Are you dealing with kneecap pain? Is it bother someone you bend your knee all the way? Or do things like squat down to take care of things at home or kneel? Is it so bad that it bothers you, even at night when you’re sleeping? And is it rough when you wake up in the morning, or if you go to stand up after you’ve been sitting for a long time.

Doctors most of the time, have no clue how to treat this except throw medications at it, but give people injections and look at a possibility of any surgeries to clean out the knee joints. When in reality, there’s simple things that you can do at home to improve your kneecap pain, also known as patellofemoral Pain Syndrome, and make sure that it heals for the long term.

In today’s video, I’m going to show you three treatments that you can do at home on your own. And I’m also going to talk about a couple things that you absolutely need to avoid. So watch till the end of this video, so that you can avoid these things. These are things that healthcare professionals tell people with kneecap pain to do that you need to stop doing right away because it’s going to make your kneecap pain worse.

My name is Dr. David Middaugh. And I’m a specialist physical therapist at El Paso manual physical therapy. This channel here is dedicated to helping people stay healthy, active and mobile, while avoiding unnecessary surgery, medications and injections. Please subscribe so that you don’t miss out on any of the helpful videos that we upload every single week.

This video is going to be more of a tutorial on how to fix your knee problem at home, your kneecap pain. But if you’re looking for how kneecap pain happens, you want to get more of the science behind it and figure out where this came from how this problem came to be. I’ve got another video talking about that. And it’s linked in the description below.

The very first thing that you’ve got to do for kneecap pain is to move your kneecap bone on your thigh bone, let me show you what this looks like. You’ve got to sit somewhere where you can stretch out your leg in the affected leg needs to be out just like this. So I’m sitting on this table here. And I’ve got this stool under my leg, you can sit on a chair, like your kitchen chair and put another chair in front of you.

Or if you’re on a couch or on a bed, just swing your leg over like that so that your knee is as straight as possible. without stretching it, you don’t want to force it down. Because then you Tension up your knee joint, you want to have it relaxed. So you can see here, my knees just a little bit bent, that’s going to work for me, what you’re going to be doing is grabbing your kneecap and moving it up and down inside aside and you can try circles if you want, it doesn’t really rotate much.

Technically, there’s a bit of rotation, but we don’t want to worry about it today, I’ll want to do some gentle movements. And before you start, I need to warn you that if your kneecap pain is really bad if you’re just really inflamed, I mean you got swelling, it’s sensitive, even just to touch it like this, this is going to bother it and you need to start out a really light or maybe even wait and just rest until it goes down, the inflammation goes down and the swelling goes down. Before you try this out.

You can’t do this on a super inflamed knee joints on that on a kneecap, you’ve got to just rest maybe I said do the easy stuff where you just lie around and do nothing. Basically, in order to let that inflammation go down so that you can get to the point where you’re doing this technique. And I’m going to show you next.

So let’s say you’re ready to do this technique, you’re going to make a circle with your index fingers and your thumbs overlapping, it doesn’t matter which ones over which one to just get your hands in this position. And you’re going to put your hands over your kneecap, and we do it this way might have a better angle. And real gently, you’re going to start to glide it down and glide it up.

So just like that, I’m hooking my thumb’s around the edge of it right here to move it down. I’m just going to bounce a bit downwards, I’m going to hook and bounce a bit upwards, say about four or five little bounces, and then change directions. There isn’t any magic number to this. You can split hairs and find numbers in the research.

But I haven’t found any in practice, that makes a huge difference. The bottom line is we need to just move the joint and get that to get the fluid inside the joint to move. That’s what this is accomplishing. There’s cartilage behind the kneecap that needs to be nourished, it’s been pressured, too much spin pressed on too much. And by moving the knee joint now moving outwards, I’m using this side of my hand.

By moving the knee joint here the kneecap, you get to a lot, you allow that fluid to get into the surfaces of the kneecap better. There’s also cartilage on the end of the thigh bone where the kneecap meets and we’re also nourishing that getting the fluid to move in there. It’s also just taking pressure off the cartilage. And this is much needed.

Now you’re probably asking, well how hard do I do this? Do it up to your tolerance. So if you are a little more sensitive, and you start pushing and you feel pain coming on, back off, that’s your limit. You only want to go to that pain barrier and just try to stay below it. In fact, because you can irritate this worse if you’re pushing this as hard as possible.

If you’re feeling like you can take more force without hurting it, now it’s going to feel weird. This is an odd sensation to move your kneecap, I’m not talking about that I’m talking about actual pain or aching This is coming on, then you want to back off, move it inwards here, outwards, up and down.

And generally, you want to do this for a few minutes after about two or three minutes, you get diminishing returns, meaning it’s not going to help you that much more, you’ve already moved in enough, you’ve accomplished what you set out to do.

This one, along with the other things that I’m going to show you next need to be done outwardly in most cases, if your knees pretty flared up, I would like to do this as often as possible, basically every hour, so in a day, you can get this in 10 plus times a day, the better off you’re going to be for your knee.

