Knee Pain: A Complex Problem to Solve

Fibromyalgia is a chronic condition that is characterised by widespread pain across the body which is often accompanied by secondary symptoms including fatigue, anxiety, difficulty sleeping, joint stiffness, headaches and even difficulty concentrating. It is not yet known what the exact cause of the condition is, it is thought that the pain may be caused by neuro-chemical imbalances affecting how the CNS and the brain interact and process pain. It is also speculated that lifestyle, genetics and psychological factors may play a part but research is ongoing at present. What is clear is that for its duration this condition causes mass discomfort for the person suffering from it and it seems to be becoming more prevalent in society given greater awareness of the condition. This in turn means that as therapists we are seeing more clients present with this condition who ask – ‘Can you help me?’ and the answer to this question is ‘Yes you can!’.
answer is – it depends……
When you initially strain a muscle or sprain ligaments or tendons there are tears in the fibre, bleeding and swelling. This leads to inflammation and heat being radiated from the area as the dead cells are removed and new ones brought in to start the healing process.
After a thrilling day at Wimbledon on Friday, my own little tennis ‘victory’ and some pretty tender ribs for the last week, I have been inspired to think about why my ribs hurt, why we ‘Grunt’ under pressure and how we can get more power in our tennis shots.
I myself can be guilty of the ‘Grunt’. It comes at two stages for me. Firstly when I am completely overstretched for a shot, the ‘Grunt’ makes an appearance – the result of me digging deep to get the power to return the ball with at least some pace when in this weak, lengthened position. Secondly, it seems to appear on even the tamest of shots when I am in the third set and feeling weary. So it’s clear that for me at least the ‘Grunt’ helps me to find power where there is none. So why do so many women tennis professionals grunt on almost every shot? Am I missing a trick?
Feet. Something I avoided for years given a propensity to tickley feet myself and just simply blocking them from my mind. It’s over the last 12-18 months that I have become OBSESSSED with feet. They tell us so
much about the story of someone’s body and can act as great guide do identifying dysfunction in our clients. What I want to give you today is an idea of what the foot could be telling you at the most basic level to give you an insight into why you need to look whole body, when you are suffering pain or dysfunction in just one area. First time I see a client I like to do a ‘Toe to Top’ visual assessment. What can I see just by looking at how my client stands or walks. Is the arch overly high? Are the feet flat? If so what does that tell me? Well it may not tell me anything definitively but it certainly gives me clues as to what to check next.
And so we come to the final installment, although in writing this I feel this should have been Part 1 given how critical it is to healing and that is how what you put in your body dictates not only the length of time needed to heal but the quality of the job itself.
What you put in to healing is what you get out! The Food Factor
As discussed over the last two blogs, your body has its work cut out in terms of removing damaged cells, laying down new healthy cells, fibres, collagen and to do this is needs the right base materials. We all know the quality of the building is only as good as the quality of the materials used – your body is no different! In order for your body to generate the right parts at a cellular level, it needs the right mix of vitamins, protein and hydration to do this.
Now that we have established that your injury needs to go through a number of stages and processes to heal the next step is to establish is the type of injury. There are two aspects that I will consider here ‘What tissue is damaged?’ and ‘How badly is it damaged?’.
‘What’ you have damaged makes a significant difference to healing time whether it is muscle, tendon or ligament can be the difference in weeks and months when it comes to healing:
‘Fascia’, if you haven’t heard of it, take note as it is the big thing in ‘Soft Tissue’ these days. What is this stuff dubbed ‘The Cinderella’ tissue by Dr Schleip and how does it impact how we treat clients as massage therapists? In its simplest terms it is a web of collaginous fibres that hold everything in the body together so we act as one strong and co-ordinated unit, a single organ. Fascia connects skin, veins, organs, nerves, muscles and bones together so we can move and function by distributing the stresses and strains across our body. On that basis, if it is restricted or damaged its impact on the body can be vast.If that is the case then why has Fascia been ignored for so long?
One view is that since it differs from person to person in texture & quality it has been difficult to describe. In addition it cannot be split easily into segments that we can name like muscles and bones (Dr. Schleip) which again has made it harder to document and study. The good news is that technology has now improved to a level where Fascia can now be studied in more detail so research is catching up on proving why this tissue is so important and how it impacts the body.
The dreaded question we face as therapists – ‘How long to heal?’. It is not because we don’t want to commit to a timeline but it is because there are so many variables to healing time that it truly is like asking
‘How long is a piece of string?’. To go some way to helping you understand the process and what you can do help the body along I have written a three piece blog on Injuries.