Wednesday Rehab – Grumpy Knee Diagnosis

In this series, we are all about “Grumpy Knee Syndrome” – a highly technical term 😉 – that perfectly describes one of the greatest challenges for Strength and Conditioning Coaches and Rehab Specialists ( Trust me on this one!)

Have you done what I asked you to do last week? If you have knee pain you need to honestly answer each the 4 Q’s before you go any further (actually they kind of apply to any pain or body problem you might be challenged with..):


 Q1 Have you prepared yourself for the long slow road, or are you hoping for a quick fix? 


 Q2 Have you assessed and begun working
on your feet and / or hip function?
Work on those weaknesses above or below.


 Q3 Are you listening closely to what your knee is saying about
changing your habits – in lying down, standing, walking, running, lunging or squatting? Are you making changes?


 Q4 Have you found any ways to strengthen your Quads that
a) don’t aggravate your knee, and that 

b) really make your Quads burn and come alive?

What’s the Diagnosis of your Grumpy Knee?

I’m going out on a limb here when I make the call that as an industry, we have focussed too much on the Q: “What’s the Structure That is Causing the Pain?”, rather than doing what we know will help, and doing it really well.

On the chronically painful knee, have we perhaps made it too big a deal whether the pain is Patello-Femoral or ITB or Meniscal?? Don’t misunderstand me here, though – if your knee is acutely injured, or swollen, or under management by a Medical Professional, then fair enough discussions around diagnosis are relevant.

But if the statistics (as quoted by Specialist Australian Physiotherapist Jenny McConnell) are anything to go by…”15-30% of patients report little or no functional improvement 12 months following a knee replacement..”. That’s with a TOTALLY NEW KNEE. What about all the 1000’s of arthroscopes done daily in the western world to “clean out” rough joint surfaces…the odds are even worse that all these knees will be fixed by a diagnosis and operation! 

To look at it from another perspective, to quote Jenny: “Most individuals over 50 have structural abnormalities consistent with Osteoarthritis (OA) on a knee MRI, but only 1/3 will actually have knee pain”! So, a lot of knee OA is potentially from other sources; less structurally significant sources.