Desk Knees, Theater Knees, Plane Knees, and Etc.

 

As human animals, we’re instinctive. If something on the physical body is sore, we reach to touch the area, lightly rub it to see if pain dissipates, or palpate it to see if we can discover anything. Yet while we’ll instinctively use touch to ease, resolve, and learn, human anatomy is still beautifully complex and addressing pain in our soft tissue (or working on a client’s) can be confusing; it varies per area, per context, and per individual.  Because certain areas tend to make us more nervous when they’re in pain, it’s worthwhile to have an ever-increasing understanding of how our bodies work, how soft tissue can be addressed, and how touch really can promote and be an important aspect of healing and feeling good ongoing.

Aching, painful knees are a great example of an area that once off-balance can take us from irritated to worried. “Have I worn my knees out already? Is there something truly wrong in the joint?  Will my activities be limited?” Think of sitting at a desk, in a theater, or on a plane, no comfortable way to extend the legs into a relieving stretch, and that 90-ish degree angle the legs are bent into begins to make for some “chat” in the joints. Automatically, we may reach to the area surrounding the patella/knee cap and rub the tissue. Actual joint pathologies aside, since generally more than half of knee pain is referred from dysfunction in the upper thigh muscles, rubbing the tissue controlling the movement of the knee-joint ultimately can help. Soft tissue dysfunction in the form of hypertonicity, trigger points, adhesions between muscle fibers, and scar tissue, along with imbalances in strength amongst the upper leg muscles can all refer pain to the knee, pull it off alignment, and create improper movement and wear patterns in the joint.

There are so many good ways to address thigh muscles leading into and controlling movement at the knees: using a foam roller on the muscles, general to focused massage work on the upper legs, strengthening exercises to rebalance how the upper leg muscles are working together, etc. Given that,  I’ll focus this time on the lateral aspect of the knee; an area that can be surprisingly sore, yet we don’t usually feel it until it’s palpated. Because of how the femur/upper leg bone angles from the hip socket to the knee-joint, it creates a stronger pull on the knee laterally/to the outside of the leg. Accumulated soreness from being overly tight can lie deeply in the tissues to the outer side of our knees. Trace your fingers from the outer patella/knee cap to where the upper leg and lower leg meet along the side of the knee, exploring this zone in a circumference of a few inches. It can feel bony with less tissue mass and even “gristly” because different muscle tissues here thin down as they transition into tendons; the quadriceps muscles (which make up the bulk of the anterior upper leg muscles: rectus femoris, vastus intermedius, vastus medialis, and vastus lateralis) actually share a tendon that passes over the knee cap and attaches on the tibia bone below. All this makes for a bony, gristly, lumpy feeling landscape which can feel awkward and daunting to massage. Going back to exploring that outer knee zone, there is often a sore to bruised feeling in a few spaces here. Get lost in this region, seeking these hidden spots. Do small circular or back and forth friction movements with clustered fingertips, a supported thumb, and/or the heel of the hand; changing up how we use our hands is good so as not to overwork them. Spending time feeling where it’s tender, being interested by it, trying to gently move it, following where it may lead us to another spot in this small zone, or even applying several seconds of sustained pressure on a sore spot and then rubbing it away, can all help clear open the tissue.

I would never dissuade a client from checking in with an orthopedist if they had serious symptoms or concerns about their knees (or any other problem area in the musculoskeletal system), but it is important to remember that even if a pathology exists there, the surrounding musculature will respond to this imbalance via bracing or tightening to help offset the problem and maintain some kind of workable biomechanics. Meaning, no matter whether a joint pathology exists or not, if the knees are sore the surrounding tissue will have some dysfunction to address either way, leaving massage as a healthy addition in supporting the knees. And honestly, it feels great to get bodywork from both a therapist and via our own exploration. Giving care to oneself, accepting that the body needs and relishes nurturing, attentive touch, is fulfilling. It’s an emotional kindness back to oneself and a centering back into the physical form; a grounding back into the tangible, into something both simple and miraculously complex, reassuring us of our own solidity, presence, and intrinsic value over and over again.

 

Copyright © by Lara Stillo 2017

 

Advertisements

Author:

I have been licensed and working full time in the massage therapy field since 2001, teaching and writing MT courses since 2006. My experience has led me through working with several different chiropractors, hotel and boutique spas, corporate massage, a climbing gym wellness center, private practice, two different massage schools, one acupuncture/massage college, and my current capacity of working with physical therapy clinics and their patients. And the learning continues…

4 thoughts on “Desk Knees, Theater Knees, Plane Knees, and Etc.

  1. As a former ballet dancer I know only too well how vulnerable our knees are to injury and imbalance, Lara. Thank you for this practical “owner’s guide to checking out knee pain.”

    Thank you also for your beautiful and eloquent writing! Your account of the soft tissues around the knee reminded me of something an explorer might write to some old king back in Spain, describing a newly discovered landscape. Your familiarity with (and reverence for) the human body never ceases to amaze me.

    Liked by 1 person

    1. You danced ballet! How wonderful! I love dance “) – Thank you for your such praise, Heather. I hope it really is useful to people. Knee pain is tricky and come come from many factors, so trying to be succinct and still helpful on this topic (as on any health matter) is equally tricky. This is really just scratching the surface, but still a practical note on the subject 🙂 I find your writing to be quite wonderful, so many thanks again for these compliments (and great analogies!) on mine – means a lot =)

      Liked by 1 person

      1. Knee pain is indeed tricky, Lara, which is why I found your approach so brilliant: Encouraging people to explore the entire area around the kneecap and pay attention to the sensations is a wonderful first step in making a good diagnosis — and as I read your post I realized that not once had I or my doctors actually taken that step (instead usually relying on a verbal description of where it pops or hurts). So bravo to you! I promise you next time something aches or hurts I will ask myself, “WWLD?” 🙂

        Liked by 1 person

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s