Yes!
My new course, “The Knee Reboot”, is finally finished after almost 4 years of work!
This video is a sneak peek into the course because I’m going to run you through what I think is the perfect formula to help someone with knee pain build strong knees that feel great in just 3 steps. I’ll also show you some of the craziest facts I discovered in the 1,700 scientific publications I read during the research for the course.
Let’s start with step #1 of our formula.
This will seem obvious, common sense even, but you’d be surprised how many people skip this step or make wrong assumptions only to pay the price later.
There are over a dozen different types of chronic knee pain and to get started, you need to know the exact problem you’re dealing with because that has huge influence on what you should do next. For example, an exercise that works wonders for patellar tendinopathy can make another knee injury worse and, in some cases, even cause serious problems as you will see later.
That brings us to our first crazy fact from research. One study on strength of the patellar tendon, that’s the tendon you use every time you squat, run, or jump, found that 8 weeks of complete rest required a whole YEAR of training to achieve a full recovery[1] because tendon properties such as tendon cell shape, cell number, and collagen fibre alignment had changed.[2]
Wow! Eight weeks rest and then a year to get your tendon strength back. Pffft.
Okay, let’s get back to our formula. So the first step is to get a reliable diagnosis. Only a doctor can diagnose injuries and I strongly recommend against self-diagnosing because I’ve seen it go wrong way too many times. One of the next videos I plan on doing is about how the location of the pain can indicate what injury it likely is, but even then, you still need to have your suspicions confirmed by a doctor.
Please trust me on this.
Okay, step number two, this is where the fun begins because now, we get to really dive in and understand the injury. Your goal here is to discover: how it happens, risk factors, causes, which treatments work, which treatments don’t work, and everything else you can find. For example, here’s an overview for patellofemoral pain syndrome that I put together for The Knee Reboot course.
I’ll share my research approach at the end of this video if you don’t know where to start. Yes, finding all this information takes a while and it’s not easy, but you need to understand the injury inside and out if you want to make sure you’re doing the right things. Here’s another crazy fact from research to show what I mean.
You’ve probably heard about PRP injections. It’s an expensive treatment in which part of your blood is reinjected into your body to support the healing process. For knee pain, the recommendation is to go with at least three injections, which in 2020 cost $2,100 on average, but depending on where you live may cost up to $15,000.[3]
This right here shows why knowing your exact problem is so important because research into whether PRP works for different types of knee pain has found that often it’s just an expensive coin toss.
We’ll talk more about PRP in a future video, but I wanted to share this info with you now to show how much time and money you can save by understanding your problem. Plus, we need this understanding for step #3 of our formula.
This step is about using everything we know to reverse-engineer the perfect strengthening plan for your situation. Here are three examples to show how you can do this.
Patellar tendinopathy is caused by tendon overuse through explosive loading with too little rest in between training sessions. To reverse this, you need to use slow strengthening exercises with adequate load and enough rest days. Also, researchers agree that training through pain is often necessary.
In contrast, IT band syndrome is caused by a part of the knee becoming irritated either through friction or compression. To reverse this, you must avoid pain as best as you can and instead focus on relaxing your leg and improving gait to unload the irritated tissue. Strengthening exercises can still play a role, but they’re not a key piece of the puzzle, like in tendinopathy. If don’t know this and try to use the wrong exercise, it can even cause more pain again.
Example #3 is medial plica syndrome with a type D plica that is bow-stringing across the cartilage of the knee. This is a congenital condition in which you will have pain on the front of the knee, like what you’d feel in other knee injuries, but trying to fix this problem through exercise without consulting a doctor is a bad idea because it could cause permanent cartilage damage.
While we’re on the topic, here’s one more crazy fact from research. For medial plica syndrome, cortisone injections can be a treatment option.[4] For other conditions they can be risky. Injected directly into the intra-articular space, higher doses can cause cartilage damage.[5] For tendinopathy, the British Journal of Sports Medicine even called it “ideal treatment for people you don’t like”.[6]
These examples perfectly show why understanding the problem is so critical. Without this understanding you’re just throwing stuff at the wall to see what sticks. If you’re lucky it works. If you’re not so lucky, well…
——
Of course, it would be great if we could solve all problems with one single strengthening plan.
That’s the approach I used in my first book in 2012. Strengthen the legs, resolve imbalances, fix misalignment, you know all these things.
This worked great for a lot of people, but over the years I realized that using the same approach for every injury is not ideal. It’s much better to have individual strengthening plans for each injury based on its exact causes, risk factors, and treatment approaches. That way we’re no longer trying to squeeze the square peg into the round hole.
But finding all this knowledge is the exact reason why creating The Knee Reboot course took so long. I wanted to be able to give you a step-by-step strengthening plan for your exact situation. That’s why in early 2020 I decided to read every research paper I could find about every type of chronic knee pain.
Once it was done, I had read over 1,700 research papers and collected over 5,000 facts or other pieces of noteworthy information. Insane numbers when you think about it.
Too much actually, for me to hand this to you and say here you go, everything mankind knows about chronic knee pain. Good day to you sir.
