Knee Pain
Most knee pain cases involve pain in the front, inside, or outside of the knee. But I start by treating the back of the knee first, and I am very successful at treating knee pain because of it.
Most people do not hu
rt in the back of the knee, so why would I start there?
I first evaluate by having people lie face down on the table, and I push into their hamstrings, calves, and the back of their knees, looking for hard and stuck tissue. Guess what I always find? Yes, hard and stuck tissue. Often, these muscles are so hard they feel like bone, yet they do not hurt in day-to-day life and get overlooked because they do not hurt… ever!
I pick the worst spot that could offer the most relief and laser it, getting it to soften up some or a lot. Then I have the person stand up and test it out, and they are often quite surprised by how much better their knee feels in the areas I never even lasered.
Why is this? Think of your leg as two sticks. Your thigh is one, and your lower leg is the other. Now squat. The two sticks would just buckle away from one another where they connect, wouldn’t they?
Your knee is held together in the front by your quadriceps muscles, your patella, and your patellar tendon. If that was all you had to hold your knee joint together, it simply could not withstand you squatting. But our hamstring muscles travel from the back of the thigh, cross the back of the knee joint, and insert into the tibia and fibula just below the knee. When you squat, your hamstrings contract strongly to prevent the tibia from buckling forward, thereby decreasing the stress on the front and sides of your knee, including muscles, tendons, and ligaments.
Treating the back of the knee, thigh, and lower leg is way more productive and successful for treating knee pain than treating the area where you hurt. Ten minutes of laser therapy on the back of the knee is often enough to show some improvement, lending credibility to the method and the laser. It is a show-and-tell process.
I treat other parts of the knee as well, not just the back. Often, the area where you hurt actually needs direct treatment, especially if there is swelling and sharp pain. But if I overlook the back of the knee and it turns out to be a primary problem, I won’t resolve the knee pain entirely.
The Role of the Hamstrings and Gastrocnemius Muscles
When this muscle is tight, the knee simply cannot function properly.
Take a look at the back of the knee in the picture of the superficial back line. There are four separate hamstring muscles. Three long ones that traverse from the ischial tuberosity to below the knee. The fourth attaches along the back of the femur and attaches to the fibula. More simply stated, there are two hamstrings on the outside and two on the inside.
Notice how the outer head of the gastrocnemius goes underneath the two outer hamstring muscles. And also on the inside back of the knee, how the inner head of the gastrocnemius goes underneath the two inner hamstring muscles.
Rarely, and I mean rarely, does anyone ever hurt here. But these areas become incredibly tight and stuck, so the muscles can’t slide over one another very well, and this messes with their function in stabilizing the knee.
This is hard to feel on yourself because by the time you reach down and forward to feel it, you are stretching your hamstrings, and everything feels tight. Instead, this must be felt by someone else, while the patient is face down and relaxed with a straight leg.
Lasering these areas along the back of the knee is critical to solving knee problems, yet it goes unnoticed most of the time because people do not feel pain here. A common theme on this website is that primary problems often do not hurt in everyday life.
Another amazing benefit of working the back of the knee and calf is that it helps loosen the entire body on the same side that gets treated. Often, people have most of their symptoms on one side of their body. The superficial back line and deep front line are often tighter on a person’s symptomatic side. Therefore, I usually start by lasering that side, from the back of the knee to the calf. People often notice changes within 10 to 20 minutes, not necessarily when they’re lying down during the treatment, but when they stand up and test it out.
If a person has tingling and numbness in the lower leg or feet, the back of the knee and calf can be a source of the nerve impingement. It is simply a matter of feeling the muscles adjacent to the affected nerves and treating those areas. I usually find that I can recreate or increase a person’s tingling or numbness with light compression over an affected area. That’s a strong indicator that that’s “the spot” that needs treatment. I cover more of this in the numbness and tingling page of this website.
The Role of the Popliteus Muscle
When this muscle is tight, the knee simply cannot function properly.
According to an AI search on Google, the popliteus is a small, deep knee muscle that acts as the “key” to unlock the knee from a fully extended position, initiating flexion. It stabilizes the posterolateral corner, prevents forward femur dislocation, and rotates the knee to manage gait, specifically rotating the tibia internally (non-weight-bearing) or femur externally (weight-bearing).
