Speaking the Language of Knee Pain

July 31st, 2011

Knee pain comes in a variety of forms spurred on by a variety of conditions.

And all these conditions have very fancy names.

However and regardless of the condition, resolution for knee joint pain involves taking care of the obvious problems first and foremost.

Each of these obvious problems has a name and I have come to know them by name and recognize their approach.

Years of training and experience have allowed the most obvious knee pain antagonists to rise to the creamy top.

Their voices have been heard in many different people.

They are easy to spot and when they are present I always greet them, not as foe but as friend.

I recommend being kind and attentive to the pain.

To hate it, be troubled by it or wish it to go away will only keep you further from the truth.

Ignorance is only bliss when pain or misfortune are not present.

After all, this pain is part of you.

A messenger, if you will, with important news.

Speak kindly, be attentive and listen.

Antagonists, especially those which are painful, aren’t used to such respectful and hospitable treatment.

Sometimes they are taken off guard within the span of initial introductions and disappear taking their pain with them.

Other times they carry messages with them and stay longer so as to be heard.

These antagonists are then messengers for the body.

I suppose I was lucky in regard to my upbringing.

Had I not been vastly younger than my direct and extended family, I may have failed to develop the perspective and skill to quiet the tongue and hone the ears.

It is from this perspective and practice of being attentive to the surroundings and noticing subtle nuances and the connectivity they share with the bigger picture which gives rise to the complex reality lying inconspicuously beneath the external flesh.

There is a language being spoken there.

One simple, yet foreign.

Once translation is understood, be it “sign” language or intuition, sense can be made of a painful knee joint.

First and foremost, listen to the words.

The words coming from the pain.

What do they say?

Not on the surface, but deeper.

Is it sharp and are the words harsh?

Do the words sound as if the knee joint is complaining in a dull, whiny voice?

Are they gruff, grinding and angry?

Just as important and lending more understanding to your knee pain is to watch its behavior as it moves.

Maybe ask it to move again to gain perspective of the big picture…the movement pattern disruptions.

Does your knee pain coincide regularly with specific movements?

Then listen until you think you understand the messages.

Listen and watch until you are able to make connections.

In the least, this attention will help you to fully articulate and explain when you feel pain in the knee joint which will help lead to the “why”.

Here is a list of common knee pain symptoms which I will translate for you.

Knee Cap Pain

Your knee pain is telling you your quads (front of the thigh) may be overly tight.

Your lateral (outside) quad muscle may be too strong in comparison to the much smaller medial quad muscle and may be contaminated with hot spots in need of foam rolling and stretching.

You are most likely too “quad reliant” or anterior inclined.

This tells me you are in need of much posterior work with exercises like the dead lift and single leg hip extension.

Your knee cap may be saying your ankles and hips are restricted, weak and in need of strength and mobility.

And if your knee cap speaks in the feminine tongue, pay attention to keeping your knee joint lined directly above your ankle joint especially when bending the knee.

You must resist the urge to allow your knee joint to “cave inward” when attempting movements like the squat and lunge.  Push the knees outward and keep the foot-bed firmly planted.

Pain on the outside of the knee

Lateral knee joint pain is likely saying to you your I.T. Band is tight.

This is a symptom not the cause.

The cause is likely tight glutes, especially the external rotators of the hip.

Foam rolling, flexibility exercises and posterior chain exercises are needed.

You may have stiff ankles which can be caused by inappropriate footwear.

You will then need ankle mobility exercises and possibly even barefoot training unless you have extremely flat feet.

You knee says it doesn’t like running on crowned roads.

Learning the art of keeping the entire foot-bed planted during movement is essential.

This technique must be mastered not only with everyday movements but also with symmetrical movements like the squat and dead lift and most importantly, the single leg dead lift.

Feminine lateral knee pain suggests you most likely stand or “hang” on a hip.

Meaning: stand with your weight mostly on one leg and cock that hip outward.

Moms holding their children on their hip do this often.

Pain on the inside of the knee

Your knee pain is telling you strain or damage has been done to the ligaments, cartilage or meniscus.

Your knee is asking you to keep your ankles and hips mobile and strong so they are able to aline the knee joint in accordance to the position of the ankle and hip joints.

Your knee joint is asking you to press outward on knee dominant exercises and movements to unload the painful areas.