So to turn this gargantuan mountain of data into something useful, I did the following.
First, I created a “research briefing” for each single injury. These briefings contain all the facts I could find in academic research about the respective problem. They’re in plain English, easy to understand for everyone and they contain detailed illustrations drawn by a doctor.
Then I took everything we know about how an injury happens, its causes and risk factors, its proven treatments, as well as the knowledge of expert clinicians about these topics, and turned it into a step-by-step strengthening protocol.
When you use the course, you can just open the research briefing, then read the strengthening protocol, and you’ll know exactly what to do.
If exercises are the best way to move forward, the course will hand you the exact exercises you can use, together with a training plan. If getting some other treatment is a better idea in a specific situation, the course will tell you as well. I only care about what works.
This was really important to me because I wanted to push beyond the mindset that exercise is all it takes. I love the idea of fixing problems in the body through exercise and the results can be amazing, but sometimes it’s not enough. We shouldn’t pretend otherwise.
The goal I set for myself when I created The Knee Reboot course was to give you everything you need to build knees that feel great for life. But to do this we need more than just strengthening exercises, training plans, and treatments.
I know this because I’ve been helping people with knee pain since 2012, so I’ve have seen thousands of stories play out in real life, including mine. To make this goal possible I’ve had to add a few more ingredients to the course, and most of them I haven’t seen covered anywhere else.
This all-encompassing approach is why I think this course is better than every other knee program out there. It’s 100% evidence based. The advice isn’t my personal opinion about what works, but it’s the consensus of thousands of researchers and clinicians.
To learn more about the course you can go to kneereboot.com. For me it’s a lifetime achievement and I’m proud to be able to share it with you.
That’s it for now and I will see you in another video, or maybe in The Knee Reboot course.
Publication bibliography & Footnotes
Bellary, Sharath S.; Lynch, Garret; Housman, Brian; Esmaeili, Ehsan; Gielecki, Jerzy; Tubbs, R. Shane; Loukas, Marios (2012): Medial plica syndrome: A review of the literature. In Clin. Anat. 25 (4), pp. 423–428. DOI: 10.1002/ca.21278.
Borgers, Anton; Claes, Steven; Vanbeek, Nathalie; Claes, Toon (2020): Etiology of knee pain in elite cyclists: A 14-month consecutive case series. In Acta orthopaedica Belgica 86 (2), pp. 262–271.
Donovan, R. L.; Edwards, T. A.; Judge, A.; Blom, A. W.; Kunutsor, S. K.; Whitehouse, M. R. (2022): Effects of recurrent intra-articular corticosteroid injections for osteoarthritis at 3 months and beyond: a systematic review and meta-analysis in comparison to other injectables. In Osteoarthritis and Cartilage 30 (12), pp. 1658–1669. DOI: 10.1016/j.joca.2022.07.011.
Karim Khan (2017): Yep, corticosteroids are ideal treatment for people you don’t like. More pain in long run., 7/24/2017. Available online at https://twitter.com/BJSM_BMJ/status/889417443835117568.
Kuwabara, Anne; Fredericson, Michael (2021): Narrative: Review of Anterior Knee Pain Differential Diagnosis (Other than Patellofemoral Pain). In Curr Rev Musculoskelet Med 14 (3), pp. 232–238. DOI: 10.1007/s12178-021-09704-9.
Momaya, Amit Mukesh; McGee, Andrew Sullivan; Dombrowsky, Alexander R.; Wild, Alan Joshua; Faroqui, Naqeeb M.; Waldrop, Raymond P. et al. (2020): The Cost Variability of Orthobiologics. In Sports Health 12 (1), pp. 94–98. DOI: 10.1177/1941738119880256.
Noyes, F. R. (1977): Functional properties of knee ligaments and alterations induced by immobilization: a correlative biomechanical and histological study in primates. In Clinical Orthopaedics and Related Research (123), pp. 210–242.
Rovere, George D.; Adair, Daniel M. (1985): Medial synovial shelf plica syndrome. In Am J Sports Med 13 (6), pp. 382–386. DOI: 10.1177/036354658501300603.
Wang, James H-C.; Guo, Qianping; Li, Bin (2012): Tendon Biomechanics and Mechanobiology—A Minireview of Basic Concepts and Recent Advancements. In Journal of Hand Therapy 25 (2), pp. 133–141. DOI: 10.1016/j.jht.2011.07.004.
Wernecke, Chloe; Braun, Hillary J.; Dragoo, Jason L. (2015): The Effect of Intra-articular Corticosteroids on Articular Cartilage. In Orthopaedic Journal of Sports Medicine 3 (5), pp. 232596711558116. DOI: 10.1177/2325967115581163.
[1] Noyes 1977
[2] Wang et al. 2012, p. 138
[3] Momaya et al. 2020
[4] Rovere, Adair 1985, p. 384, Borgers et al. 2020, p. 267, Bellary et al. 2012, p. 427, Kuwabara, Fredericson 2021, p. 236
[5] Wernecke et al. 2015, p. 6, Donovan et al. 2022, p. 1666
[6] Karim Khan 2017