Key functions of the popliteus include:
- Unlocking the Knee: It initiates knee flexion by rotating the femur laterally (external rotation) on a fixed tibia when standing (closed chain).
- Internal Tibial Rotation: When the leg is not bearing weight (open chain/swing phase), it rotates the tibia medially (internal rotation).
- Stabilization: It acts as a crucial posterolateral stabilizer, protecting against rotary instability.
- Meniscus Protection: It pulls the lateral meniscus posteriorly during knee flexion to prevent it from being trapped.
- Knee Flexion: It aids in weak flexion of the knee joint.
After seeing a bulleted list like that, is it any wonder why this muscle is extremely important?
The popliteus is deep and, in my experience, next to impossible to reach without super pulsed lasers. The difficulty is that the popliteus wraps around the back surface of the femur and tibial bones with the gastrocnemius and hamstrings overlying it. The point is, it is deep and takes some time to loosen.
This muscle is key to solving knee problems. It can also be treated from the front of the knee by going through the patella, femur, and tibia at different points, and by approaching it from the sides.
I am so glad I have the Lumix Q laser to get to this deeper structure, which is also part of the deep front line shown here as the diagonal muscle at the back of the knee. I have included the adductors and piriformis for fun.
It is for this reason that I find working the back of the knee to be so effective. I can get the hamstrings, gastrocnemius, popliteus, and the knee ligaments all at the same time, and people often feel a change after 10 to 20 minutes.
Notice the three long and thin muscles along the back of the lower leg. These are critical as well to loosen because they are fascially connected to the popliteus. These muscles are larger and stronger than the popliteus, which is along the same fascial line. And if these larger muscles are really tight and are not handled first, good luck getting the popliteus to relax and function normally.
I have to feel around, find the tightest tissues, and start treating them with the Lumix Q laser.
Knee Arthritis
What if you have arthritis in your knee? Can lasers help with that?
Yes, they can, and I’ll give you my take on what’s going on besides aging.
There is a law called Wolff’s Law that basically says that bone under stress grows more bone to handle the increased stress.
Here’s an AI overview: Wolff’s Law states that healthy bones adapt to the loads placed upon them, remodeling to become stronger under increased stress and weaker in its absence. Proposed by German anatomist Julius Wolf in the 19th century, this principle implies that bone density increases with exercise and decreases with inactivity.
With that said, is arthritis, with its extra bone growth and spurring, just an application of Wolff’s Law? I believe it is.
What then could cause the extra stress on the bones of the knee? Yes, there’s gravity, walking, sports, etc. But what if your knee were under constant compression simply from the tight muscles and ligaments that cross the knee joint? What if tight hamstrings, a tight gastrocnemius muscle, tight ligaments between the femur and tibia, and a tight popliteus cause constant compressive forces across the knee joint, forcing your body to lay down more bone so your bone doesn’t crush?
Is it also possible that the arthritis isn’t necessarily the painful part, but the tight muscles and ligaments are? Now I’ve had some tough knee cases, but most respond rather quickly when I treat the tight areas, usually starting with the back of the knee. Do they still have the arthritis? I believe so because the extra bone doesn’t go away quickly. It needs more study, but someday I will do the study. But for now, I’m pretty good at helping people with their knee pain if they give me enough time.
I have had a good number of people whose knees are so bad, and they’re scheduled for surgery or thinking about it and want to try something else to see if it will help. They often give me one or two visits, and because it cannot work that fast, they get the surgery anyway. Most of the people who have had surgery are happy they did. But what if I could have gotten to them a few years prior, before their knee deteriorated so badly? Could we have saved their knee?
Meniscal Tears
When people come to me asking if I can help with meniscal tears, I have to say no. But I probably can help with the knee pain.
Meniscal tears are not the same as tight muscles and ligaments. I can work on the structures I’ve been talking about to help them with their knee pain, but I’m not going to fix the tear. Surgeons usually remove the torn parts of the menisci to help prevent locking. But what caused the tear in the first place? Was it a hit to the knee from the side? Was it wear and tear? I work what I can and go from there. People usually start feeling pain relief fairly quickly, even if their meniscus is still torn. It’s just that it is spotted on MRI and immediately sourced as the cause of the person’s pain. Again, another study to be done in the future.