Your knee joint says get the external rotators of the glutes mobile and strong to help control the knee joint through it’s movements.

And if your pain speaks loud enough when squatting, it’s telling you to dead lift more often than squat.

Maybe a lot more often.

Numerous connections can be made regardless of the degree or type of knee pain you experience.

But only if you attempt to listen to the language through attention.

These connections provide answers.

These answers shed light on direction.

Direction opens opportunity.

Opportunity gives rise to change.

 

Rochelle Gravance

LoseTheKneePain

 

 

 

 

 

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The Politics of Knee Pain

July 22nd, 2011

 

Approximately 230 million people have jobs in the US.

Twenty seven million people operate a business or are business owners in the US, give or take.

There is quite a difference between running a business with several moving parts in an ever-changing economic structure which requires constant change and adaptability compared to someone who is required to accomplish a set of tasks repeatedly.

A set of tasks once mastered, becomes partially an unconscious, repetitive occupational exercise.

Sure, there will always be new things to learn but generally speaking, decision making and calculated risk taking is removed from the responsibilities of an employee and is left to management and or the business owner.

And sometimes, depending on the nature of the job, an employee is urged to “do” and not to “think”.

Some individuals were born entrepreneurs and others would rather have the security of knowing what is expected of them and a regular paycheck.

Regardless of your skills or desires in the work place, we must all regard ourselves as patrons, authors, architects and presidents of our own tangible flesh and intangible being.

It is the pinnacle responsibility to ensure our institution thrives.

This requires attention, decision making and risk removal of all the systems of the institution.

It also requires one to be sensitive and attentive to how those systems are operating and to provide the most beneficial “operating” environment possible.

One must be present, compassionate and empathetic to manage a system as intricate and vast as the human being.

If one fails to be present then one loses the ability to understand the messages from the institutional systems and soon the system becomes ineffectual and impotent.

When this is the case, symptomatic breakdown occurs.

It would benefit you to look toward yourself as the president and decision maker/risk taker of the Institution of You.

Your knee joint is an employee of the institution along with the remaining vast number of parts and systems that make up the institution..

In the case of the knee joint, one must take on the role of high level management to ensure a safe and productive work environment is provided.

If knee pain is present, it is the decision makers job to gather all relevant information in an attempt to restore a healthy working environment.

It may be wise to consult with various experts however, having concern and being attentive to the situation will afford you the experience and understanding to be the ultimate authority.

With willingness to carry out the necessary modifications, restoration of the working environment and redemption can be cultivated.

Remember, the health of each part determines the overall health of the institution.

Some parts may be slightly more sensitive than others but in most cases the parts are willing participants and able to overcome nearly every obstacle.

In actuality, the knee joint asks for very little.

I have yet to run into a knee that could be termed “high maintenance”.

Mostly, the painful knee is just “stressed out” and in need of recovery.

Sometimes the knee is “worn out” and needs a greater amount of stress relief.

40 (+ or -) years on the job and not even a gold watch for its service…you know what I mean?

Unfortunately, it’s easy to ignore a few complaints when the institution is running in “the black”.

We tend to compartmentalize these minor complaints and move forward with grand expectations.

Eventually, the disgruntled employees (various parts of the knee joint) become tired of the unhealthy “working environment” and threaten to strike.

A painful knee joint can make quite a big stink and remind you with each step of the dissatisfaction it is in.

Put yourself in the following situation and ponder the decisions you could make and the ramifications of those decisions.

I will pose as mediator during this “press conference” for translation purposes .

(I will leave out all the disgruntled expletives.)

Imagine you are the President of the United Parts and Systems of the Republic of You.

Behind the podium you must field questions from the various parts and systems of your body.

Your painful knees have the floor and ask why haven’t you done something about all this weight they must withstand.

Clearly upset, your painful knee speaks: “I am tired and worn out from lifting and holding all this heavy weight day in and day out with not one day off in _years.  I can’t take much more.  What are you going to do about it?”  (The other parts and systems shout out in agreement.)

Here’s where you speak up and answer the question.

What would your answer be?

Would you be politically correct and explain how you have implemented various “policies” utilizing third party expertise (weight loss pills, processed diet foods, etc) which hasn’t produced the results promised or expected and you currently have your Chiefs of Staff (Ego and Super Ego) in negotiations with other third party experts which look much more promising?

