- Are you experiencing knee pain
with daily activities or exercises?
Well, there's a number of reasons
that you could be having this,
and we're gonna go through this, but-
- Many individuals will assume
knee pain is related to arthritis.
But there are many other things to consider.
- And we're gonna go through these
and show you some exercises,
some things that you may not have thought of
to get rid of this at home by yourself.
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- So we have worked with many people over the years,
and they often come in with knee pain,
specifically in the front of the knee,
kind of over the kneecap.
And often they complain about pain increasing
when they go up or downstairs.
- You know, I found a lot of times,
it's even more down steps, but it can be either direction.
But there's good news with this,
if we need to assess the knee a little closer.
And oftentimes you can see Mike is working
with his patella or the kneecap,
and it should be movable and mobile like that.
There's a tendon here
and a tendon here that connects the quadricep
and the patella to the bone here.
Those two tendons can oftentimes lead to knee pain.
Actually, my sister had knee pain so terrible
that she was literally walking on or kneeling,
crawling on her hands and knees, forgive me,
and ended up to find out it wasn't her knee joint,
it wasn't arthritis,
and we'll tell you what it was and how she took care of it.
- So there are six solutions we're gonna go through
to help decrease your knee pain here.
And the first one is to simply avoid activities
that irritate this pain, make it worse,
which we talked about earlier, could be the stairs.
- That's right. So it's just a simple thing there.
Number two is we're gonna actually take a closer look
at the kneecap or the patella.
You wanna get it up in a position like Mike has
and have the leg completely relaxed,
particularly the quadricep muscles.
Now when these are completely relaxed,
you're gonna find a very interesting thing
that some people may not be aware of, is that the patella
or the kneecap will actually be very mobile.
You can see me moving it right to left.
And we're just want to make sure
that all the connective tissue has no scar tissue
or not tight from being immobile,
or if you're sedentary over the past months or years.
So we can go right to left.
You can move it up and down.
This should not be painful.
If it hurts a little bit the first couple motions,
that's okay, as long as it feels better with time.
And I mean over five to 10 seconds.
So right to left, feels better.
Does it feel better?
- [Mike] It feels great.
- Yeah, if it feels good or better, go ahead,
up and down, same thing.
And you can actually kinda work some angles on it as well.
You'll spend maybe 30 seconds
to a minute probably doing this.
This will help certain amount of people.
There are gonna be other people that they'll do this
and they'll find, ah, it moves, everything's good,
so then we're gonna go on to the next solution.
- So the third solution
is to do manual cross friction massage.
It's a fancy way of saying
you're gonna massage the painful areas.
So if your pain is below the kneecap here,
you can take two fingers, cross it over,
or I'm gonna use my thumb,
'cause it's a little bit easier for me.
I'm gonna put my other thumb on top.
I'm gonna push down,
and I'm gonna go back and forth on this tendon.
You're gonna do this for two minutes if you can tolerate it.
Obviously the harder you push,
the more it's gonna dig in there.
Now, if your painful area is above your kneecap,
and here the quad tendon region,
you can do the same thing up there.
Do it for two minutes, like I mentioned before.
And this will increase the blood flow to these tendon areas,
helping decrease your pain, bring nutrients,
and make it recover faster.
- There's one exception I wanna bring involved with this.
As you're doing the cross fiction massage Mike described,
after about 30 seconds,
if the pain doesn't reduce or if it feels numb,
then it's okay, but if it just continues to irritate it
and you're getting into that 30 seconds to 60 seconds
and it feels like it's, eh, this really hurts more,
then you need to stop.
It's too early to do this cross fiction massage.
You're gonna need to wait a day or two.
All right, so you're gonna find out
after massaging your tendons or the muscles with your hands,
which works quite well actually,
your fingers will probably get tired,
particularly if you're having success
in you're doing it for that two minutes
like Mike had suggested.
If you happen to have a massage gun
or a friend that has one, use it.
It'll save your fingers.
If you wanna purchase one, that's an option,
but you don't need to.
