When your knees are acting up, how could using them more possibly help? Many of our patients have the same concerns during the injury rehabilitation process, especially when they first start physical therapy.
Knee pain often stems from a reduced ability to tolerate stress. This stress can occur during activities like squatting, lunging, running, or jumping.
Every tissue in the body has a certain stress tolerance—the amount of stress or load it can handle before pain or injury occurs. When this tolerance decreases, it takes less stress to cause discomfort or injury. However, when the tissue’s loading tolerance increases, it can withstand more stress. In sports physical therapy, finding the right balance between these factors is crucial.
The only way to increase a tissue’s loading tolerance is through training—or in other words, applying stress to the tissue!
The key is to apply the right amount of stress to the targeted tissues. Too little stress won’t prompt the body to adapt, while too much could lead to further injury.
It’s similar to weight training. To build stronger muscles, you need to lift weights, which stresses the muscles. This stress triggers an adaptation, allowing the muscles to handle more in the future.
In cases of chronic knee pain, people often avoid loading the knees. Over time, this avoidance leads to a decrease in the loading tolerance of the tendons and tissues around the knees. As tolerance decreases, the likelihood of pain increases, creating a snowball effect.
We can reverse this by introducing pain-free exercises that challenge the tissues around the knees. Isometric exercises, which involve holding a challenging position for a set period, are particularly effective.
Another type of exercise that often benefits those with chronic knee pain is eccentric exercises. These exercises work the tissues as they lengthen slowly. One of my favorites, which we frequently use, is the Eccentric Step Up.
When dealing with knee pain, there aren’t inherently “good” or “bad” exercises. The goal is to find the exercises that apply the right amount of stress so the surrounding tissues adapt appropriately.
Our team of Performance Physical Therapists would love to help you find the best exercise routine to improve your knees’ loading tolerance. Contact us to receive a comprehensive home program tailored to you!
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