Or would you admit that personally, you have failed to look into or attempt a “grass roots” resolution package involving a real look at fuel quality and consumption?

I guess the answer all depends on your view of politicians and political policy.

I suppose it also depends on whether you are willing to be truthful with yourself.

Either way, you’re gonna have to answer to your joints and systems in the end.

This surely won’t be your last press conference even if you aren’t re-elected.

You see, the parts and systems are stuck with you through the end.

Not by choice, but by an agreement made before you inhaled your first conscious breath.

By the way, would you re-elect yourself given your decision making background if you had to punch the ballot right now?

With a strong desire to be heard, your painful knee joint rises to speak again: “Why aren’t you giving us the exercises you promised many treaties ago which clearly make us feel better?  All of us parts feel like reservation cast-aways waiting for our annuities which never arrive.”

Wow…not even I saw that one coming.

Well, I suppose you could say you were wrapped up in foreign policy negotiations with other heads of state concerning the security and accumulation of future revenue.

You could also say you have been diplomatically networking and consulting closely with congressional leaders so your policies may have the broad and bipartisan support making them more effective which takes much time and preparation.

Ummm…Mr./Ms. President, before you say another word, I would suggest you look at the expression on the face of the knee joint.

The look of pain, disappointment and dissatisfaction is so thick you could cut it with a knife.

I’m not so sure $10 words and elaborate excuses will work this time.

Knee joint: “And Mr./Ms. President, can you tell us why you keep importing and consuming vast amounts of foreign fuel from suppliers who are ripping you off and whose fuel is environmentally unsafe and fails to meet the EPA clean burning fuel standards?”

Ouch….

Are you sure you want to touch that one with an explanation?

There is not a campaign in the world strong enough to overcome the potentially disastrous fallout of an attempt to excuse this question.

It’ll be mutiny.

And rightfully so.

I think we all see the common black thread that runs through the political arena.

I know not one person who hasn’t complained about this patriarchal system of ours regardless of their allegiance.

To be compared to such a system with regard to your own personal decision making may quite possibly be the grandest insult one could receive.

It may be best to throw out the current government and employ a personal matriarchal system where the pyramid is cast aside for the circle or hoop of life.

Either way, I hope this press conference allowed you, the Prime Minister of Decision Making, to see a reflection of truth without feeling the shadow of shame who’s heavy burden makes change and progress much more difficult.

Rochelle Gravance

LoseTheKneePain

 

 

 

 

 

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Knee Pain Q and A: Protagonist and Pain Free

July 17th, 2011

Officially, this is Part 2 of last week’s post.

In that post we talked about two main influences, pelvic width and hormones, which predispose women to knee pain.

Catch up with last week’s post here: http://losethekneepain.com/?p=1687

However, with knowledge and attention, one can dramatically reduce the implications and potential risks these two factors carry with them.

With regard to hip width, spend less time pounding your joints and more time shoring them up.

If you have narrow hips, you can probably get away with long distance running unless you run on crowned surfaces most of the time.

If you have average hip width AND you have great running form, you may be fine to run for distance.

If you have wider hips and you insist on running for distance, knee pain is likely your future.

There are so many factors to consider that most women fail to understand what they’re up against.

  1. General wear and tear leading to arthritis of the knee joint
  2. Q-Angle
  3. Lack of balanced strength
  4. Absence of Flexibility
  5. Reduced joint mobility
  6. Running on a crowned surface
  7. Poor running form
  8. Neglecting other training modalities
  9. Surpassing joint load capacity

It’s a funny thing.

You know, in all my years of working in the industry I have never experienced something so addicting as running.

Individuals that become addicted will run even when their limbs are threatening to turn blue and fall off.

There are other things in life that need to be done in order that one may run without increasing potential risk and injury to various joints and creating soft tissue damage.

Heck, even I run….

But not for distance.

I run sprints…uphill.

It’s the only type of running I can get away with over time that doesn’t cause swelling and further damage to my knee joints.

Sprints are not my only exercise modality, however.

And it is because I place attention on the mobility of my ankle and hip joints, the strength of my glutes and hamstrings, the flexibility of my quads and the rest of my body and constantly rotate my training regimen that I am able to do what I can.

