A little over two years ago, I hurt my knee. I was doing some vigorous aerobic workout style dancing. I might have twisted my right knee and it started to hurt really badly. I thought it would be fine in a couple of weeks by giving it the usual TLC. But it took over two years to heal it. And it turned out to be quite an opportunity to learn.

Whenever I talk to my contemporaries, the topic of knee pain comes up frequently. So, I thought I would share here my journey of healing my knee pain and more importantly the resources I found useful. Trust others will find this information useful.

In this Part 2 of this series of blog posts, I share different resources for the major underlying causes of knee issues, that is knee alignment.

History and Background

You see I have been dealing with knee pain off and on for a long time. About 30 years ago, I took up the goal of running a marathon. I started the training. Ran my first 5K and then my right knee started hurting whenever I would run. Could not figure out how to run pain free. So, that was the end of my marathon running goal.

Since that episode, over the last thirty years, I have been working on bringing my knee functionally to 100%, judging by the capacity and capability of my left knee. It is still not there 100%, but it is the closest it has come to that goal in thirty years.

Orthopedic specialist diagnosed the causes of my knee pain to be arthritis. Initially, arthritis was diagnosed as mild. At my last check up about two years ago, I was told it was more like mild to moderate.

But what caused my arthritis? And was there another reason for pain? So, could you I just everything I wanted to do in spite of my arthritis. After all, my left knee also has mild arthritis. But I never feel any pain issues in my left knee.

In Part I, I discussed structural issues of the knee that could lead to knee pain. Knee misalignment is the topic of this blog post.

Turns out if knee is not properly aligned between the hip and the ankle, that can be an issue two different ways.

First, if the weight is born disproportionately by the spot where the cartilage is missing, it will cause pain.

Second, the part of the cartilage that bears disproportionate amount of the body weight, repetitive motion, e.g., running or jumping rope, can also erode cartilage on that part of the knee.

Knee misalignment becomes a sort of a vicious negative cycle. So, fixing knee misalignment is imperative for a lasting solution.

Resource for Fixing Misalignment – The Egoscue Method

I got introduced to Pete Egoscue the creator of the Egoscue Method almost 30 years ago at Tony Robbins Life Mastery program in Hawaii. Pete Egoscue demonstrated a very unique way of correcting joint pains due to one or more body misalignment. Even more amazingly eliminating the pain through some simple exercises, he called e-Cises.

Unfortunately, when I first encountered my knee pain, Pete Egoscue was not easily accessible, since he lived and practiced on the west coast. On hindsight, I should have probably gotten on a plane and worked with him anyways. I basically relied on his first book. And, ended up helping myself and  a lot of other people with some issues, including back pains. But could not really fix knee misalignment on my own.

Now his technique is accessible through Egoscue clinics around the world. You can find probably one in every major city in the US. And now therapists can also work with you over a Zoom Call.

This time around, that is what I did, since my traumatic knee pain episode occurred in the middle of COVID pandemic. I worked with the Egoscue Clinic in Arlington VA.

The therapist takes pictures and checks out the alignment to diagnose what misalignment might be causing the issue. Here is one of set of my pictures. You simply draw a straight line from hip to the ankle. If the line does not cross in the middle it indicates misalignment can can cause knee issues over time.

Also, it is important to diagnose whether your knee is overly internally rotated, i.e., pronated, or overly externally rotated, i.e., supinated. During load bearing activities, either of these situations can lead to greater stress at the knee joints and the ligaments and can lead to knees issues and knee pain.

My right knee was bow-legged and externally rotated. See the below picture before I started the Egoscue therapy.

Those conditions were causing stress on the inside of the knee joint, where cartilage had also eroded. What came first the cartilage erosion or the bow-leggedness and the external rotation? That was the question, I have always wondered, but don’t know the answer to this chicken-or-egg question.

Based on the diagnosis, the therapist then have you try a series of e-Cises. Those e-Cises become the menu that you would do over the next couple of weeks or longer.

After practicing the give menu of e-Cises, with the therapist again, to reassess and create a new menu. Often, it becomes a process of “peeling the onion” by resolving first the superficial issue and then go on to resolving the deeper issues that might be at the core. Lot of time, taking care of the superficial issues often resolve the pain. However, it is really important to get the whole body in alignment to resolve things permanently and even preventatively.

The following picture shows alignments after working with the Egoscue therapist. As you can see, alignment of the right knee is a whole lot better, but head alignment still needs work. Ideally, head should be in line with shoulder, hips, knee and ankle. And, both shoulder should also be parallel to the ground.

My experience – Working with an Egoscue therapist, I discovered bow-leggedness and the tendency for my right knee to outwardly rotate lessened significantly. While working on the knee, the therapist also pointed out issue with the curvature of both my lower back and the upper back. These curvature issues were leading to pain in my lower back. I also worked on the back issues and significantly improved the alignment. Another important outcome was that I got quite aware of my posture and how that could lead to other musculoskeletal issues.

Bottom Line:

From my research and experience, I have found that it is important to find out what is the underlying structural issue for knee pain. It is equally important to diagnose to see if knee falls outside a straight-line connecting hip and ankle and if knees is rotated inward or outward. Either of these conditions can cause wear and tear of the cartilage and/or undue stress on the other connective tissue from repeated use under load-bearing conditions.   It can also be the source of knee pain.

Working with a therapist trained in the Egoscue Method can be very effective in re-aligning the knee. 

Of course, this is not medical advice, and you should check with a medical doctor about your specific situation.

What are your thoughts or experience on this subject?

Have you used other therapies or methods for correcting body misalignment.

Would love to hear from you and learn from you.

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