Knee Pain Treatment

The human knee is an amazing structure, able to withstand enormous force loads during physical activity, and to support your body weight and provide stability during standing, walking and running. When you consider the amount of work performed by your knees on a daily basis, it is not surprising that they sometimes begin to hurt or become injured. In sports, knee injuries are the most common type of athletic injury.

Knee Anatomy

The knee is formed where four bones converge: the femur, or thigh bone; the two bones of the lower leg, fibula and tibia; and the patella, or knee cap. The knee is a synovial hinge joint, with the capacity to rotate slightly in a bent position. Knee movement is governed by the hamstring and quadriceps muscles of the upper leg.

Knee stability is achieved with the help of tough ligaments that hold the joint in place. Torn or sprained ligaments are a common injury in sports that require jumping, deceleration and rapid directional changes, like basketball, football, soccer and other field sports.

Ligaments of the knee include:

  • Anterior Cruciate Ligament (ACL): Prevents forward movement of the tibia and inhibits knee hyperextension
  • Posterior Cruciate Ligament (PCL): Prevents the femur from sliding off the front of the tibia and the tibia from sliding backwards
  • Medial Collateral Ligament (MCL): Prevents the knee from extending inward and allows for slight rotation
  • Lateral Collateral Ligament (LCL): Connects the femur to the fibula
  • Medial and Lateral Coronary Ligaments: Responsible for limiting knee rotation and stabilizing the medial and lateral menisci

Bursa and menisci within the knee capsule provide shock absorption to protect the bones from wearing against each other. The menisci also mediate weight distribution between the tibia and the femur. Synovial fluid within the joint capsule lubricates the joint to enable it to glide smoothly. Cartilage lines the ends of the bones to further reduce friction.

Common Causes of Knee Pain

Knee pain unrelated to sports trauma or overuse often results from misalignment and muscle imbalances along the lower kinetic chain. Misalignment can lead to deficient biomechanics and altered motor control that causes wear and tear on the structures of the joint. These alterations can in turn lead to instability or hyper mobility of the joint that results in repetitive trauma, wearing away of cartilage (osteoarthritis), bone dislocation and even ligament tears.

Weakened muscles from lack of physical activity and imbalances brought on by too much sitting are often the root cause of structural alterations and pain in sedentary, non-athletic populations. Obesity is also a contributing factor. Structural alterations of the knee can be prevented and corrected by reestablishing proper alignment and muscle balance in the lower extremities.

Diagnosis of Knee Pain

In addition to a thorough health history and clinical examination, we use diagnostic ultrasound to visualize the structures of the knee, to get a clear picture of alterations in the joint capsule. We then use gait analysis technology to conduct a dynamic analysis of the lower kinetic chain, including the hip and foot. Data from gait analysis reveals dysfunctional gait patterns that may be contributing to the patient’s knee pain.

Knee Pain Treatment

Traditional knee pain treatment often focuses on alleviating pain, but neglects to address the mechanical issues that caused it in the first place.

Traditional treatment methods include:

  • Medications, including NSAIDs, arthritis medications and opioids
  • Injections, including corticosteroids, hyaluronic acid and platelet-rich plasma
  • Physical therapy to strengthen surrounding muscles
  • Surgery

Treatment at NYDNR

Once we have arrived at an accurate diagnosis of the nature of your knee pain, we begin by treating injured tendons and other damaged soft tissues. At this point we introduce avoidance strategies in daily activities to reduce habitual harmful movement patterns in the affected limb.

Our physical therapy approach combines traditional methods with innovative rehabilitation methods and cutting edge technologies, including:

  • Gait analysis and retraining: By visualizing and quantifying movement dysfunction, we are able to train you to walk, run and move in mechanically more efficient ways. Using 3D video and force plate technology, gait analysis enables us to see movement deficiencies that are invisible to the naked eye.
  • ESWT (extracorporeal shock wave therapy): ESWT uses high frequency sonic waves to increase blood flow and promote healing in damaged tendons and other tissues.
  • EMG biofeedback training: This technology helps us identify and correct faulty movement patterns that are often at the root of knee pain.
  • Myofascial release techniques: Myofascial trigger points can cause pain and dysfunction throughout the body.
  • Alter-G treadmill: This gravity-reducing treadmill offers the most advanced technology for treating knee pain.
  • CAREN (computer assisted rehabilitation environment): This state-of-the-art virtual reality technology can be used on its own or with other methods to provide progressive treatment of front knee pain, ACL injury, meniscus injuries and osteoarthritis.

We offer the most advanced comprehensive treatment for a variety of running knee injuries, patellafemoral pain syndrome, ACL post surgical rehabilitation, and more.

Knee Conditions We Treat:

  • Meniscus Tears
  • ACL/PCL Tears
  • MCL/LCL Sprain/Strain
  • Patellofemoral Syndrome
  • Anterior knee pain
  • Patella-tendinitis(jumpers knee)
  • Prepatellar Bursitis
  • Pes Anserine Bursitis
  • Chondromalacia patella
  • Illiotibial Band Syndrome
  • Peroneal neuropathy
  • Hamstring Tendinosis

Please check out the pages for our running gait lab, our Alter-G treadmill, biofeedback motor control training with real time force plate analysis, and ESWT shock wave therapy, to see how these technologies can help you.



130 West 42 Street, Suite 1055, New York, NY 10036
130 west 42 street, suite 1055 New York, NY 10036

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