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Knee Pain India, 16-B, Govind Marg, Opposite Gurudwara Raja Park, Delhi (2025)

23/01/2024

A good posture doesn't mean that our spine is well aligned and flexible. Our posture generally defined that how we look alike and how our body is behaving.

Generally, we want to live in most comfortable position, where our muscles & tendons are under least stress, but because of faulty lifestyle, workplace ergonomics and surroundings generally force us into an abnormal or faulty posture.

First contact point of our body with the ground is our feet, and hard surface related overpronation forces us into anterior pelvic tilt, and subsequent lumbar hyper-lordosis and secondary changes in dorsal & cervical spine.

So whenever assessing posture it is very important, not to assess only spine but assess the patient from top to toeas, because a small defect in our vision also can force us into faulty posture. So, manage your posture for a healthy & pain free life.

22/01/2024

OA knee patients, especially patients who have varus malalignment, had higher peak adduction moments in comparison to the normal population. The knee adduction moment is the moment that acts on the joint in the frontal plane. This acts to rotate the tibia medially on the femur while walking.

The knee adduction moment tends to force the knee outwards, compressing the medial joint compartment and stretching the lateral joint structures. This adduction moment also relates to the severity and progression of the disease, higher adduction moments are related to a higher rate of disease progression.
High, peak knee adduction moments were positively associated with greater pain and were negatively associated with the knee functional score in OA knees.

Theoretically, the higher hip abduction strength, the lower knee adduction moment, which could lower pain and improve function in OA knee patients.
Therefore, it is always better to either increase the strength of the abductors or reduce the strength of the adductors. By doing so, we can easily stop the progression of OA knee and improve the functions with time. OA knee (Uni-compartment) is very responsive to conservative treatment if used appropriately and on time.

Surgery can be avoided if intervention is directional and timely interventions.

18/01/2024

Maintaining a fine balance between the two divisions of Autonomic Nervous System (ANS) is very important for healthy living. We often ignore the origin of any life-style illness and often start focusing on the symptoms only. But, for any secondary life-style illness there should be a cause, and by simply treating the cause we can prevent ourselves from many life-style illnesses.

Our body is full of irritating factors often responsible for sustained high sympathetic tone. We also unaware about the existence of many "Myofascial triggers" in our body and often tries to suppress the symptoms arising out of it instead of looking for a cure of these triggers. These latent triggers are responsible for sustained higher Sympathetic tone in our body and this high sympathetic tone is an initial trigger for many life-style illness like Diabetes, Hypertension, Thyroid Disorder, Metabolic Syndrome and Chronic pain in our body.

We can simply manage all the secondary life-style illnesses by timely treatment for these latent myofascial triggers. This requires an early aggressive approach followed by regular stretching exercises and supplement intake. Instead of starting lifelong medicines, we can simply take treatment for these triggers.

Maintaining a fine balance between the two divisions of ANS (Sympathetic and Parasympathetic nervous system) is very important for a healthy living. For that you don't you have to be aware about your problem. Wake up now and just look for cure and not just suppress the warning signal.

16/01/2024

Biomechanical factors play an important role in the health of diarthrodial joints. Altered joint biomechanics and loading — associated to obesity, malalignment, trauma, or joint instability — is a critical risk factor for joint degeneration, whereas biomechanical correction, exercise and weight loss have generally been shown to promote beneficial effects for osteoarthritic joints.

The mechanisms by which mechanical stress alters the physiology or pathophysiology of articular cartilage or other joint tissues likely involve complex interactions with genetic and molecular influences, particularly local or systemic inflammation secondary to biomechanical alterations, injury or obesity.

An abnormal, altered, or injurious loading is associated with inflammatory and metabolic imbalances that may eventually lead to osteoarthritis.

An improved understanding of the biophysical and molecular pathways involved in chondrocyte mechano-transduction can provide insight into the development of novel therapeutic approaches for osteoarthritis. The recent studies indicate that biomechanical correction and exercise may play many important beneficial roles in an overall therapeutic regimen for osteoarthritis. These include decreased pain, increased mobility, and increased muscle strength and slow down progression of the disease.

03/01/2024

Knee osteoarthritis (OA) is a leading cause of disability among older adults and also in middle age. Patients with knee OA demonstrate reduced functional capacity that can be attributed to joint pain, stiffness, and loss of muscular strength of the lower extremity muscles.

Although OA is diagnosed and defined as a loss of hyaline cartilage within the joint, muscle impairments associated with the disease may be the primary underlying cause of functional impairments, and muscle dysfunction may actually precede and expedite the cartilage deterioration. As such, knee OA cannot solely be considered a disease of the cartilage, and clinical management of the disease must also take into account associated muscular impairments.

