I Am a Knee Pain Expert, This is What I Found Out.

Quick Overview

Dr. David Middaugh, a Manual Physical Therapist, presents survey data suggesting that 90% of people with knee osteoarthritis were told they had the condition by a healthcare professional, yet 80% of those surveyed were advised to start walking as a primary treatment, despite 61.1% of respondents finding that increased walking caused them more knee pain; furthermore, 80% of those who attempted quad-strengthening exercises reported that these exercises either caused increased knee pain or required compensation from other muscles, indicating a disconnect between common advice and patient experience.

Key Points: 90% of respondents were officially diagnosed with knee osteoarthritis by a healthcare professional. 80% of respondents were advised to start walking as a treatment for knee osteoarthritis, but 61.1% of those felt increased walking caused them more knee pain. 55% of respondents had previously been advised to perform quad-strengthening exercises for knee osteoarthritis. Of those who tried quad-strengthening exercises, 40% reported that the exercises caused increased knee pain, and another 40% reported that their thigh muscles began to compensate when they did too much. 85% of respondents have seen an Orthopedist/Orthopedic Surgeon, 70% have seen a Primary Care Physician/General Doctor, and 70% have seen a Physical Therapist/Physiotherapist. Only 20% of respondents indicated they can reliably tighten their glutes in all activities without fail, suggesting widespread gluteal activation issues.

Context: Dr. David Middaugh, a Manual Physical Therapist, presents internal research data gathered from his online community members, including those in his Knee Osteoarthritis Recovery Program, to highlight common diagnostic labels and treatment recommendations given to patients, specifically focusing on the prescribed use of walking and quadriceps strengthening exercises.

Detailed Analysis

Dr. David Middaugh analyzes survey data collected from his community to challenge conventional advice given to individuals with knee osteoarthritis. Initially, he confirms that 90% of respondents received an official diagnosis, with 80% of those being told they had bone-on-bone degeneration. Regarding treatment, 80% were advised to start walking, yet 61.1% of those who followed this advice experienced increased knee pain, suggesting walking is not universally beneficial. Furthermore, when asked about quad-strengthening exercises (recommended to 55% of respondents), 40% reported increased knee pain from these exercises, and another 40% noted that their thigh muscles compensated when they overdid it, implying poor gluteal activation. The data on glute activation itself shows that 40% can only tighten their glutes with thigh compensation, and 20% can reliably tighten them without compensation, while 40% experience no glute activity when attempting to contract them. The most common healthcare professionals seen were Orthopedists (85%), PCPs (70%), and Physical Therapists (70%). Middaugh concludes that the conventional advice to walk more and isolate quad strengthening may be detrimental for many, as it can increase joint pressure and hinder progress toward pain-free activity.