physiotherapy needs. Scott was so incredibly knowledgeable, kind, attentive and helpful and from my first visit with him up until my last visit, he always knew just how to help me feel better and get me on the road to recovery. Every exercise that he showed me worked magnificently and before I knew it, I was no longer experiencing any pain or weakeness and I was back to myself! I am so thankful and grateful to Scott, Victoria and everyone at Covent Garden Physiotherapy & Sports Injury Clinic for providing such an excellent service and for being so kind and compassionate! I highly reccommend them to anyone in need of Physiotherapy! :)read more
Jay Owens
Jay Owens
13:41 03 Dec 19
Cannot recommend highly enough. Physio Anthony Vidis is genuinely a wizard, and has often managed to set me right in a single session. This makes Covent Garden Physio way more cost-effective than other places that might have you coming back week after week - and I have recommended him to many friends. Booking online is easy and convenient, they often have appointments available before/after work - and practice manager Victoria is helpful with bookings short notice. Don't go anywhere else.read more
Stevie Mann
Stevie Mann
11:42 29 Nov 19
Very happy with my experience here, the consultation was thorough and came out with a plan to move forward. Physiotherapist makes you feel at ease. Highly recommend.read more
Geoff Y
Geoff Y
10:11 10 Oct 19
My shoulders and neck are broken, well not broken but in a bad way. On a suggestion from a colleague, I went to try this out. I saw Anthony Vidis and within a few minutes he'd already started on a plan. He seemed skilled and knowledgeable, asking a lot of questions before he started any manipulation. The first session left me with a lot more movement and the second session even more so. Less pain and more flexibility has definitely provided a better life experience.read more
Dan Redfearn
Dan Redfearn
19:39 24 Sep 19
I was referred to Scott Branney due to a shoulder injury. This was my first physio experience and I have been very satisfied with the treatment I have received from Scott. Scott is very knowledgable, has set a really thorough exercise routine to compliment the treatment. On top of everything he's a really nice guy! Very happy to recommend him.read more
PB Creative
PB Creative
11:29 15 Aug 19
I've been receiving treatment from Scott for the last 8 months following shoulder surgery and have been very happy with everything throughout. Scott has done a great job in successfully rehabilitated my shoulder back to pretty much full health and has been very supportive and proactive in prescribing and monitoring my progress through bi-weekly checkups and home exercise programmes. In general, I have found Covent Garden Physiotherapy to be a friendly, welcoming and highly effective place to receive treatment and would highly recommend them.read more
Rachel Sloan
Rachel Sloan
20:53 31 May 19
I went to Covent Garden Physio with a groin injury three weeks ahead of the Edinburgh Marathon. My physiotherapist, Scott, was extremely helpful and as well as clearly explaining and quickly sorting the problem, gave me good advice for avoiding future injuries. Highly recommended!read more
Owen Turner
Owen Turner
16:57 25 Mar 19
My physiotherapist, Scott, was able to help me to sort my knee out in time to complete the London Landmarks Half. Very happy with the price and service. The advice he gave me on running technique will serve me well in the future, hopefully avoiding any future injuries due to bad form. Would recommend to friends and family!read more
Carlos Heywood
Carlos Heywood
21:11 05 Dec 18
Kevin Kong. Make sure to book him as he knows his stuff and can help massively.
Jennifer Tye
Jennifer Tye
12:20 10 Sep 18
Excellent. Smiley staff, great physio.
Giulia F
Giulia F
20:30 19 Sep 17
Had a very good experience. The team was very quick to book me in and answer my questions. I was visited by Anthony who was very friendly and helpful, he really helped me to fix my issue, explaining what had happened by my back and the pain was gone in 24h! Very good price for excellent service.read more
Ryan Jay
Ryan Jay
13:47 28 Feb 17
I have been seeing Andrew Marshall for the past six weeks, after my recovery of a hip replacement had slowed. I must say that the service has been fantastic, and I have felt significant improvements in the functionality and comfort of my new hip. Andrew has demonstrated a remarkable expertise on the muscular and anatomical factors regarding my recovery, but he always explains them in a concise, practical fashion. He answers questions brilliantly and ensures that I am comfortable and confident with each exercise before leaving me to progress through them. On top of this, Andrew's colleagues are friendly and the facilities they operate in are top notch. I would recommend Covent Garden Physio to anyone with not only hip issues, but any other injuries or recovery periods that they may need help with.read more
Pete McDonnell
Pete McDonnell
18:37 20 Feb 17
Been using Covent G Physio on and off for 10 years... from post surgery to sports injury. Recommended to a number of friends who were equally impressed. Physio, deep tissue and acupuncture .. very friendly, polite and professional staff ... issue sorted every time. Highly recommend them. And in a very interesting & lovely location. read more
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