What’s the Next Step to Fix Your Knee Pain?
What should I do for my knee pain?
I often get asked “my knee hurts, what should I do?” This is a complicated question to answer.
My first thought always goes to: was there an injury? Should you go get an x-ray?
If you have knee pain that’s been ongoing for a while you’re probably like my client Jillian. Jillian had a meniscus tear a few years before she started working with me. She was running, stepped wrong, and twisted her knee. It wasn’t much, just a little twist. It sidelined her for a week or so and then she was back at it. Over the next few months her knee would act up. So she saw her doctor who referred her to an Orthopedist. The Orthopedist said she could do surgery, a meniscectomy to clean it up, or a cortisone injection. She chose a cortisone injection. It worked like magic, the pain was gone. Her doctor said she “could try physical therapy, it might help”. She decided to not do physical therapy, but she wanted to make sure the pain didn’t come back.
Her mom said to go to physical therapy, it helped her with her knee arthritis.
Her sister said to get a personal trainer to build up strength.
Her dad said to go get a massage.
But what to do? Who to see? Who to work with?
I’m going to walk you through different scenarios to help decide what the next step for you could be.
How to decide what the next step is:
Should I go to physical therapy?
If you wonder if you should go to physical therapy I want you to ask yourself a couple of questions:
Did I have a recent surgery?
Did I have a recent injury that has been checked out and I’m still in pain but otherwise ‘good to go’
Do I have long standing pain and I don’t know what exercises will do more harm?
Someone should go to physical therapy if they had a recent surgery. There are guidelines after the surgery of when you can use the body part, put weight through your leg, start using weights for exercise, etc. The physical therapist will be able to instruct you in how to use your assistive device, put on an arm sling/brace, how to use the bathroom, get in and out of a car and do other activities of daily living. They will also be able to instruct you in the proper exercises to do that will support healing, and not do more harm.
If you had a recent injury, you didn’t break a bone, but you tore a tendon, ligament, muscle or have a tendinitis you should go to physical therapy. *This is with the caveat that this is a new injury. If it’s a long standing injury and you’ve tried physical therapy before, read on.
Physical Therapy is excellent to help rehab an injury, recent surgery or recent accident. The physical therapist can teach you how to do regular activities, how to exercise without doing more harm and actually help the body heal.
You should consider going to a physical therapist if you have one or more medical conditions that affect how you exercise. If you have diabetes and your sugar levels aren’t controlled, have high blood pressure and it’s not controlled, or you have low blood pressure and it’s not controlled, these in addition to other medical conditions would warrant seeing a physical therapist. The physical therapist can guide you in how to monitor your signs and symptoms including sugar levels with test strips, can monitor your blood pressure throughout the session and guide you through exercises that are less likely to make your blood pressure spike or plummet.
Physical therapy is great for someone who:
Is injured or recovering from surgery
Needs to learn how to basic daily activities including toileting, getting in and out of a car, getting dressed, using a sling, etc
Has lots of medical conditions that affect their exercise routine
To go get massage therapy
Should I get a massage?
If you wonder if you should go to massage therapy ask yourself these questions
Do I get muscle cramps that come and go and limit me from exercise or activity?
Do I get muscle spasms that leave me in bed all day?
Do I have soreness in muscles after exercise/running?
Massage therapy is great for:
Muscle cramps
Muscle spasm
Soreness in the muscles
Massages are excellent for helping calm down tight, cramped and spasmed muscles. If you’re getting charley-horses in your calf muscles that make it hard to sleep, massage can help. If you have a back spasm that comes and goes, and spasms so hard it makes you lay in bed all day a month of massages can help. If you are regularly exercising or running and you are sore for more than a day or two after the exercise, massage will help.
I will say there is a caveat with this: for the first two instances: the charley-horses/muscle cramps and the muscle spasms massage therapy should not be the only treatment. The muscles are cramping and spasming for a reason and you should also seek guidance on how to strengthen those muscles so they stop spasming.
Should I get a personal trainer?
If you are looking to start working with a personal trainer ask yourself a few questions:
Are you brand new to exercise?
Are you recovering from or currently have an injury?
Do you want to learn how to use equipment, weights and machines?
Do you like being accountable to someone?
If you are brand new to exercise and aren’t recovering from or currently have an injury then working with a personal trainer is a great step. A personal trainer knows how to guide someone through an exercise program to help them reach their fitness goals. Many people sign up with a personal trainer to lose weight, and this can be really helpful because increasing your fitness can help you lose weight.
If you have an injury or are recovering from an injury, a personal trainer is not the best place to start. I recommend going to see a physical therapist first. Then once you are done with your rehab program and still need to continue to progress with your strength and exercise then sign up with a personal trainer.
If you are looking to learn how to use the equipment in the gym including weights and machines, signing up for a few sessions with a personal trainer is a great idea. The ones at the gym you are a member of will know how those machines in that gym work. Take a few sessions with the personal trainer to make sure you know how to use each piece of equipment properly to decrease your chances of injuring yourself or breaking the equipment.
If you know how to exercise properly but tend to let everything else get in the way and you feel like you never make it to the gym, or never work out then a personal trainer is good for you. A personal trainer will hold you accountable to keeping up with the routine and the workouts. They are there at the gym so have someone waiting on you to show up. I love personal trainers for clients who already know how to exercise but need some help with the accountability piece.
Finally, I will note that you want to make sure you are clear with the personal trainer about what your goals are, and what kind of exercise and workouts you like to do. If you sign up with a personal trainer who likes and trains people in HIIT workouts but you don’t want high intensity, and want something challenging but more mellow then that personal trainer wouldn’t be for you. Make sure to talk to the personal trainer about what kind of workouts they train people in.
