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Train Your Way Out of Knee Pain

Knee pain descending stairs (Zac)

Seems counterintuitive right?

When your knees are cranky, how could using these joints more be helpful? Many of our patients share these same questions when during the injury rehabilitation process as they begin physical therapy.

Knee pain often originates from a reduced ability to tolerate stress. This stress may occur during movements such as squatting, lunging, running, or jumping.

Every tissue in the body has a stress tolerance. This is the amount of stress or loading that the tissue can tolerate before pain and injury occur. If the stress or loading tolerance reduces, less stress is required for pain or injury to occur. However, on the flip side, when the loading tolerance of a tissue increases, it then is capable of tolerating more stress. Sports physical therapy is often a balancing act between these factors.

The only way to increase loading tolerance is to train (or stress) the tissue!

The key is ensuring that the correct amount of stress is being administered to the target tissues. Too little stress will not be enough to force the body to adapt while too much may result in further injury.

Think of it like weight training. To build bigger muscles you must lift weights which is stress to the muscles. This triggers an adaptation to better handle the stress that was applied to it.

In cases of chronic knee pain, it is common for people to intentionally avoid loading the knees. As this occurs for extended periods of time the loading tolerance of the tendons and the various tissues surrounding the knees begin to decrease. This decrease in loading tolerance then increases the likelihood of further discomfort creating a snowball-like effect.

We can reverse this trend by introducing pain free exercises that force the tissues around the knees to work hard. These commonly include isometric exercises which are drills that involve holding a challenging, stationary position for an extended period.

Another category of exercises that often help those with chronic knee pain are eccentric exercises. Eccentric exercises force tissues to work as they are slowly lengthening. The exercise below is an example of one of my favorites that we commonly use.

Eccentric Step Ups

When it comes to knee pain, there are no “good” or “bad” exercises. The key is finding the exercises that provide the optimal amount of stress so that the surrounding tissues adapt properly.

Our team of Performance Physical Therapists would love to help you discover the best exercise routine to improve the loading tolerance of your knees. Contact us to receive your comprehensive home program today!

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