So when you use a massage gun
for this particular cross fiction massage,
you have to have a massage gun
that reciprocates back and forth like this.
Okay, otherwise you will not get the same results.
And you need about 10 millimeters
of amplitude that direction.
That's really not that critical.
Just gives you an idea if you're shopping around.
The headset you'll want to use is the round head,
which I am using.
That's my preferred for this technique.
Or you can use the cushion head here.
It's an air cushion head,
because you're gonna be around your kneecap
and the bones of your knee.
And if you massage your bone anywhere on your body,
it is not gonna do anything except create pain.
We don't want that.
So we're not gonna massage the bone at all.
And I'll show you the technique if you're using.
Now the tendon that we talked
about below the kneecap is here, in here,
and there's a soft spot right below the kneecap.
We talked about that.
You take the massage gun,
and I think this part particularly works best
with the round head.
Do not go straight in.
That's gonna pound and beat up your tendon and your knee.
It's gonna do nothing but bad. Go sideways.
And then you get that cross friction massage.
Just blow that kneecap in that hollow spot.
It's so much easier and it's just a delight.
It works out very well.
Now, Bob actually had this tendonitis knee pain,
same as my sister, above the kneecap where the muscles,
our quadricep muscles all come together
and connect to the kneecap.
So we're gonna do it this way.
And Bob was massaging his actually manually,
and his fingers were getting tired.
Right, Bob?
Yeah, he's shaking his head, and he started the gun.
And within how many days?
Within a couple days having great success
and things are going well.
Now, one thing that you may wanna assess
is see if the muscles up this direction are tight
or have any knots in them.
That may be the case.
And you'll know, 'cause when you're pushing around,
and you'll feel a tender spot,
kinda like a Tootsie Roll in that muscle.
If you have that, then you can actually go into that muscle,
'cause you have more mass, more muscle mass, muscle fibers.
Then you can get more aggressive
when you're away from the knee.
And again, work that for a few minutes.
This is actually the case with my sister's knee problem.
Part of it was the knee, part of it was the tendons,
or the muscles up and here were really tight
and limiting that kneecap mobility,
which is needed for a healthy knee.
Wow. And actually, it's a nice deal.
We could probably go on like this for five or 10 minutes,
but we've got more information to help you out with.
All right, and the last technique, number six,
is we wanna actually stretch the quadricep muscles again.
They connect to the kneecap here up to the pelvis area.
Right in here we're gonna show how to do that,
as well as there's another structure, which is the IT band.
It's kind of like a wide ligament.
It actually is exactly where these three stripes are.
Connects up from the pelvis down to just blow the knee.
And we need to stretch that out a little bit as well.
That can take pressure off that knee as well.
So Mike, it's all yours.
- So you're going to lay on the firm mattress
or bed of sorts.
You can also do this on a table if your bed is too soft.
You don't wanna fall off the edge.
So you're gonna start on your back.
Your feet are gonna be off the edge of the bed.
If you want more of a stretch in the front hips,
you scoot more towards the bottom of the bed here.
But for now, I will stay here.
Try to bring both knees to chest to start.
And now you're gonna drop the side that's painful down.
Now, when you go down like this,
you wanna try to keep in a straight line.
If it's too tight pulling out or pulling in,
that's not gonna be the stretch you want.
You wanna keep your legs straight.
Now to get my quad stretched even more,
all I'm gonna do is bend my heel back like this.
And I feel it more.
Now if this feels good, you don't feel stretched at all,
just scoot your buttock off the edge more
and you'll start to feel it.
Now, an important thing to remember
is bring your opposite leg up here.
Bring your knee towards your chest,
hold this position, try to do it for 30 seconds.
After 30 seconds, bring this leg back up,
rest here for a second.
And then you're gonna switch sides.
And you might notice one side is tighter than the other.
If one side is, really focus on that side,
but it is good to do both sides.
Do 30 second holds and do it two to three times a day.
- And I do wanna mention,
it's real critical when you do this
that you have either some shorts on, some stretchy pants.
