Knee pain can happen for a variety of reasons. Integration Massage will do a thorough assessment, and careful treatment, with the goal to get you moving again. I only use techniques within my scope of practice, however. And some knee issues will need to be treated by other professionals.
For example, knee pain can be from recent or old injuries, sports, arthritis or even surgery. I see these a lot. In particular, Ortho-Bionomy®, neuromuscular and myofascial therapy and exercises work quite well for musculo-skeletal issues. However, some conditions, such as severe sprains or meniscus tears require doctors or physical therapists.
How will you know? I will first take your history. Then I watch you move, and ask where it hurts. Finally, I palpate areas around your knee, so I can find out what movement or pressure re-creates the pain. This tells me whether what I can do will relieve it.
Kinds of knee pain, and how I bring relief:
→Is it just knee pain, or also ankle instability?
Many people with knee pain have an old ankle injury. How are they related? Perhaps you sprained your ankle in childhood and ignored it ever since. Or it might be unstable from repeated sprains. You may even have no sensation at your ankle, but you notice it tends to roll under when you walk on uneven ground.
If it has been five to ten years or more since the first sprained ankle, I often hear about knee pain as a consequence. It is not always easy to see the connection. However, when your body tightens lower leg muscles to compensate for ankle instability, it makes it harder for your knee to bend. For more details, see my post, Sprained Ankle Still Bothering You?
Or, perhaps you have a newly twisted knee, and you come to me for detective work. Either way, I will check out your ankle first.
→Muscle pain or tightness?
A principle of Ortho-Bionomy® is to move in the direction of ease or comfort. Another principle is that your body has intelligence and pain is a signal that something may be out of balance. So I will find the direction of ease for your leg muscles and tendons. I will hold them gently. Then I will wait until your body releases the tightness in a self-correcting reflex.
When the first area is complete, I will look at other areas until I see that your knee pain is resolved. (Also see Alison Zuber’s Ortho-Bionomy®: To Find Balance)
→Recent sports or athletic injury?
Doctors used to recommend the RICE method–Rest, Ice, Compression and Elevation. But that is changing. Current research encourages you to move your knee as soon as possible, to increase circulation and prevent stiffness (see, Rethinking RICE). Come see me after the swelling is down.
→Knee sprain, a.k.a. ligament injury?
A sprain is an injury to a ligament, the small dense tissues that help to stabilize a joint. Knees have many ligaments. Each has specific functions and directions of movement. When you have injured one, various muscles may tighten to limit movement and prevent further injury.
So I will examine your entire leg for muscle tightness or guarding. Then I will zero in on the area where you have the most tenderness. However, a serious injury such as a complete tear of ACL, MCL or LCL (see picture) requires a physician’s expertise!
A bursa is a fluid-filled sac. A synovial bursa protects tissues such as bone, muscle and tendons, around a joint. It decreases the friction of rubbing as these tissues move against each other.
Although synovial fluid lubricates joints, a synovial bursa can sometimes become inflamed. The most common causes of knee bursitis are frequent kneeling, sports, or impact from a fall.
More than one bursa may even be inflamed! Depending on which bursa you have injured, gentle massage and Ortho-Bionomy® can be effective. Treatment may take two weeks to two months.
→Osteoarthritis of the knee?
Movement and massage have helped knee pain from osteoarthritis. One research study showed that over eight weekly visits, patients showed “significant improvements in pain, function, and global response” (Massage Therapy for Osteoarthritis of the Knee: a randomized dose-finding trial).
Massage and movement exercises can also help you at home: Effects of Self-Massage on Osteoarthritis of the Knee. Those people improved in their ability to walk and stand. They also had better overall physical function, with decreased pain and stiffness.
Integration Massage aims to have you experience these same benefits.
I start by encouraging your muscles to relax. Ortho-Bionomy®, neuromusclular release and massage are effective for this. Next I apply gentle movement to lubricate the joint, stimulate synovial fluid and decrease inflammation. Afterwards, I teach you to continue the treatment at home so that your symptoms continue to improve.
If you indicate pain in the area of the meniscus, I assess how you move. Depending on what I notice, you may need to see a physician first.
Perhaps your doctor has already diagnosed a meniscus tear and said you don’t need surgery? Then I can treat you. The goal will be to relieve your knee pain, improve pain-free movement and increase circulation.
→Post-surgical knee pain?
Depending on when you had the surgery, and what you had the surgery for, I may ask you some questions: Was it a knee replacement? Was it surgery for tibial plateau fracture? Do you still have pins in it?
Or, was the surgery for a meniscus tear or ligament reconstruction? Does it get more painful after you have put weight on it and walk, or climb stairs, or when you sit still for a while? Is there still swelling? Are you still getting physical therapy?
I have had training in post-surgical treatment of knee pain, but I recommend you complete most of your physical therapy first. For total knee replacement, I find where you are in this timeline: Total Knee Replacement Surgery Rehabilitation Timeline.
What will it take to jump for joy again?
Because of the complexity of the knee, and the many possible causes of knee pain, I cannot tell ahead of time how many sessions it will take. I can bill your insurance, if you have a medical diagnosis, if your insurance includes massage therapy, and if you bring a prescription with the diagnosis codes.
Please call with any questions: 503-708-2911.
Or, you may schedule an appointment at a time of your convenience here: Schedule Appointment
Ortho-Bionomy® is a registered trademark of the Society of Ortho-Bionomy® International, and is used with permission.