Ongoing hip and knee pain
‘’I have been suffering with my knee for years and my doctor wants to refer me for an MRI and is saying that surgery is most likely my only option’’
‘’I’ve been limping and struggling to get around due to hip pain and feel like my world is becoming more and more limited with this persistent and worsening pain, is there anything that can be done for it?’’
Here at APC, these are 2 common stories that we hear all the time and in response to the second statement. There is plenty that can be done!
We have a common phrase that we use a lot, which is very relevant to a person’s ongoing pain experience and that is: Let’s control the controllables.
So let’s delve into these a bit more with respect to helping out chronic (long term) hip and knee pain injuries.
1. Get to the root cause of your pain
Listening to your story and getting to what is actually causing your ongoing hip or knee pain
A typical complaint we get in the clinic would be someone who has had a lot of back, and buttock area pain and hip stiffness which has been on and off for years.
In the last 12 months, this pain has been felt more consistently and is now affecting how they move.
After assessment, we realise that the back is moving quite well with no significant signs of nerve involvement.
We find that the hip is very stiff, painful and irritated on certain movements.
This is combined with weakness around the surrounding musculature and the person has poor movement patterns as a result.
There could often be a previous injury like an ankle fracture, tendon injury or muscle tear that was never fully addressed.
This results in poor single leg balance which weakens the hip muscles and puts extra strain on the hip or knee.
Therefore, without addressing the ankle and hip stiffness and weakness, the back will continue to take the majority of the load. As a result, the back will continue to feel strain and pain.
2. Taking a holistic approach
Try to look at the whole picture of your health
Asides from the purely mechanical factors which are contributing to your pain (for example overloaded muscles and tendons or ligaments under too much strain).
Lifestyle, mental health and beliefs could all be significantly impacting your body.
Stress will lead to increased release of cortisol and adrenaline (fight or flight response). These are naturally occurring hormones but overproduction of these will lead to more inflammation in the body. So let’s briefly talk about different stressors.
Decreased sleep – Ongoing pain can disrupt normal healthy sleep (7- 8 hours) which in turn leads to poor recovery and increased stress (We have all been a bit cranky after a poor night’s sleep!).
Decreased sleep could be due to the pain itself, so getting this addressed and managed is very important. It is fair to say though, that there is usually a combination of factors that is causing this reduction in sleep time.
Increased emotional, work or family related stress is another causative factor. Recognising this is the first step.
Exercise, talking about the issue (trusted family member friend or mental health professional) or meditation can all be quite helpful tools. The trick is to find what works for you.
Oftentimes from experience in the clinic, recognising these factors alone can have a major positive impact on this.
Poor nutrition (high sugar foods and processed foods, we all know them!), excess alcohol intake and smoking are all stressors to the system. They will ultimately add to inflammation in the body.
Making small but consistent changes and keeping yourself accountable (while not beating yourself up!) is the key to changing these over time.
3. Get moving and exercising
Keep active but don’t over do it. Start small and progress.
Light and simple exercise can ease your hip and knee pain and you’re trying to get back on track with more walking or exercise. Less is more sometimes and with persistent pain, this is an extremely truthful statement!
With persistent pain your body has become accustomed to decreased activity and can sometimes perceive excessive activity as a threat.
Listen to the body, make it easy and achievable and enjoy the benefits of gradually adapting your hip or knee to its regular activity levels.
This is where physiotherapy can be very useful in guiding this part of the process.
There are also significant mental health benefits from exercising and this can help with stress levels, as well building back confidence.
4. Beliefs and outlook
Belief affects thoughts and this affects how we subsequently feel and act.
Poor beliefs and altered negative perceptions of one’s own abilities and function is commonly seen with someone who has long term ongoing pain.
There are physiological as well as psychological reasons for why this happens with persistent and ongoing pain.
These beliefs about your knee or hip need to be somewhat challenged and this can be done setting realistic achievable goals for decreasing your pain and increasing your function.
There will be bumps in the road in terms of having times when you will be experiencing pain.
Our goal over time is that this pain becomes less intense and is felt less often.
This is achieved by making those positive changes we have mentioned and in doing this and feeling the benefits, it allows you to have more control over your situation.
Keep the changes small, consistent and progressive and the beliefs and outlook will slowly change alongside this.
If this sounds like a familiar story to you and you want to find out more, click the button below to download our free guide to ongoing and recurrent pain.