Knee pain is something that a lot of people struggle with at any time of year, both in the winter months when they are less active and also in the warmer months, as people tend to be more active. Which leads me to this week’s article…
This question was sent to me yesterday by a reader suffering with knee pain: “Trupti, I’ve been suffering with on-off type knee pain for more than a year now. What I can’t put my finger on is when it started or why, and what’s more confusing is that my pain gets worse as the day goes on. But whenever I wake up, the pain is gone – or is considerably less. Yet by the end of another day, my knee aches, sometimes it feels hot and swollen and I’m often in considerable pain – especially if I’ve been out for a long walk with my dog. Any ideas?” – Beth, 58, Mount Pleasant, DC.
What’s happening here is likely to be a simple case of the muscles around Beth’s knee joint being “weak”. The muscles just aren’t strong enough to last through the day, or cope with what she wants her body to do and where she wants to go. Think of it like this: When you go to bed at night and are ready to sleep – your body is obviously tired from all of the energy you’ve used throughout the day. Your muscles have been working in order to keep you upright and move your body through space.
In short, when you sleep your body gets a chance to recover, the muscles supporting your knee ache less because they’re less tired and feel “energized” and ready for a new day. But if a muscle, any muscle, is weak or damaged in some way, it’s not going to be able to support you through the long day ahead.
So, somewhere around dinner time, after a lot of “being on your feet”, your muscles will “pack up”. When they do this, joints, such as your knees, are left to fight their own battles. And that’s not good! Particularly if you’re aged 45+… as that’s the period of time where cartilage damage really begins (arthritis) and the boney surfaces of your knee start to rub together.
Without muscles to support these knee joints, or just really tired and weak ones, you’re much more likely to suffer pain or aches. The same thing often happens with neck and shoulder muscles at night too. This is also the reason why when you have the “flu” or a common cold, you always feel worse at night. Have you ever noticed your child get more exhausted than usual as the night draws in if he or she has a virus?
The same thing is occurring: your body puts up a better fight after a good night’s sleep, as it begins to get tired again through the day, the virus or bacteria wins the fight! This boils down to energy expenditure. The body only produces so much energy and this energy is expended throughout the day completing daily tasks, consuming food, etc. Even breathing costs a small amount of energy from the muscle responsible for expanding your lungs (the diaphragm).
So the answer to Beth’s knee problem? Well, it’s likely to be a simple case of strengthening the knee muscles (and hip and lower back ones) to make them stronger. But here’s something people often get wrong: walking a dog everyday will do very little to strengthen muscles – if anything, it will make weak muscles worse. Meaning you’re more likely to suffer more pain, not less. No, the answer is not found in more exercising, it’s in doing the right exercises to strengthen the right muscles, which means your knee will be strong enough to walk. With proper strength conditioning comes walking pain free, and walking pain free means you can keep your heart and lungs healthy without the worry of aches at the end of the day.
Local to the DMV area? Looking for movement experts to help you with lingering knee pain at night and unsure where it’s coming from and how to make it go away? Schedule a free discovery visit with us today
Trupti graduated with a Master’s degree in Physical Therapy from UNC- Chapel Hill in 2001. She has furthered her studies with numerous post-graduate courses focusing on the Neck, shoulder, knee, and back, with a strong emphasis in manual therapy. Recently completed courses in Maitland-Australian Physiotherapy Seminars (Levels 1- 5), has afforded her an excellent way to relieve pain and help people get moving, active and healthy quickly and effectively.
With 20+ years of experience in Physical Therapy, Trupti has practiced in various orthopedic and sports focused clinical settings, in both the Raleigh-Durham, NC and DC regions. She has been Director of multiple Physical therapy Clinics in DC and also worked with some renowned specialists at Georgetown University Hospital in DC. During her years of service, Trupti has had the privilege of caring for a wide variety of clients: from school-aged children to retirees; from homemakers to business professionals; from weekend warriors to professional athletes.
Trupti is an avid fan of the outdoors, art, traveling and of course the Tar Heels. She enjoys spending time with her niece and nephew.
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