Not super human, not extraordinary….just attentive.

I better quit before this starts to sound like some sort of anti-running blog post.

As far as hormones go, just adjust your activities accordingly.

If you feel tired, weak, wore out…pay attention to that.

Reduce the load, intensity and duration of your activities until your hormones settle down.

Be nice to yourself and pay attention to what both your body and emotional self needs.

Helluva recap (not intentional) from last week’s post.

It’s time to move forward.

Let’s talk about preventable risk factors you need to understand clearly so that you can be a knee pain protagonist.

Sounds kinda super hero-ish, doesn’t it.

Here we go…

Why women experience knee pain more often preventable risk factors:

  1. Inadequate activity levels

This needs little explanation.

We sit, our muscles get weak and tight, we gain weight and we develop knee joint pain.

No mystery, right?

Well, here’s something I want to add that may have escaped your realization.

We’ve already determined potential, predisposed risk for knee pain with regard to hip width and Q-Angle.

Women especially attempt to gain balance while performing knee dominant exercises like the squat and lunge by squeezing their knees inward as the knee(s) and hip(s) flex during movement.

This action increases the already present Q-Angle, which in turn increases the wear and tear of the knee joint.

Now we have a whole unfortunate chain of events taking place.

Weak, tight muscles struggling to properly align joints by failing to fire the correct set of muscles (compensation) in an attempt to support a framework of joints which may be under heavier loads than the joints were pre-designed to handle due to weight gain.

Messy.

Diamonds are not a girl’s best friend.

A girl’s best friends in reality are flexible ankles, strong flexible hips and hamstrings, core endurance and body awareness.

And they go nicely with all your outfits.

2. Inadequate and improper coaching and training.

I see this mostly with young athletes.

However, if you’ve ever talked with a personal trainer or exercise specialist and they failed to mention the importance of posterior chain muscle influence, core endurance (not strength), joint alignment or the basis of their programming revolved around machine exercises, then you were mislead (not intentionally).

Female athletes and exercisers need to be educated on the functionality of their bodies.

And as a coach/trainer, we need to select exercises and design programs which will stimulate the weak, suspect areas while reinforcing body awareness and attention to the “feel” of movement rather than how we may perceive what our vision allows us to view.

Professionals in the field need to stop training for fat loss.

Training for fat loss is just treating a symptom.

Fat loss will be a byproduct of sound nutrition and a properly designed exercise program.

Prehab exercises with emphasis on body awareness regardless of the condition of the individual is always the initial phase.

This will prevent unnecessary strain and injury to the client/athlete and also give the coach/trainer a good idea of what the individual is capable of and what the next steps will be.

3. Predisposition to psychosomatic disorders of the knee joint.

Education and information are the keys to helping individuals battle and resolve all types of knee pain.

However, the fact that I have given your unconscious brain plenty of reason to develop bodymind knee pain symptoms just by the content of these articles seems to give rise to the catch 22.

Bodymind pain needs only the power of suggestion to adhere to the trend.

That’s the beauty of it.

If you have missed the genesis of psychosomatic pain dilemmas, here are a couple of posts you should read:

Bodymind pain

Mindbody pain

This is a quite an expansive and demanding topic which I will be exploring more of in the weeks to come, however the magnitude of information related to the topic is too grand to delve into inside the walls of this article.

I highly suggest you investigate what has already been written thus far by clicking on the two above links.

So there you have it.

What you can do about what you’ve been given and a whole new understanding about how you can prevent further knee joint pain.

Questions and comments are always welcome and appreciated.

Rochelle

LoseTheKneePain

 

 

 

 

 

 

 

 

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Knee Pain Q and A: Feminine Frustrations

July 10th, 2011

Last week we talked about a recent conversation I had with a new acquaintance that centered around particular questions related to knee pain.

And since so many people now experience knee cap pain as the first signal of a body out of balance, I decided to devote the whole post to just that singular topic.

If you missed the discussion last week, here’s a link to get you up to date:

Click here: http://losethekneepain.com/?p=1681

However, our conversation didn’t end with just a discussion on the potential causes and remedies for painful knee caps.

As my new friend talked about various individuals who complained of knee pain, the realization came that most of these people experiencing knee joint pain were women.

So, the question came…

Q: Are more of your knee pain clients men or women?