So one of the mistakes that people make is they see a treatment like this, try it once or twice, maybe maybe they strive for a day. And then it doesn’t really work. Well, it’s kind of like getting a discount, it’s kind of like changing your diet, you can eat one salad and assume that you’re going to lose weight, you have to keep eating salads, it’s the same thing for this, you’re doing a really healthy thing for your knee.

But you’ve got to keep going, you’ve got to keep doing it brushing your teeth, same thing, you can brush teeth once and expect your teeth to be clean the rest of your life are you in for a week or a month, you’ve got to keep going over and over again, to get that fluid circulating in there.

So this needs to be done hourly, for as long as it takes for your knee pain to go away, I would do this literally. Maybe even a week after your knee pain goes away, then you can stop. You just need freedom in your kneecap. It’s super important for patellofemoral pain syndrome.

That’s one of the second thing you got to do. I’m going to show you an exercise for your glutes very, very important for patellofemoral pain syndrome. In my video that talks about how patellofemoral Pain Syndrome happens or kneecap pain, how that happens. You’ll see why the glutes are so important.

So check out that video. It’s it’s posted in the description below. But for this exercise you’re going to do is push your back flat as hard as possible. squeeze your butt muscles and then work to lift your leg just a bit lifted by just a bit. When you do this hold right there for 10 seconds. After about 10 seconds, come on down.

Now what you should feel is button muscles working really hard what you shouldn’t feel is your hamstrings working really hard. your back muscles working really hard that shouldn’t be happening. And you should not feel a huge stretch in the front of your thigh here.

What you should do how you should tweak this if you feel your hamstrings back muscles working or your quad stretching, is you need to not lift so high. It might be even that you don’t lift at all You might just put your back flat, squeeze your butt muscles. And if you feel your butt muscles working, they’re hanging out there without lifting.

Because if you start to lift right away, you get a big stretch in your quads, it’s going to be counterproductive, you’re going to be pulling those quads, smashing your kneecap against your thigh bone and further irritating your kneecap.

So you don’t want you don’t want that kneecap irritated so you don’t stretch it a lot you want to back off and any sort of stretching. Also you’re firing your hamstrings your back muscles, you’re not going to take advantage of what’s called reciprocal inhibition. big fancy words for when you fire your butt muscles, these quad muscles should relax.

That’s what you need to take that pressure off your kneecap long term. So 10 second holds 10 reps back flat but tight lift up and hold it there for 10 seconds. Once you’ve done 10 of these, then switch to this next glute exercise.

Now I’m going to switch around here so that you can so I can keep focusing on this leg because this is the one I’m pretending to have an injury on and I’ve had this by the way, and it had I had it for a long time patellofemoral pain syndrome. I was before I became a physical therapist, I was very into sports was completely imbalanced in my muscles had big dominant quads and not much in the glutes as far as strength goes.

And I started to get a crunchy kneecap I still to this day have a noisy kneecap but it doesn’t hurt me I’m fine. I run I lift weights, I do everything I want to do. But my knee does make noises and if you catch if you pay close attention to some other videos, especially when I’m doing squats or lunges, you can hear my knee making funny noises. It’s kind of cool, but it doesn’t work.

So anyways, you’re going to do a clap next, this is your third exercise clam exercise for the butt muscle about where your back pocket is right here. So what you got to do is lie on your side and then you’re going to roll forward with your upper bodies so that it moves your hips over just a bit like this and makes the top leg stick out forward past the bottom leg.

I’m looking at my knees from my viewpoint and I can see my knees sticking out a good two or three inches forward past my bottom knee. Now my feet need to stay together. A lot of people will say let me just move my knee forward like this. But now my feet aren’t together. They need to stay together. We’re all from your hips.

When you do that now puts this muscle in a position to work. You’re going to lift up your knee and hold it there for 10 seconds, just like the bridge exercise, after 10 seconds, you can relax down, and you need to focus on making this buck muscle work. So it doesn’t take much lifting to do that I feel it already right here, I could feel it under my fingers. But I can feel it working as well, I can feel the muscle getting a little bit tired.

What you don’t want is to work your quads for this muscle quite a bit. If you feel like the front pocket muscle right here is working or the front of your thigh, then you need to roll over even more straighten out your legs a bit to give you space to roll over and do the exercise like this, I actually feel even better that way, right now.

And notice I’m not going up very high, because as soon as I start going higher, my hips have to roll over like that. And I start feeling it in my quad more than my butt actually don’t feel my butt at all anymore.

So I’m going to stay low, right there, that feels the most intense on that glute muscle right here in my back pocket area. So 10 second holds 10 times, do this on both sides. If you have the time, if you don’t have the time, for some reason, completely focused on that side that is bothering you.

Now let me tell you two things that people with patellofemoral pain syndrome or kneecap pain often end up doing either because they found these exercises and stretches on the internet, or they’ve been told this by a healthcare professional like a physical therapist, a personal trainer, even physicians, and doctors tell people to do these things, and unknowingly before I you know, don’t think I’m throwing anyone under the bus.