Patients with knee OA typically present with reduced force-generating ability in the quadriceps that can be attributed to muscular atrophy as well as muscular inhibition, which is the inability to fully and volitionally activate the muscle. Subjects with knee OA are functionally limited compared with age- and sex-matched controls. These limitations may be attributed to weakness of the quadriceps muscle because quadriceps strength is an important determinant of physical function in subjects with knee OA.

In addition to force output, other measures of muscle function are related to physical function, and muscles other than quadriceps are also impaired in patients with knee OA. Simply, going for analgesics and exercises and in advance cases knee replacement is not a good option. Knee functions can be improved simply by correcting biomechanical impairments around the knee joint. Pain is just a warning sign that there is some ongoing damage because of biomechanical aberration and that can be corrected easily without opting for surgical interventions.

Always consider curative options first and damaging procedures in the last for a healthy life.

01/01/2024

Most of the time, the initial trigger is imbalance in muscular activity around the knee joint. Our bones/skeleton works as a static framework and muscles are working as mobility framework. Movements are always directional as so attachment of the muscles to bony structures.

In the maximum number of cases, the initial symptom is stiffness, restricted and difficult movement, and not the only pain. That happens because of change in the direction of pull at the knee joint. With time our feet started going into overpronation and that causes compensatory tightness of adductor muscles. With time all these changes cause dampening of shock absorption capacity of the knee joint and secondary OA changes. If acted early and appropriately we can easily save our knee joints.

If managed actively and appropriately, the requirement for Knee replacement is much less. Simply balancing the activity around the knee joint can provide us extensive relief from knee pain and discomfort.

Thats why understanding the disease process is the most important initial step in knee pain management. Managing the cause is better than removing the cause.

28/12/2023

It is a common perception that causes of knee injury may have proximal origin. It is a proven fact that impaired trunk proprioception and deficits in trunk control are predictors of knee injury particularly in females.

In next few lines we will highlight the biomechanical influences of abnormal hip mechanics on the increased incidence of knee Osteoarthritis (OA).

Impaired hip muscle performance can render the hip joint susceptible to dysfunction in all planes. Abnormal motion of the femur can have a direct effect on tibiofemoral joint kinematics and strain the soft tissue restraints that bind the tibia to the distal end of the femur.

Excessive hip adduction and internal rotation during weight bearing have the potential to affect the kinematics of the entire lower extremity. More specifically, excessive hip adduction and internal rotation can cause the knee joint center to move medially relative to the foot. Because the foot is fixed to the ground, the inward movement of the knee joint causes the tibia to abduct and the foot to pronate, the end result being dynamic knee valgus. Excessive knee valgus has been shown to be related to diminished hip muscle strength and has been implicated in contributing to numerous knee injuries, including anterior cruciate ligament (ACL) injury and patellofemoral joint dysfunction.

In almost all cases, abnormal hip mechanics is the initial trigger for knee pain and aggravated risk of OA knee. Progression can be prevented easily by timely action. The knee is always being erroneously overtreated and so many people become dependent on oral medications and unwanted surgical intervention.

So, it is important to Identify your problem and take timely action for a healthy & pain-free joints.

19/12/2023

Flatfoot, or pes planus, is a condition that causes collapse of the arch during weight bearing. This flattening puts stress on the plantar fascia and the bones of the foot, resulting in pain and further breakdown.

Overpronation can lead to injuries and pain in the foot, ankle, knee, or hip. Overpronation puts extra stress on all the bones in the feet.
The repeated stress on the knees, shins, thighs, and pelvis puts additional stress on the muscles, tendons, and ligaments of the lower leg. This can put the knee, hip, and back out of alignment, and it can become very painful.

Along with overpronation, adductor muscle tightness can put more stress on our medial compartment of our knee joints and make us vulnerable to medial compartment collapse of the knee joint and rapid progression of osteoarthritis knee joint.

We think we are perfect but on daily basis we are committing mistakes that are making us vulnerable to many Lifestyle issues/diseases. Instead of just managing symptoms, management of the cause should be our first priority.

16/12/2023

Knee osteoarthritis (KOA) is a common disease in middle-aged and elderly people. Pain is the chief complaint of symptomatic KOA and a leading cause of chronic disability which is most often found in medial knees. Management of patients with knee pain requires a combination of pharmacological and nonpharmacological treatments, including surgical interventions when necessary.