A: Without a doubt, women.

Q: Why do you think that is?

A: How much time do you have?

Q: What?

A: Well…this could take a minute, probably much more.

Q: Really?

A: Yes.  Would you like the long version or the bullet point version?

Q: Uhhhh…?

A: Never mind.  Listen closely.

Women experience a higher incidence of knee pain for numerous and varying reasons.

1. Women are predisposed to knee pain due to but not limited by:

a.  Musculo-skeletal structure

The upper leg bone inserts at the hip in a somewhat wide position in contrast to the opposing end of the same upper leg bone where it meets the lower leg bone at the knee joint in a much more narrow position.

The width of a particular woman’s hip structure will determine how much Q-Angle is actually created.

The greater the angle (consequently, the wider the hips) the more potential wear and tear to the knee joint.

If you remember back a few months, I wrote a post about I.T. Band Syndrome as it related to knee pain and I voiced my strong opinion (which has yet to waiver) that most women have no business running.

The justification for this statement comes from the fact that too many women with wide hips are trying to pound the pavement for exercise and consequently experiencing knee pain and I.T. Band pain.

The reasons for this are numerous, not limited to just the pelvic angle and beyond the scope of this discussion, never-the-less…one of the commanding antagonists in this scenario is the width of the hip.

Here’s a link to that article: http://losethekneepain.com/?p=1380

b. Hormones

Let me preface the following statements by first saying that researchers and scientists really have just the faintest of clues as to what goes on in the inter-workings of the human body.

We know some things about quite a few things but rarely (if ever) everything about anything.

Follow me?

Read it again.

The same holds true for hormones.

And we chicks have a lot going on with ours.

Regardless of what we don’t know (as vital as it may be), what we do know is the hormone relaxin fluctuates throughout our monthly cycles.

An increase in relaxin softens connective tissue.

This increase takes place at the time of ovulation preparing for the potential pregnancy and added space needed within the body for the expected child.

If pregnancy does not occur, relaxin decreases at the onset of menstruation.

Why do you need to know this?

Because you need to be aware as a female athlete or a female that enjoys working out vigorously or one who plays recreational sports or anything more demanding on the joints and connective tissue to be more cautious during the period of ovulation until menstruation when relaxin returns to normal levels.

Loose connective tissue means loose joints.

Loose joints in a demanding activity means more potential for injury.

Many studies have attempted to link female athlete ACL tears with the period between ovulation and menses and the puzzle pieces seem to fit nicely.

So, word to the wise, adjust your activities accordingly.

Those that require more strength, power, control, endurance or those activities that are more demanding should be reserved for the first of your month if possible.

If not, be extra careful and aware.

This cautionary statement is especially pertinent for expecting mothers as well since relaxin levels stay elevated during the duration of the pregnancy.

Side Note:

I should mention an indirect relationship regarding the hormone relaxin and one to take note of because of its potential effect on your knee joints.

Relaxin inhibits collagen synthesis and causes collagen breakdown.

And as you probably know, collagen is what makes up the connective and protective tissues of your joints.

Double whammy!

Now before all the ladies have one more reason to protest having been given the short end of the stick, I think it best to end today’s discussion before the male counterparts begin receiving death threats.

We’ll continue the discussion after we all simmer down a bit.

The above mentioned realities are a given and out of your control.

However, there are many more pitfalls and influences that can cause knee pain that are preventable.

Just remember, there is always something one can do to better position themselves given what they have.

That’s where we’ll pick up next time as we explore preventative problems of the female knee joint.

Talk shortly….

Rochelle

LoseTheKneePain

 

 

 

 

 

 

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Knee Pain Q and A: Knee Cap Pain

July 6th, 2011

There are many interesting topics that get passed around the proverbial campfire.

It’s as if the heat and mesmerizing qualities of the flames draw on our unconscious and eventually release questions and insight.

I like to think the flame is still the inherent symbol of “light” and security for our primitive brains.

The light of the fire may also represent universal unconscious intelligence or knowingness which may also spur creative thought whether we choose to verbally express those revelations or not.

And when our defenses have been relieved by the hypnotic flames, interesting questions come to rise.

The following is a presentation of campfire enlightenment.

Q: What’s the most common knee pain symptom you run into?

A: Undoubtedly, knee cap pain.

