Do Your Knees Hurt?

If you were to ask me this question a few days ago, I would have answered YES. But I've spent a few days fixing the problem. Because I make a living moving my body, I can't afford to ruin my knees. Nor any other joint. So I need an arsenal of tools to use when pain occurs.

I've been dancing, and teaching dance classes, for more than 30 years. So some of my bodyparts feel the wear and tear. Some parts more than others. Until now, my knees have always been pain-free. I want to keep it that way.

What causes knee pain?

There are several different injuries that could be behind knee pain. If you have a sudden, sharp, debilitating pain in your knee that causes you to limp or worse, this is a significant injury that probably requires a doctor visit. I am not a doctor and a blog is not a place to diagnose a serious injury. Anything approaching serious pain could be a torn muscle, ligament, or tendon. See your medical practitioner!

The kind of pain you can heal at home is much less serious. Mild to moderate pain is usually caused by a misalignment of the knee. Normal, healthy, correct knee placement will not create pain when you move. But when the knee is misaligned, due to shortening and tightening of muscles which cross the knee joint, the patella (knee cap) will be pulled off track. This will cause pain.

How do you know which muscles are tight and short? You may have to do some detective work. I knew I had done a lot of deep lunges in a recent class I attended, and my knee pain began shortly after this class. I had used the hip flexors to pull my knee forward repeatedly (WAY TOO MANY TIMES!) so I guessed it was tight hip flexors causing my knee pain. In fact, the area just under my knee was very tender to the touch. I took a look at an anatomy diagram and determined that it was my sartorius muscle which connected at that point. This is the longest muscle in the body, one of the hip flexors.

A tight muscle needs to be stretched, but first, a tight muscle must RELEASE. A tense muscle simply cannot stretch. And if an area has been irritated, inflamed, injured, and possibly is in spasm, then trying to stretch that area will only result in more tension and probably more pain.

STEP ONE: figure out the best way to help the tight muscle RELAX.

Some possible options: positional therapy, massage, deep breathing, pressure, rest.

Positional therapy involves putting the tight muscle(s) on the slack. This is the opposite of stretching. So if you know how to stretch the tight muscle, simply do the opposite action. Or do the action that the muscle is designed to execute, but hold the position in stillness, without tension, for at least two minutes. For example, my tight muscle, the sartorius, is designed to flex the hip. So to put this muscle on the slack, I needed to flex the hip by drawing the knee to my chest, then hold it in place with my hands.

Massage might involve hiring a professional or doing it yourself. I used a foam roller. You can purchase one cheaply online. Place the affected bodypart on top of the roller, apply weight, and roll. I needed to roll my thighs. Do not roll on top of bony protrusions such as knees, as this will be painful!

Deep breathing should be used with all of these therapies. Deep breathing will encourage your tight muscles to relax. It will also help you de-stress. Being in pain is stressful and no fun at all, so use your breath to help relieve some of that stress.

Pressure is a deeper form of massage that can be used CAREFULLY when normal massage is not effective. I used a kettlebell (heavy weight) on top of my thigh to encourage the sartorius to release. Was this painful? YES! But not dangerous, as I moved very slowly and gently over that muscle with the rounded part of the heavy weight. This did not cause any bruising. I also used a lacrosse ball under the thigh, just above the knee, to deeply massage the muscles and tendons. This was pretty darn intense! But again, no bruising. So no damage was done to any tissue. End result: the tension was reduced.

After applying all of the above therapies, I moved on to STEP TWO: stretching the now not as tight muscles. Hold each stretch for at least two minutes. Use a clock or stopwatch or timer, as two minutes is a lot longer than you might think! Repeat your stretch at least twice on each side. I needed to stretch my sartorius which involved bringing my heel to my butt. This stretch can be done standing, lying on the floor, or in a lunge position.

Once you have successfully stretched your tight muscles, rest! If you jump up and start exercising again right away, it is very likely those tight areas will seize back up again. Give your poor body a break. Put your feet up and watch a good movie. Drink plenty of fluids to hydrate your tissues. Take a warm bath with epsom salts. Take your magnesium citrate. Magnesium must be present for muscles to relax.

Listen to your body! If you need a doctor's attention, get that first. If you need more information about self-massage and injury prevention, check out the book Becoming a Supple Leopard by Dr. Kelly Starrett. Highly recommended!