By Laura Gordon
From time to time you will have a client that comes to you with a knee problem. This blog is created to give you some ideas to try out, and if you like them and they are successful for you, you will want to add them into your practice.
Knees take the brunt of daily activities such as kneeling, walking, running, jumping, and sometimes falling. Pain in the knee area can come from wide range of causes. First let us acknowledge that pain is a good thing. It may be uncomfortable and interrupt activities, but pain is our body’s indicator that something needs our attention. It’s a symptom not the cause, and as complimentary health practitioners, which massage therapists are, we like to get to the cause.
Referral Pain: Acute (quick onset and short duration) and general pain around the knee capsule most often is referral pain from muscles in the thigh that due to hypertonus, toxicity, fascia adhesion, or injury. Massaging the IT band, quads and hamstrings with attention given to compression, trigger point and friction not only to the muscles but, also to 
the ligament and tendons around and below the knee, will be beneficial to the client. Adding hot compresses prior to the massage will assist in loosening and relaxing the area. Demonstrating and adding foam rolling as homework for the client will further assist in breaking up muscle and fascia adhesions and bring blood flow to the region. Blood flow brings nutrients needed for repair and takes away waste material (i.e. lactic acid) – much like massage does!
Tendon and Ligament Pain: This pain, unless caused by an injury, is most often chronic (slow onset and long duration) and occurs in middle aged and older clients. It is an indication of the formation of adhesive scar tissue in the tendons, ligaments and joint of the knee. In general, 
the build of this scar tissue binds the joint creating an environment for more adhesions and increased pain. Not fun at all! Palpating around the area of pain for adhesions is a first step which is usually along the joint line or attachment site. The second is to friction the location of the adhesion for five or six minutes using the forefinger if the area is that small or the medial side of the palm if it is larger area. Next apply deep massage to muscles above, around, and below the knee then repeat the friction as described above for another five or six minutes. According to Ben Benjamin, who studied under Dr. James Cyriax, the client will need to come back for this treatment twice a week for three or four weeks. If the client cannot perform a full range of motion of the knee after the treatment, the therapist assists the client in passive ROM. Homework for 
the client’s first week is swinging the effected leg from a seated position for several minutes two or three times a day. After the second week, with their back to the wall, the client should lower their upper body to do squats no deeper than a 45 degree angle of the effected knee and building up to a 90 degree squat over time.
This is a brief over view of some techniques for the knee. It is a complex joint and a more thorough study would be appropriate if you are going into sports massage.
Take a few minutes and palpate one of your knees to feel for the joint line. Is one knee more tender than the other? Try some friction to the tender area and let us know if the tenderness decreased or increased.
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I have a family member that suffers from joint pain, specifically the knees, and I find this article to be very insightful and hope that one day I can put this to use and maybe help her ease some of her pain!
This is really good to know if you have a client come in with knee problems.
I’ve always problems with my right knee. This info was helpful and friction will make it more tender at first, but it will feel better throughout the day
I do agree with this friction does help with taking away some of the pain in the knee and it helps with make it more flexible.
I completely agree on the idea that we strain our knees constantly. I can understand that I will have a lot of clients come in with knee problems and these techniques are amazing even in self massage. After learning these techniques I’m going to add them to my practice and use them in my regular routine post graduation for externship.
Knees are amazing things they do so much for us, I know I have had pain from time to time. I have done circular movements with pressure on muscles all around the knee before it does help. I will try the back to wall exercise to see what it feels like, I need to get one of those foam rollers too. I am glad I am in this class I will come out stronger than when I came in.
The tendon and ligament pain is interesting to me. I have had chronic issues with my right knee for several years. I would be interested in trying out that routine to see how it helps me.
I like this blog, it was very informative. I understand completely about hurting knees. I would definitely try to help a client with knee problems
I have a friend who has knee problems off and on, so, I’m going to try some of these techniques on him. Also, I will tell him about these strengthening excersises. I will also use these to strengthen my knees for volleyball. I am also going to have to keep in mind that pain is a good sign and it’s not the problem, it is telling me there is one.
I do like using foam roll and heat for the things that are wrong with my knee. Thanks for the help with this!
I’m so glad to have read this! i never focused much on the knee and wouldn;t have known what to do other than to just palpate and frition the knee. Thank you.
I haven’t ever had knee problems but I think this is a great reference in case i have a client who comes to me with knee problems!
Ive never actually had Knee pain, nor do i know anyone with knee pains. I know on the other hand its very common for people, especially as they age. When i have my own practice, Ill remember this would be a good way to relieve pressure and pain for a client. Im thinking more of a homework kinda sense for a client.
The information given in this article can help me not only with future clients, but with former teammates and friends who suffer from knee injuries. I have never used the foam rolling technique but I am excited to try it.
This was very interesting to me because I have problems with my knees. So it will help me when I have clients with knee problems I will be able to keep them comfortable.
I have knee problems. This is good info. for me and clients.
I like the article it is very detail and helps me understand the tendon and ligament pain better so when I do work with a client that has this discomfort I will be knowledgeable instead of lost and cant help.
This article tells me to assess my clients carefully! Treatment choices for the same general ailment may be totally different depending on deeper assessment of “knee pain.” Detailed treatment of both acute and chronic knee pain along with rationale is covered-great read!
Easing tension on tissue surrounding the knee helps quite a bit in relieving knee pain.
Also, keep in mind is if the client has excess weight, then weightloss can help significantly to relieve pain.
Losing 25 pounds reduces 100 pounds of pressure off the knees due to joint leverages.
This was very informative. It is good to know there are exercises that can be done at home to help strengthen the knee.
These are very valuable things to know if u had someone come in with knee problems and I pray to god all then time that he saves my back and my knees! I feel like those would be the most painful body parts to injure or damage! U
We went over some of these stretches on Monday and they were very helpful because I already have issues with my knees locking up. Thanks Ross!
Ive never had knee issues or any body issues or surgerys but this is some great info for me to knoww incase my client has knee issues
Thank you for all your responses to this blog. Your feedback is most helpful. I’m glad so many found “Don’t Knock Knees” to be informative and useful.
This is awesome! this will help a lot with my brother because he has issues with his knees often! thank you
Since my accident, I have been having some problems with my left knee. This blog gave me some great ideas to try out! Thanks!