Q: Why knee cap pain?

A: It’s the first sign of a body being out of balance.

I could go the traditional route, which I will for a moment, and tell you about how sitting too long tightens the muscles in the front of our legs (quads, hip flexors) which pulls on the patello-femoral tendon which attaches to the knee cap and then onto the lower leg bone (tibia).

When this happens, the pull from the tight muscles and connective tissues restricts the natural flow of the knee cap inside the trochlear groove (the “V” shaped formation of the end of the upper leg bone) which creates wear and tear under the knee cap.

If you’ve ever heard the terms patellofemoral syndrome, patellofemoral stress syndrome, patella subluxation, patella partial dislocation or chondromalacia then you understand we are talking about problems associated with the knee cap.

All problems with a relatively quick and easy fix if the problem hasn’t persisted too long.

If we are talking about a problem that has persisted for a number of years then more attention must be given to prevent further damage and continued wear and tear which inevitably leads to arthritic conditions of the knee joint.

However, I want to talk about why the thigh muscles become so tight aside from the obvious lack of movement and relinquishment to a chair for too many hours in a day.

Vision and body awareness.

Humor me for a moment.

Have you ever seen someone walk out of a restroom with their shirt tucked in and their underwear showing above the waist line of their pants?

Or maybe they are oblivious to a stretch of toilet paper stuck to the heel of their shoe.

If this is a conscious fashion statement…that’s one thing.

But most are embarrassed after being informed and quickly alleviate the source of their embarrassment.

Why these situations arise is because of the placement of our eyes.

We humans have predator eyes like the wolf, bear and lion.

We can easily focus our attention on what’s in front of us and be aware of what’s in our peripheral vision.

However, we have no way of “seeing” what is happening beyond our peripheral vision.

For this we must rely on another sense.

The sense of feel.

Unfortunately, we’re not taught to “feel” with regard to movement.

It is only when we have an injury in the back of our bodies that the pain reminds of our movements.

Being able to inherently “feel” our body and what our muscles and joints are doing at any given time can be referred to as body awareness.

This is especially essential when exercising to maintain balance, coordination, proprioception and to elicit proper muscle activation.

The largest muscles in our body are located beyond our peripheral vision in what is considered the posterior chain.

These muscles are the “movers” which produce “movement” in 2/3 of the exercises a person should have in their workout program.

But since we can’t “see” this part of our body and aren’t taught to “feel” it, we rely on what is in our line of sight or vision which is the anterior chain of muscles or the front of our body.

To give you an example of what I mean I’ll pose a question.

Which muscle should produce the most force in the squat or lunge exercise?

If you said the front of your thighs or your quads, you would be wrong.

As a matter of fact if you are using primarily your quads to produce the squat or lunge movement then you are actively creating knee cap pain.

A knee dominant movement like the squat or lunge is a collective effort produced by the entire body.

When speaking in terms of just the force produced from the legs, I like to break down the movement in percentages.

50% of the force coming from the glutes

30% of the force coming from the hamstrings

20% of the force coming from the quads

Quite a contrast from what you may have previously thought.

But because of the position of our eyes, we tend to rely, feel and think with the front of our body.

If this is you, an awareness shift is in order.

Foam rolling will “free up” these muscles which will help to produce “activation”.

Stretching will undoubtedly be in order since muscle restriction and tightness tends to proliferate our sedentary lifestyle.

Stretching will also relieve the tension from the tight connective tissue which will “free up” your knee cap to flow through the trochlear groove again.

Here’s the link to the stretching video: http://losethekneepain.com/?page_id=592

Activation exercises follow which will “wake up” these relatively dormant muscles of the posterior chain.

Here’s the link to the muscle activation video: http://losethekneepain.com/?page_id=599

The LoseTheKneePain free videos take care of all that for you.

Then you must place conscious attention on every repetition to create body awareness.

And if you need to lose weight…do it.

Your muscles and joints were pre-designed to handle a max load.

Breakdown of frame work will follow if that load capacity is surpassed.

My advise regarding today’s post would be to stretch your quads really well for immediate knee cap pain relief.

Then use the activation exercises in the free videos.

And finally, pay attention to your movements and “feel” your glutes and hamstrings create movement.

Talk again soon…

Rochelle

LoseTheKneePain

 

 

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