According to Doctors Janet Travell and David Simons in their widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual, pain in hip and knee joints can be nothing more serious than referred pain from myofascial trigger points (tiny contraction knots) in overworked or strained muscles of the hip and thigh.
Travell and Simons believe that even when a hip or knee joint has suffered a verifiable physical injury, trigger points in associated muscles always contribute a major part of the pain. Referred pain can be every bit as intense and debilitating as pain from a damaged joint.
The usual medical explanations for hip and knee pain include arthritis, bursitis, tendinitis, ligament injury, and deterioration of joint cartilage. X-rays, MRI’s and other tests often seem to substantiate such diagnoses. Although these medical conditions are sometimes genuine, Doctors Travell and Simons contend that they are too often mistaken diagnoses.
Even in the absence of objective evidence, hip or knee pain alone is assumed to be proof that the joint itself is in trouble. As a consequence, replacement surgery for hip and knee joints is commonplace and heavily promoted. These surgeries are probably unnecessary in a large number of cases.
Cause of Arthritis
Travell and Simons quote other researchers who suspect that trigger points may actually be the root cause of true osteoarthritis and other kinds of joint deterioration. This is because muscles afflicted with trigger points become shortened and stiff.
When this happens, even normal movement puts undue strain on muscle attachments at the joints, which can eventually result in damage to connective tissue and distortion of the joints themselves. Popping in a hip or knee is evidence that muscles afflicted with trigger points are partially disarticulating the joint.
Stiff Knees and Stiff Hips
Since trigger points make it difficult for muscles to lengthen, they can be the reason for stiffness in hips and knees. Trigger points protectively weaken muscles too, causing hip and knee weakness and unexpected buckling or collapse.
If athletes knew about the effects of myofascial trigger points and took the time to do the appropriate self-treatment, there would be many fewer sports injuries.
Quadriceps trigger points are responsible for an amazing amount of trouble commonly attributed to the knee itself. A locked knee, for example, is often due to trigger points in the vastus lateralis, the outer part of the quadriceps.
The quadriceps is the first place to look for the cause of knee pain. A case of jumper’s or runner’s knee is ordinarily not as critical a problem as it seems. It's usually just referred pain from overused quads.
Restless legs can be a simple matter of trigger points in overused (or under used) thigh muscles. The age-old mystery of growing pains in the legs and knees of children very often can also be traced to trigger points.
Pain referral from trigger points can be the cause of the phantom limb pain felt by amputees. Travell and Simons give many other examples of these misleading effects.
For example, trigger points in thigh muscles can make the inner knees so hypersensitive to pressure that it’s uncomfortable to lie on your side with your knees together.
Trigger points can also cause thigh muscles to compress the sensory nerve that supplies the front of the thigh. Superficial numbness and tingling is the result, which will draw a diagnosis of “meralgia paresthetica,” an elaborate way of saying that you have numbness and tingling in your leg. Like too many diagnoses, it leaves the cause unnamed.
Are Painkillers Bad Medicine?
Painkillers are typically prescribed for hip and knee pain, although they can be the worst kind of therapy, because they don’t fix the problem; they only diminish your awareness of it.
Painkillers invite you to go on with the same activities that caused the problem in the first place. In this way, pain medications may actually contribute to the high incidence of sports injuries.
The Dangers of Stretching
Physical therapy for hip and knee pain in the form of exercise and stretching can make trigger points worse and, in turn, worsen the pain. These forms of therapy are useful, but only after trigger points have been deactivated. Unfortunately, trigger point therapy isn’t taught yet in very many physical therapy departments.
Luckily, you don’t have to wait for the medical world to catch up with the science of trigger points and referred myofascial pain. You can take care of trigger points yourself.
In The Trigger Point Therapy Workbook, nationally certified massage therapist Clair Davies has simplified Travell and Simons’s extensive research into myofascial pain and made it accessible to the layman.
Self-applied trigger point massage will relieve hip pain, knee pain, runner’s knee, buckling knee, stiff knee, locked knee, meralgia paresthetica, growing pains, phantom limb pain, and restless legs when trigger points are the cause.
To find out more about the book and the method, please visit the homepage. To read a growing number of reviews by people who have been helped by the book, take a look at the book’s page at Amazon.com.