The Knee Pain Workshop: How to Avoid Surgery, Shots and Pills

This morning is for you if

• Your knee hurts walking, on the stairs, kneeling, or getting up from a chair
• You've tried the creams, the brace, the rest, the pills, maybe a shot or two, and every one of them wore off
• An X-ray or MRI showed arthritis or a meniscus tear, and the next word you heard was surgery
• You're not ready for surgery and you'd like to know what else really works
• You missed hunting camp, a round of golf, or a day with the grandkids because you couldn't trust the knee
• You were told to lose weight, and nobody told you how with a knee that hurts every step

It isn't for someone who wants a quick fix that just covers the pain, or who doesn't want to take control of their own health.

Your knee is stuck in the middle

The knee bends about 140 degrees. It only twists about 5. It hates twisting.

Now look above and below it. Your hip rotates. Your foot rolls in and out with every step. When the hip is stiff or the heel bone won't move, the twist has to go somewhere, and the knee is stuck in the middle with nowhere to go.

That's why the cream, the brace, the pills and the shots wear off. They all work on the spot that hurts. None of them change how your hip and foot move.

What the pictures don't tell you

Researchers scanned the right knee of 991 adults, ages 50 to 90, in Framingham, Massachusetts. Plenty of them had a torn meniscus. Then they asked who actually had knee pain.

61%

of the people with a meniscus tear did not have knee pain, aching or stiffness on most days. (Englund and colleagues, New England Journal of Medicine, 2008)

Wear and tear on an X-ray or MRI is about as normal as wrinkles on your skin. A picture alone is not a reason to have surgery.

And the two most common fixes have their own problems. In 2017 the BMJ published a guideline that strongly recommends against arthroscopic surgery for nearly everyone with degenerative knee disease, including meniscus tears. The same year a two-year trial in JAMA found that steroid shots every three months caused more cartilage loss than a saltwater placebo, with no better pain relief.

What you'll learn

• The three most common types of knee pain: arthritis or "bone on bone," meniscus tears, and pain around the kneecap
• What "bone on bone" really means, and why your bones aren't actually grinding together
• The three most common causes: a stiff heel bone, missing hip rotation, and a stiff upper back
• What the research says about the pills, the shots and the surgery
• The single biggest mistake knee pain sufferers make, the one that so often leads to surgery nobody needed
• What successful treatment looks like, and why some physical therapy fails
• How to relieve knee pain even with arthritis, and what is really causing the pain
• How to tell if your pain can get better: if it's reproducible with movement, it's usually reducible
• A simple test you can try on yourself, right there in the room

What our knee patients say

What happens at the end

Who is running it

Treating knees in northern Michigan since 2011. Adjunct faculty at the Gray Institute and clinical instructor for the Doctor of Physical Therapy programs at Michigan, Central Michigan, Western Michigan and Grand Valley State.