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Treating Knees with Physio

Ever booked the dream active holiday and then started to panic that your painful knee might not last the holiday?


This happened to me 2 years ago when I booked my dream skiing adventure to Japan. Being an average skier at best I thought I had better fulfil my dream before the kids were too old and busy to want to come with me (as I need them to potentially rescue me). No sooner had I booked my holiday and friends started telling me of their horror stories of rupturing ACLs on the first day of skiing in powder. This reminded me of the pain and weakness I had felt in my knee on previous skiing holidays.

I had always considered myself to be reasonably fit having an active job, 2 dogs that demand regular walks and playing golf once a week.

Initially I started riding my bike to work at Balance Physio. I was surprised that my body was totally unaccustomed to aerobic activity and my right leg did not seem to be working as hard as my left.

I know that strong muscles around the knee support the joint and relieve pressure. But I also know that muscle imbalances can cause pain. I had to admit that my core and hip strength was not as good as I had hoped. Indeed my right leg was not working like my left causing uneven pressures around the knee. Had I been an elite athlete maybe I would have realised this sooner. They regularly have their muscle strength tested knowing that imbalances in certain muscles can predispose them to injury.

My balance on my right leg was also much less. A small squat just using my right leg caused my hips to rotate and my knee to drop inwards due to balance and strength problems. Balance is also something elite athletes have routinely monitored due to its relationship to injury and function.

Fortunately, this was enough motivation for me to start working. I became a frequent user of our pilates gym at Balance Physio making the most of breaks between clients. I committed to daily stretches and build up my ability to ride to work.  Six months later I enjoyed my powder ski holiday and was glad I had strengthened my knee. My right knee was still a bit weaker and a little sore but I survived. Two years down the track I am still in our pilates gym. Still improving my right leg strength and control. Aware I continue to have less knee and back pain. Must be time to start planning my next active holiday.

At Balance Physio we often see clients with knee pain. Many are fearful that they might have osteoarthritis in their knee. They are keen to get an X-ray to see if they have arthritic changes. This is not always necessary and in fact can make clients feel worse. Often clients in their 40s will have arthritic changes and meniscal tears. Studies that have looked at pain in relation to arthritic changes have shown that only about 15% of people with X-ray evidence of knee arthritis actually have knee pain. But once clients know they have arthritic changes they become very concerned.

Some clients believe they will need surgery. Recent studies suggest that arthroscopy can often be no more helpful than physiotherapy at relieving knee pain. In fact the risk of knee osteoarthritis rises from 60% for a cartilage tear without surgery to 100% after repair of knee cartilage with arthroscopy.

Between 2003 and 2014, the number of knee replacement procedures undertaken in Australia per year increased by 88%. The increase is partly due to population ageing but also to the growing use of this intervention for people at earlier ages. One has to ask why are so many people so willingly getting an operation that is expensive, can take a year for full recovery and is certainly not without serious risks. Especially considering this will need to be replaced in 15 to 20 years.

At Balance Physiotherapy Norwood we love to treat knees. Our pilates classes have many clients who have reduced their knee pain allowing them to return to the activities they enjoy. Some have been able to put off knee surgery. If you prefer and are very motivated we can tailor a home program for your needs. Sometimes knee surgery is necessary and strengthening prior to surgery helps recovery.

Regular exercise can be helpful in reducing weight.  The risk of osteoarthritis of the knee in overweight people is double that in people of normal weight; in obese people, it is four times as high. Shedding just 7kg can reduce knee pain by half.

If knee pain is stopping you doing the things you would like to do come and see us at Balance Physio Norwood and see what we can do to help you.