I hope everyone is doing well! I know some of you are training for and participating in marathons this season. All of you crazy individuals that decide to pay money and go out and run 26.2 miles. You know… you can just do that on your own. You can go out on a weekend and run 26.2 miles…alright, I’m joking. 

Kudos to everybody that is either at the peak of their training for these fall marathons, or has just completed a marathon. We’ve had some clients who just completed marathons. It is an unbelievable accomplishment. I have done a half marathon, I have never done a full…I can’t say if I will get to it or not. I am not sure I have that much drive or determination like some of the people that we are working with. 

Today’s blog is about what they don’t tell you about your knees. I love the use of “they.” They is in quotes because “they” refers to the so-called experts, physicians, orthopedics, some physios, chiros, and personal trainers. What THEY don’t tell you about your knees is what they should be telling you. Hopefully we are gaining awareness to these things they don’t tell you and starting to communicate this more to dispel some of the terrible knee myths that are out there.

This is framed around any individual that is just finishing up or is in the peak of their marathon training. This also pertains to crossfit athletes. Please take heat of this advice and content. Take it to heart. I don’t write these blogs at random without a plan. There is some pretty solid research that has been done behind this information. It is important that we get this out there in the community. 

Knee Pain Due To Cellular Change Is Normal

Again, we will put “they” in quotations because everybody loves saying they. They, in this case, are the people who are making some big decisions for you and what they might not be telling you. I’m not going to go into why, or the ethics of it all, but what you do need to know is that this is my clinic experience and what people are telling me. I then look at the research of it all and make sure that we are all aware of what is really happening here. 

First of all, let’s talk about body changes. The first thing that they do not tell you about your knees is that cellular change, cellular evolution, and joint modifications are normal. If you are 25+ and have any sort of active history, and someone takes an image of your knee…I hate to tell you this, but it is not going to look like it did when you were 18. It is going to have evolved. 

What happens with knees is that we are so quick to get imaging, diagnostics, and exploratory arthroscopy to find out what is wrong with the knee. For all of us, your knee is going to take on cellular evolution as you age. This is 100% normal and 100% okay. 

The analogy that I use is…

Do you think it is normal for our face to get wrinkles as we age? If you answered no, I would like to know what source of juice or botox you are utilizing these days. It is normal. Cells change and evolve. I’m not even going to say age because the term “aging” has this negative connotation like it is something bad…it is evolution. 

How Are Wrinkles Similar To Knee Pain?

If we do not get overly concerned about changes in our face (aka wrinkles), and those wrinkles don’t automatically cause pain (I don’t think a lot of us are walking around with wrinkles on our forehead and saying, “Oh my gosh, my forehead hurts because of those wrinkles” ), then why are we so concerned about cellular changes in our knees?

The same thing in a lot of cases (not all the time because sometimes the knee changes because of trauma or really significant degenerative arthritis and I am not avoiding those things) a large majority of people, there are going to experience cellular changes and therefore when we take images and say, “look, see right there. You’ve got x, y, z and this is why we need to do a meniscectomy or surgery,”  we need to analyze the situation before jumping straight to surgery. Cellular knee changes are normal. In 5, 10, 20% of us MAX, aree things actually abnormal causing us pain.  Cellular changes in your knee are normal and they do not automatically guarantee that you have pain because of them. 

Take that advice for what it’s worth. It is very important if you are going to get your knee looked at, assessed, evaluated, or treated that somebody is considering the whole picture. The WHOLE clinical evaluation. One image of your knee should not dictate what you are going to do next. 

If you have been down this road, please hop on board and share this word. Now, knee replacements where the degeneration has gotten so bad, torn ACL’s, and other traumatic events are going to call for more than conservative care.

Cellular change is normal. Wrinkles on your face are to wrinkles of your bones.

The Second Thing That They Do Not Tell You

Squatting is not bad for your knees at all. Actually, squatting below parallel (below your knee) is actually a good thing. Now, if you have a cute, hot, flared-up knee, you might not want to load up the bar and go crazy with deep squats. Squatting is good and squatting below parallel is even better. Everybody is going to have their own individual variances on that, but we have solid research that shows joint reaction force is actually not increased the deeper we go. If anything, it is good for the knee because we are going through a full range of motion with the knee under tension. 

All things considered, squatting can be good. It can be preventative and it should be utilized in your strength training plans. If I hear one more person without an understanding of the benefits and mechanics of squatting say, “you have knee pain, you shouldn’t be squatting. You shouldn’t have been squatting in the first place,” I might jump out the window.

Again, all things considered. Squatting is not bad and squatting below parallel is pretty darn good and safe for you. 

50+ Knee Pain And The Choices You Face

For our individuals who are reading this and are 50+, besides joint replacements (which is happening with fairly good success as we live longer and technologies get better.), I am talking the arthroscopic, meniscus, and cartilage surgeries. There is no difference at a year + between conservative care (working with someone like us, physiotherapy, personal trainer, strength and conditioning coach, athletic trainer, chiropractor) or having surgery.

Worse yet, at multiple years out, the people that had surgery were worse off. The common question that will come up going forward is that if you are 50+, and having some knee pain, and they find something wrong with the internal guts of your knee (meniscus/cartilage) minus the ACL or the ligaments, be very cautious of surgery at that time in your life. The changes are minimal, if not worse, when having surgery vs conservative care. We have research on that. 

I want you to consider how many individuals you know, or have yourself, been told because of something internal within the knee (meniscus or the cartilage) is being worn away and they would like to go in and complete an arthroscopy. They want to investigate, clean up something, and close you back up quickly. Be very cautious with that. You are going to do a lot for yourself with moderate exercise, well-designed and programmed exercise, and conservative care. Once exhausting all efforts, then get it opened. 

Again, I would not say some of this if there wasn’t great research to back it up. That is what they will not tell you about your knees.