Next to low back pain, knee pain is one of the most common issues seen in physical therapy. The knee is a relatively simple joint, but pain in the knee can be tricky to overcome. When it comes to the knee, a funny phrase is usually employed: “Where it is, it ain’t”. Meaning, that the problem in the knee usually stems from elsewhere.
General Knee
(Every time I see “general” outside of the context of a military ranking, I think of “How I Met Your Mother, when they salute each other every time the word general comes up in conversation. Anyone else do that? No? No one?)
There are tons of specific issues in the knee that we could discuss, but I think it would be more helpful to talk generally, and to use two common examples that can be associated with knee pain.
Knees In
First up, a common abnormality in the knee is genu valgum (knock knees, knees going in). This is oftentimes due to weakness in a specific area in the hip (although it can also stem from specific knee issues or issues in the ankle and foot). What usually happens is that our “external rotators”, the muscles in our hips that turn the femur (big thigh bone) outwards, are very weak. Which in turn causes our femur to passively rotate inward, creating the look of “knock knees”.
This can put strain on the ligaments, muscles and other structures within the knee joint, because the knees are not meant to be in that position for extended periods of time.
Knees Out
The second issue in question, is the exact opposite of above: genu varum (bow-legged). With this condition, the knees bend outward, akin to riding a horse. In contrast to genu valgum, this condition can be the result of many things, but the femur is often stuck in an outward or externally rotated position.
Can These Issues be Corrected?
I think a more important question is: should they be corrected?
In either case, I would say the answer is: it depends.
A common theme that I like to talk about is “goal related outcomes”.
So for either of these issues, or any issue: what is the goal? If you’re in pain and through assessment we can determine that correction of these abnormalities will decrease that pain, I would say yes, let’s get to work.
If you just don’t like the way your knees look, I would say: let’s think about this and if the only reason is aesthetics, is it worth all of the trouble? Maybe you’re in your 80’s, get around without pain, but had a goal for your 85th birthday to finally get those knees looking right. The appearance of them might change slightly with some targeted therapy, but I’m not sure it would be worth the effort. Again though, it’s always up to each person on a case by case basis.
If you have knee questions, I got knee answers!
Disclaimer: The information provided in this post or anywhere on richardsonpt.com is no substitute for an evaluation by a licensed healthcare provider. Always consult with your doctor before beginning any exercise or diet plan.
