Knee Rehabilitation: Managing Chronic Inflammation and Pain

Knee rehabilitation

Hello, Doctor: I have chronic inflammation in both of my knees.
I have been undergoing physical therapy at a general outpatient clinic for about a month, completing approximately 18 sessions.
I feel much better now, and walking or standing for long periods doesn't hurt as much.
However, when I squat, my knees feel very tight, and pressing on the sides of my knees still causes some internal pain.
Does this indicate that the inflammation has not fully healed? Currently, I live in Shulin, New Taipei City, and due to the pandemic, I am hesitant to keep going to the hospital, especially since there have been confirmed cases near my usual physical therapy clinic.
I would like to know if physical therapy should continue until I am fully healed, or if it would be okay to temporarily stop for one to two weeks.

Xiao Wei, 20~29 year old female. Ask Date: 2021/05/14

Dr. Li Yanheng reply Rehabilitation

Based on the description of the condition, if there is no significant medical history or family history of rheumatic diseases, it may be patellofemoral pain syndrome in both knees.
This is often caused by factors such as muscle weakness or ligament laxity, which lead to frequent friction and inflammation of the patella.
If there are concerns about going out for rehabilitation due to the pandemic, it is advisable to consider heat therapy at home combined with strength training to enhance knee stability for long-term improvement.

Reply Date: 2021/05/14

More Info

Chronic knee inflammation and pain can be quite challenging to manage, especially after experiencing significant injuries or surgeries. Your situation, where you have been undergoing rehabilitation for about a month and have noticed improvements, is a positive sign. However, the persistent tightness and pain when squatting or pressing on the sides of your knees suggest that there may still be some underlying inflammation or issues that need to be addressed.

Firstly, it is important to understand that inflammation in the knee can stem from various sources, including previous injuries, overuse, or degenerative changes in the joint. The fact that you are experiencing tightness and pain indicates that while there has been improvement, your knee may still be in the healing process. Inflammation can take time to resolve, and it is not uncommon for individuals to experience residual symptoms even after starting rehabilitation.

Regarding your question about whether to continue rehabilitation until fully healed, it is generally advisable to maintain a consistent rehabilitation program, especially if you are seeing improvements. Rehabilitation is designed not only to alleviate pain but also to restore function, strength, and range of motion. If you stop your rehabilitation for one to two weeks, you may risk losing some of the progress you have made. However, if you feel that your symptoms are worsening or if you are experiencing significant discomfort, it may be worth discussing with your physical therapist or physician about modifying your rehabilitation program rather than stopping it entirely.

In terms of managing your symptoms, here are some strategies you might consider:
1. Ice Therapy: Continue to use ice on your knees after activities that exacerbate your symptoms. This can help reduce inflammation and provide pain relief.

2. Gentle Stretching and Strengthening: Focus on gentle stretching exercises for the quadriceps, hamstrings, and calves. Strengthening exercises for the muscles around the knee can also help stabilize the joint and reduce pain.

3. Avoid High-Impact Activities: While you may be eager to return to full activity, it is essential to avoid high-impact exercises that could aggravate your knee. Low-impact activities like swimming or cycling can be beneficial.

4. Listen to Your Body: Pay attention to your body’s signals. If certain movements cause pain, it may be best to modify or avoid them until your knee is more stable.

5. Consult Your Therapist: If you have concerns about your progress or the pain you are experiencing, it is crucial to communicate with your physical therapist. They can adjust your rehabilitation program to better suit your needs and help address any lingering inflammation.

6. Consider a Temporary Break: If you feel that your knee needs a break, discuss this with your therapist. They may suggest a temporary reduction in the intensity or frequency of your sessions rather than a complete halt.

7. Follow-Up with Your Physician: If your symptoms persist or worsen, it may be necessary to follow up with your physician for further evaluation. They may recommend imaging studies or additional treatments, such as corticosteroid injections, to manage inflammation.

In conclusion, while it is encouraging that you have seen improvements in your knee condition, the presence of tightness and pain suggests that further rehabilitation may be beneficial. It is essential to maintain open communication with your healthcare providers to ensure that your rehabilitation program is tailored to your current needs and to address any concerns you may have about your recovery. Remember, patience is key in the rehabilitation process, and gradual progress is often the most sustainable path to recovery.

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