KOA is a normal age-related joint degeneration, mostly linked to our faulty biomechanics. We often ignore that fact and started treating the symptoms which we often failed to control fully. By simply managing the pain we infect aggravating the degenerative process because we are not correcting the cause (Faulty biomechanics).

By continuously putting stress on our lower body and with age related joint degeneration and faulty biomechanics is linked to rapid progression of KOA. It's always better to manage the cause instead of treating symptoms because our dependency on medicines is increasing very fast and if we will not control that soon, our system will be used to live like a diseased body.

Have trust in your healthy and live a disease and pain free life.

06/12/2023

We spend so much time focusing on the other groups of leg muscles – the calf, hamstrings, quadriceps, and glutes – that we often neglect the adductors. Often, we think that tight hamstrings are responsible for our back pain, or tight quads are the culprit of our knee pain. While this is definitely probable, tight adductor muscles could also be the source of the problem.

Our adductors play a big part in stabilizing the body and torso when we stand. Tight adductors can cause knee pain, hip pain, groin pain, and back pain – they can even affect the way we walk and sleep.

Having tight adductors on one side and not the other will make it difficult to hold the pelvis level which means the opposite hip will drop down as you walk. This can then result in hip pain and further imbalance as the body tries to compensate for the tight muscles.

It is important to both stretch and strengthen the adductor muscle along with trigger release in the adductor muscle, so that they are strong enough to balance the weight of the body and support the pelvis and be flexible enough to allow full range of motion while walking.

13/05/2023

Excessive hip adduction and internal rotation during weight bearing can potentially affect the kinematics of the entire lower extremity. More specifically, excessive hip adduction and internal rotation can cause the knee joint center to move medially relative to the foot. Because the foot is fixed to the ground, the inward movement of the knee joint causes the tibia to abduct and the foot to pronate, resulting in dynamic knee valgus. Excessive knee valgus has been shown to be related to diminished hip muscle strength. It has been implicated in contributing to numerous knee injuries, including anterior cruciate ligament (ACL) injury and patellofemoral joint dysfunction.

During weight-bearing activities such as walking and running, the resultant ground reaction force vector passes medial to the knee joint center, thereby creating a varus moment at the knee. The varus moment is primarily resisted by the lateral soft tissue restraints of the knee, namely the lateral collateral ligament and the iliotibial band. Apart from increasing the tensile strain on the lateral soft tissue restraints, the varus moment creates greater compressive forces within the medial compartment of the knee compared to the lateral compartment. Excessive knee joint compressive forces are responsible for the accelerated risk of OA knee as mentioned above.

In simple words, knee pain secondary to knee injuries/degenerative changes can be controlled/slowed down with simple pain management/biomechanical correction measures.

Medications/surgical interventions can be avoided with simple biomechanical corrections. It is always better to opt for biomechanical correction.

10/05/2023

Tight adductors can cause knee pain, especially seen in runners. The function of the adductor muscles is to pull the thighs together and rotate the upper leg inwards, as well as stabilize the hip.

The most common symptom of a tight adductor — also known as a groin pull — is a pain in the medial thigh at the site of the strain. Pain is usually sharp when the injury is acute, and transitions to being more dull in quality when the condition is chronic. Pain increases if the area is palpated.

Although weak or inhibited glutes may only pose as tight hamstrings and adductors initially, over time this can lead to injuries such as:- Anterior knee pain- ACL injuries- Low back pain- Hamstring strains- Hip impingement- Ankle sprains Gluteus Medius Muscle: The gluteus medius’ primary function is hip abduction.

Adductor strain is a common cause of groin injury and pain among athletes. Risk factors include previous hip or groin injury, age, weak adductors, muscle fatigue, decreased range of motion, and inadequate stretching of the adductor muscle complex.

Underuse of the muscles or sitting down for extended periods can cause weak hip flexors. Conditions such as osteoarthritis (OA) can also cause weakness in this muscle group.
Symptoms of OA knee can aggravate as time passes, especially difficulty in getting up after prolonged sitting. Regular stretching is a must and needs to be done daily. By maintaining a fine balance between Abductor strength and adductor stretch, we can prevent ourselves from many musculoskeletal issues.

Dr. (Lt Col) Sonu Singh,
MBBS, MD (Physiatrist)
Associate Professor, Mahatma Gandhi Hospital, Jaipur

Knee Pain India

23/01/2024

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18/01/2024

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Monday	10am - 8pm
Tuesday	10am - 8pm
Wednesday	10am - 8pm
Thursday	10am - 8pm
Friday	10am - 8pm
Saturday	10am - 6pm
Sunday	10:30am - 2pm