Are these all stretchy jeans?
- They are stretchy.
- He's got jeans, but they're the stretchy kind.
If you wear jeans, things bind up
and you will not get a good stretch.
All right, nice work, Mike.
Stretch away.
- So those first six steps were to help remedy
your pain in your kneecap.
So if your kneecap is feeling good now
and you wanna start progressing more,
what you wanna do is start walking again.
You wanna make sure it is pain free walking.
Start on flat surfaces and slowly progress.
Don't go out walking a mile.
If you haven't walked in weeks, just start slow.
Maybe do quarter mile.
Progress each day as it feels comfortable.
- That's right.
And remember, if you have hills,
make sure you avoid those, on the flat.
And actually at roads, like on the road I live on,
there's no sidewalks and the roads always have a camber,
so the water runs off.
Well, that angle that you're walking on
can put stress on your ankle, your knee, as your hip.
So don't walk on, if you walk down the road on the right,
turn around and walk on the same side of the road,
so you balance things off.
Sometime that's not safe.
If that's a situation, try to get to a spot
where it's flat sidewalk
or trails where you don't have the unevenness.
- Now, if you were doing some form
of resistance training before or exercises
and you wanna start those again,
it's important to remember
to do maybe partial range of motion early on
or drop the weight significantly
if you were using weight while doing these.
So we're talking about things that involve your knees.
So such as like some type of squat
or some type of lunging form.
Just do a partial range of motion
as long as it feels good.
If it creates pain, hold off for a while till you try again.
- Right, and a lot of you may not have used weights
in the past, you know,
and that's fine if you wanna get back to this.
So again, like Mike mentioned,
if you wanna decrease the intensity
and you don't use weight, just body weight,
you're gonna do that by how far you go down.
So previously if you were squatting this far down
without any problems, the knee is feeling better now
and you can do it pain free,
even if it's a little baby squat.
It's like, "What good is this doing?"
But if you get down to here, it hurts, do not do that,
pain free range, give it some time.
Or if you're doing lunges,
you know, you might have been going till your knee touches
at one time prior to the injury,
you may only go down half the distance,
and give it a week or two.
Be patient with it
because you don't wanna re-irritate the old injury
and set yourself back to where you were.
Things will come along.
Just be happy and be glad that you can do 'em.
- We should add that you wanna make sure
you're using proper form with any type of leg exercises.
So if your knee tends to track in, that is a no-no.
You need to work on your outside leg muscles
and keep it straight.
So make sure your knee is staying in line,
or even going slightly out is okay,
but you don't wanna go in like this.
- Right, that's the most common error is that knee going in.
It's no good.
I always tell my patients, get that knee
over the top of your toe when you're looking down
and that'll help keep that sagittal plane
as what we call it in the therapy world.
All right, very good.
All right, give these tips and tricks a try.
There's a good chance
you're gonna find some relief with them.
If not, it may be something is more.
Maybe you do have arthritis.
You need to have a different approach.
- So if you want to find out more videos
related to this topic,
you can check out the comments section.
We sometimes pin it to the top, some other related videos.
Otherwise, if you're interested
in one of the massage ones we talked about,
they'll be located there too.
Also, you can comment down below anything maybe we forgot,
because Brad doesn't know everything that.
- Well, that's right, but I do know this.
This is a side note, you can get off.
Do you realize what happened yesterday?
It was a sad day yesterday.
- No. What happened?
- You heard of the Edmund Fitzgerald?
- Yes.
- And you know who sang the song "The Edmund Fitzgerald"?
- I don't, but-
- Gordon Lightfoot. He's 84 years old.
He passed away, and he gave a wonderful tribute
to all 29 sailors or the men in that ship,
down it went in Lake Superior,
530 feet of water, 30 foot swells.
And it made this largest cargo ship of 29 tons of ore
just broke it like a toothpick, down it went.
- You know who else passed away?
- Who? - Jerry Springer.
- Oh really? - Yeah.
- That's right. Well, he didn't sing though.
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