This is just not a common treatment approach that I have. And I’ve gone through a lot of specialist training, I just see the body completely different. Most physical therapists are helping people recover from post-surgery situations like if they’ve had a knee replacements or meniscectomy, or some surgery in their knee. And they aren’t as good at treating somebody who’s looking to avoid a surgery.

So doing these exercises and stretches that I’m about to show you is probably a good thing to do if you had a knee surgery. But if you haven’t had a knee surgery, you’re trying to take care of your kneecap pain. So it doesn’t end up a surgical situation later on, then this is what you should be doing. And the results speak for themselves.

So if you’re questioning, you know, well, I have this physical therapist I’m paying money to and he’s having me do these things that you’re telling me not to do. We’ll see how you feel if your knees feeling worse, going to that physical therapist or doing your doctors exercises, you can’t refute that. I mean, it’s how you feel.

So let me tell you the exercises in the stretches that you need to avoid. And then you judge for yourself, if it’s something that you should keep up or not. Number one, the biggest stress that everybody does, for patellofemoral pain syndrome is a quad stretch. And there’s different ways that it looks some people just sit down and they’ll pull their foot and leg in this position and put a big stretch on this area right here. And what that does is it it gives you false feedback, because the person telling you to do this is going to say you feel that stretch right there, doesn’t it feel good?

Can you feel the muscles stretching, and you are accomplishing a stretch. But what people forget to realize is that you’re also compressing your kneecap against your thigh bone, which is how you got this cartilage problem in the first place, you got too much pressure on your cartilage behind your kneecap. So you’re kind of making the problem worse by doing this, you’re irritating it a little bit. I would say avoid this, there’s no reason to do it.

Plus, if you stretch hard enough, you actually waken up the muscle and causes a contract which in the long term makes it stronger and better able to compress your cartilage or your kneecap so really is not necessary.

Another way that people do it is they’ll stand, and they’ll pull your leg back like this and stretch and they’ll say get your heel as close as you can your butt. And the feeling of the stretch itself is a euphoric feeling. In other words, it feels kind of good to stress the muscle, but it feeds into the problem long term.

So it’s the equivalent of eating chocolate cake if you’re trying to go if you’re trying to lose weight or be in a diet or be healthy chocolate cake tastes pretty good for those who love chocolate, but it’s not good for you. It’s the same thing with this stretch. The second thing that you absolutely need to need to avoid are quad muscle isolated exercises. what these look like.

The classic is the machine at the gym where you sit down and it’s got a pad right here on the front of your shins, your lower legs, and then you stretch out your legs and you’re just doing this motion. Usually, the the arm and the pad right there that’s on your legs is connected to weights that you put the pin on. And you pick up the weights when you stretch out your legs. And it makes these muscles work really hard.

Well, same thing you get that false feedback because whoever’s having to do this is telling you do you feel the burn? Do you feel these muscles working really hard? Great. We’re on the right track, but really, it’s not on the right track, you’re making these muscles stronger. And again, pushing that kneecap further onto the thigh bone, the femur over time.

And when you get really strong quads, at rest, there’s something called resting tension, meaning your muscles Tension up a bit at rest with you having to think about it, you can actively tension your muscles, right, you can contract them.

But the stronger your muscles are, the more tension they have at rest. And that low level of tension all day long, compresses the kneecap and makes the situation worse, especially if you have a muscle imbalance where you don’t have the proper strength in the glutes or other areas to offset that, that increased force that you’re pushing onto your kneecap.

So strengthening your quads is really a bad idea. There’s other ways that people do it. I mean, might happen with squats or lunges. The idea is if you’re doing an exercise and you feel your quad muscles burning, it is not a good thing for your patellofemoral Pain Syndrome for your kneecap pain. Let me say that again, if you can get this point you can get a lot of guidance and clarity on what you should and shouldn’t be doing.

If you’re doing an exercise for your kneecap pain. That is causing your quad muscles with the front of the thigh muscles above the kneecaps to get tired, fatigued and sore, like you’re making them stronger, then you’re in trouble. You’re going to make your kneecap pain last longer and more intense as time goes by. You need to work on your glutes just to let you know I’ve got a video covering five glute exercises for knee pain specifically and it’s linked in the description below. Go check that out if you’re looking for even more glute exercises.

If you want something even more comprehensive, we’ve got something called the 28 Day Knee Health And Wellness Boost Program. This is a 100% on demand an online program that you can access where you can get 28 days of help for your knee problem.

This helps your knee cartilage to heal knee ligaments to shorten muscles that influenced your knee in a good way to get stronger. And best of all, it teaches you great advice and coaching on how to keep your knees healthy for the long term so that you can decide to do whatever activities you want.

Whether it’s kneeling in the house, squatting down to pick up something from the floor, or running or picking up some more intense exercise like weightlifting, you can safely do this for your knees if your knees are injured enough and if you learn the concepts in our 28 day new program. The link for this program is also in the description below. Don’t forget to subscribe and give us a thumbs up if you thought this video was helpful. Have a wonderful day guys. Bye

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