Treating Knee Pain with Bodywork Therapies

The formation of adhesive scar tissue in the tendons, ligaments and joints is often the primary culprit in long-term pain. Although muscles get injured most frequently, they also heal more easily. Tendons, ligaments and joints, on the other hand, often take months or years to heal and often stay injured for a lifetime.

An injury is present when there is tissue damage. The damage could manifest as a swelling in a bursa or a joint; pinching of a nerve or a tendon; micro-tears in a muscle, tendon, ligament or fascia; or a major disruption of tissue like a broken bone or a ruptured tendon. When there is an injury, a part of the body has lost its structural integrity and is broken in some way.

Knee pain

When musculo-skeletal structures are damaged or torn, the body’s wisdom ensures that the damage, whenever possible, will be repaired. However, to a large extent the degree and quality of this repair depend upon our own participation. The natural mechanisms of inflammation and wound healing are usually excessive for the job at hand. The body over-compensates when it responds to injury. More plasma, red and white cells, blood platelets and chemical mediators are released than are actually needed to allow full healing to occur. Therefore, additional scar tissue is likely to form. This scar tissue often binds together damaged and undamaged structures, resulting in adhesions that can lead to re-injury and to chronic pain.

There are several methods by which we can help the body limit the formation of adhesive scar tissue and/or recover from adhesions that have already formed. Friction and range of motion exercises allow healthy tissue to grow without the reformation of adhesions.  If the injured person is able to collaborate with the body’s healing processes by adequate physical movement, complete healing is more likely. If the person is unable to perform the required exercises by him or herself, it is important to have a therapist assist the person in a full range of motion of the injured part.

Even knee replacement surgery doesn’t guarantee complete knee pain relief. Before and after surgery, sufferers may notice stiffness, decreased mobility and other painful symptoms in their knees. Massage techniques can alleviate some of these symptoms and increase flexibility, both before and after knee replacement surgery.

Recovery after surgery

Knee replacement surgery recovery varies for everyone. The length of time it takes to recover from this jarring procedure depends upon many different factors, not the least of which is the type of surgery performed. New technologies provide lots of different knee replacement surgery options, and many physicians perform partial knee replacement surgeries that are less invasive than total replacement procedures. But even the most effective surgeries will not provide total and permanent knee pain relief, and ongoing therapy may be necessary for many sufferers.

Massaging the pain away

Massage techniques can help to provide knee pain relief when utilized on a regular basis to keep the new joint mobile, flexible and comfortable, and will compliment any other therapies you are receiving, such as physical therapy.

Yoga to help your knees heal

Years of compensation patterns coupled with the lack of proper stretching (and of course, neglecting the scar tissue) result in limitations of movement.

Many people engage in habitual physical activities that contribute to pain. The love for a sport may override the initial whisper of a pain, until that whisper becomes a scream.

When addressing any injury, it is valuable to also address the joints above and below. Nothing could be truer than with the knee. Opening and strengthening the hips in every direction is important for even distribution of weight. After just a few short sessions range of motion and functionality increases while pain decreases, and you may even choose to sit cross-legged!

One of my greatest rewards as both a Board Certified Bodywork Therapist and a Yoga instructor is assisting clients to keep their sport of choice in their lives by prepping their bodies with sport specific healing movements and self-care strategies.

Scar Tissue Affects How Your Body Works

After releasing the scar tissue, I reset her pubus, rebalanced her muscles and watched her awe at being pain free in 8 years.

Last week, I wrote about how “little” injuries can affect your stress levels.  This week, is a twist on that theme.  But, before we start, let me take a moment to remind you that “stress” is not limited to emotional or mental stress, but includes physical stress.

Last week, I saw two clients presenting with dysfunction stemming from the scar tissue of having had c-sections.


Client I:  Was referred from her chiropractor when adjustments failed to really impact her groin and leg pain.  Her medical doctor had diagnosed her with bulging lumbar discs, and everyone had assumed her pain was “sciatic” related.

Her intake had me questioning whether the disc problem was contributing to her pain, and I was right to do so.  By the time we were done discussing her medical history, I was convinced that much of her pain was due to scar tissue.  Consider for a moment where the incision is generally made for a “bikini” c-section.  Both of this client’s children were delivered by c-section.  Client I is a race-walker and has competed across the country in marathons and half-marathons.  She had to quit due to the pain she was experiencing in her groin and leg.

What I found was the scar tissue from two c-sections was impacting her obliques, medial hip rotators which rotate the hip toward the centerline, hamstrings and peroneals which both point the foot and flex the ankle, lift the outside of the foot and assist in preserving the arch.

Wondering how scar tissue in the lower abdomen could be affecting her lower leg?  Think of ripples in a pond.  I used to be fascinated as a child to watch the ripples in a pond grow after throwing in a pebble:  “When it first starts, you may not even notice how that “little” injury is affecting your stress levels, but over time if not properly dealt with, the effects of that “little” injury grow . . . and grow . . . and grow . . .  Before too long, that “little” injury turns into stress manufacturing pain.”

After releasing the scar tissue, I reset her pubus, rebalanced her muscles and watched her awe at being pain free in 8 years.

Client II:  Has been a massage client for several years.  A nurse, this client often discounts her discomfort as part of the aging process.  She never mentioned having had a c-section, regardless of the numerous intakes we’ve done over the years.  This week she had a new complaint which was a result of a new workstation.  But, it made me wonder . . .

After asking some very pointed questions, I discovered she had a c-section on delivery, and all the puzzle pieces fell into place for me.

The complaint she came in with was in her butt.  Her gluteus maximus, hip flexors, transverse abdominals and rectus abdominals all tested “off-line” or not functioning, while her obliques, gluteus medius and minimus were all taking up the slack of the non-functioning muscles.

After releasing the scar tissue the “off-line” muscles turned back on.  I released the obliques and glutes, then activated the abs, hip flexors and glute max and loved her reaction to feeling the best she ever has!

Both clients had the same underlying reason for their complaints, even though those complaints were very different.

Both clients must do their homework to maintain the improvement.

Is discomfort or pain part of aging?  It doesn’t have to be . . . But, that is a subject for another time.