Personal trainers are great for people who:
Need accountability for an exercise program
Need to learn how to use the machines at the gym
Need guidance on when to increase weights
Caveat: being clear with personal trainer about what kind of exercise you do or don’t want: HIIT, CrossFit style, just using machines, etc
Should I go to a nutritionist?
If you are wondering if you should hire a Registered dietitian or a nutritionist ask yourself these questions:
Have I been diagnosed with a food allergy or sensitivity?
Have I been diagnosed with a medical condition that means I need to limit certain foods?
Do you need to supplement your diet with vitamins and minerals from sources other than food?
Do I need guidance on getting proper nutrients in my diet?
If you have recently been diagnosed with a food allergy, food sensitivity or a medical condition for which you need to limit certain foods I recommend seeking counsel from a Registered Dietitian. This type of provider can give you specifics regarding the foods you should avoid, and foods you should continue eating in your diet. Registered Dietitians are good at telling you where those foods and their derivatives are hiding.
If you need guidance on what supplements to take, whether they be in pill form, IV, or powder you want to see a Registered Dietitian. The RD can tell you which supplements to take, and in what medium to take them for the best results.
If you need guidance on getting proper nutrients in your diet and aren’t sensitive to, allergic to certain foods or have a medical condition then seeking guidance from a nutritionist or a nutrition coach is the way to go. Nutritionists and nutrition coaches can give you recipes and food recommendations to fulfill the needs for your diet. The nutritionist or nutrition coach should not be recommending supplements or formulating a diet for you, they should be guiding you through recipes and meal recommendations to fulfill the diet recommendations from the Registered Dietitian. The nutritionist or nutrition coach may make general recommendations but they should not be specific to a medical diagnosis.
A Registered Dietitian or a Nutritionist is good for someone if they:
Have a medical diagnosis and need to avoid certain foods - dietitian
Know what foods you need to avoid but don’t know how to incorporate recipes - dietitian or nutritionist
Dietitian will guide you in what foods to eat/ avoid based on medical diagnoses
Nutritionist can guide you to the foods that have what nutrients, incorporate more macros in your diet, recipes to incorporate those nutrients into your diet
To have surgery
If you are wondering if you should have surgery ask yourself these questions (specific to the knee):
Did I recently have an injury and my knee gets stuck in one position that needs another person to get it unstuck?
Is there a hard bump that’s not normally there and it moves around?
Did I have an x-ray and was told I have an unstable fracture?
Do I have osteoarthritis and my knee hurts so much I don’t even want to get up and do normal daily functions like go to the bathroom?
Surgery can be necessary and to determine if you need surgery I recommend asking the above questions when it’s related to a knee problem.
If you have an injury that makes it so your knee gets stuck in a position, like it gets stuck bent, and you can’t straighten it without someone else manipulating your leg you should seek advice from a surgeon. You may have a tear in the meniscus of your knee that blocks the knee from being able to move properly.
If you had an injury recently and now you have a bump that moves around: sometimes you see it, sometimes it goes away. This could be a floating piece of bone that chipped off from somewhere in the knee. You should seek advice from a surgeon if this should be removed.
If you recently had an injury, got an x-ray and were told that you have an unstable fracture then you should seek advice from a surgeon. An unstable fracture cannot heal on its own and it needs to be surgically repaired so it is “stable” and can heal properly.
If you have osteoarthritis, have had it for a while and now it’s to the point where you don’t want to even get up to go to the bathroom because the pain is so bad then I recommend seeking advice from a surgeon. You may need a knee replacement at this point. This is usually the point I recommend patients/clients wait until, if they are debating getting a knee replacement: wait until you don’t want to get up to go to the bathroom anymore.
Advice from a surgeon is recommended for someone who:
Meniscus tear that makes your knee get stuck in one position that you can’t get unstuck
Seeing a hard bump that moves around and “pops out” in your knee
You were told you have an unstable fracture
You have osteoarthritis that makes your knee hurt so bad that you dread even getting up to go to the bathroom
What do I do if I tried physical therapy and it didn’t work for my knee pain?
What do you do if you’ve been through physical therapy and it didn’t work? You don’t need or want the 1:1 advice of signing up with a personal trainer at the gym?
This is the exact scenario that I help clients with. I am a licensed physical therapist in the state of Nevada (also previously in Massachusetts and Rhode Island) so I have seen what the traditional physical therapy clinics look like: it’s a big reason why I left the clinic and formed my own business. I noticed that there wasn’t enough time for me to spend with each patient, and I also noticed that some patients just weren’t getting better. Physical therapy alone wasn’t what they needed. I also became a certified personal trainer and nutrition coach to help guide clients further along their strength and workout needs, plus their nutritional needs.
If you’ve been through physical therapy but felt like it wasn’t the right fit for you: you know how to exercise, you just need guidance in the correct ones to do for your pain or weakness, you like to workout on your own once you know which exercises to do, and you want guidance on how to optimize your nutrition to make the most of your workouts then I recommend finding out more how I can help you through the Move Better Method. You can email me, or If you’re looking for knee pain relief check out this free guide I created just for you.
Who is the Move Better Method good for:
A woman with knee pain
She doesn’t quite fit in at physical therapy because it’s too easy/or not enough guidance
She doesn’t want to sign up with a personal trainer because she likes to exercise on her own
She wants guidance on how to maximize her nutrition for optimal results
If you’re looking for knee pain relief check out this free guide I created just for you