Physical Therapy: The Smart First Choice for Knee Pain


I want to talk about why physical therapy is effective relief for knee pain. In physical therapy, obviously our main goal is to approach pain and dysfunction through conservative care. We want to get you back to doing the things that you want to do as quickly and painlessly as possible.

In physical therapy, we’re going to be watching how you move. When it comes to knee pain, that can include things like watching how you get in and out of a chair, how you squat, how you walk, how you jog, and seeing what that means. It’s also seeing the way the biomechanics of the joint could be affected and could be contributing to your pain. That’s assuming that there isn’t some kind of traumatic injury. We know a lot of people who play sports and might have torn their ACL or torn their meniscus in higher level activities or even from falling.

But in terms of day-to-day, we have a lot of people who have insidious onset knee pain, meaning they don’t know where it came from, why it started. Oftentimes, that has to do with the alignment of our joints. We’re going to be looking at your posture all the way down to your toes, for example:

  • How your feet hit the ground
  • The footwear that you wear
  • The positioning of your hips, knees, and back as you do certain bending and squatting activities

We’re going to be making sure that we are making everything optimal to try to prevent any uneven wear and tear on the structures.

Pain and the Structure of Your Knee

There’s many structures in the knee that can cause pain. Some people, as I mentioned earlier, might have torn ligaments in their knee. Possibly they have torn their ACL—the anterior cruciate ligament. Or the PCL—posterior cruciate ligament. These are X-shaped ligaments deep in the middle of our joints.

We also have the ligaments, the MCL and LCL, on the sides of our knee. Ligaments are structures that connect bone to bone. They’re prime stabilizers of our knee, but sometimes we can get sprains of these ligaments. Just like spraining your ankle, you overstretch those ligaments and now you might have more play side to side, which then can unevenly wear the joint surfaces.

That play in the joint can lead to pain, inflammation, eventually arthritis or a knee replacement. We want to try to catch everything early and prevent that subsequent lead up to those big surgeries.

Achieving a Good Balance Between Strength and Flexibility with PT

Obviously, we want to look at someone’s strength and flexibility balance. We have a lot of muscles that cross two joints, for example, that cross the knee and the hip. Here’s two areas where this happens: your quadricep muscles down the front of your thigh and your hamstring muscles down the back of your thigh. I bet some of you didn’t even know that you have a calf muscle that crosses the knee and the ankle.

When you come into physical therapy, we’re looking to make sure that there’s a good balance between the strength and flexibility of all of these muscles so that we can help with that alignment.

Maintaining Good Alignment in the Knee

A main component of our programs for the knee actually focuses a lot more on strengthening the hip. Some of our big hip muscles are the ones that control the alignment of our thighs falling in or out, which can affect the tracking of the kneecap in the groove.

Some of you may have heard of patellofemoral pain syndrome. The patella is your kneecap, the femur is your thigh bone. If that kneecap isn’t tracking straight as your knee bends and straightens, that can cause some rubbing and eventually wear down some of that cartilage and maybe even result in arthritis.

The Purpose of Physical Therapy

We want to make sure that we can help our patients and clients avoid surgery whenever possible. One of our mottoes in my physical therapy practices is that we want to get all of our patients back to normal without unnecessary medications, injections, and surgeries.

We want you to start with a good evaluation of all of these points to make sure that we can avoid surgery, avoid those surgical risks, avoid the time off work, the expense of all of it, and get you back to function as soon as possible.

If you’d like to have us have a look at your knee and how you move, please give us a call and set up a complimentary consultation or evaluation. Call us at 925-284-3840 today to get started.

Lauren Masi is a Doctor of Physical Therapy, board-certified clinical specialist and certified athletic trainer. She earned her bachelor’s degree in physiological science from UCLA, a master’s degree in physical therapy from CSU Northridge, and a doctorate from the University of St. Augustine. As owner of Lafayette Physical Therapy and Bay Area Physical Therapy, she has assembled a skilled team to provide highly personalized and effective care. Lauren’s extensive career encompasses expertise in various physical therapy techniques, including Mulligan and Paris methods, myofascial release, and spinal mobilization. Lauren enjoys horseback riding and family time when not treating patients.

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