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Knee Pain Treatment Protocols

Why does direct pressure on soft tissue structures (ie massage in various techniques) garnish so little research and validation. I was recently reading an article on titled How to Beat Runner's Knee that listed recomendations as "avoid doing anything, including running, that causes the knee to hurt." Also suggested was ibuprofen and an ice pack to reduce inflammation. Poor shoes and weakness in the lateral hip were also mentioned and the advise to strengthen the hip abductors and external rotators.

This advice is a clear example of what little importance is placed on the musculoskeletal system and its' related affects on the body. Rest, ice, medication, and strenghtening exercises do not address one of the major causes in any type of joint pain, including knee pain. Namely, hypertonic muscles and the causal associated stress on the tendons and ligaments. Muscles get tight from the stress of our sport,  life, or the aging process, and as that stress accumulates, we begin to experience less mobiity in our joints, possible inflammation and tendinitis, and a serious case of muscle bundling. If we do nothing to reverse this accumulation, the body will respond accordingly. Pain is the bodies way of telling you there's a problem. If you listen and respond early enough, many times, it takes very little to reverse the affect and help the body find homeostasis. However, if you train through it, and ignore those pain signals, they get stronger and more serious. 

I've done some research to find more support of soft tissue treatment on pain. I found the following research: [Effect of stiletto needle intervention combined with massage on dysfunction and pain of knee-joints in patients with knee osteoarthrosis].Zhen Ci Yan Jiu. 2012 Feb;37(1):59-63, 76. Of the two 50 cases in the control and treatment groups, 10 (20%) and 33 (66%) had marked improvement, 33 (66%) and 14 (28%) were improved. Of course this is study done in China integrates acupuncture and massage, the results are still impressive and speak to the efficacy of soft tissue manipulation.

My message is simple. If you reduce the hypertonicity or tightness from a muscle or group of muscles through direct pressure (massage, foam rolling, mobility exercises, STARwrap, etc) the inevitalbe reduction of tension around the joint will affect the mobility of the joint and the inflammation and pain around the joint. You will then be able to rule out possible causes of the pain as musculoskeletal and look into other specific joint pain syndromes.  

Remember that the amount of time you work an area and how much force is applied are the 2 most important factors regarding tissue transformation.

Happy Healing!