Dear Mayo Clinic: KNEE AND HIP PAIN

. June 13, 2019.
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Knee and hip pain without clear cause may benefit from physical therapy

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DEAR MAYO CLINIC: I’m 45, and my right knee and right hip hurt off and on, especially after I lift weights or perform strenuous exercise. I had an MRI done, and there is nothing structurally wrong. Would physical therapy be a good next step?

ANSWER: When pain is a problem, and imaging tests and other assessments don’t point to a clear cause, consulting with a physical therapist is a good idea. In your case, a physical therapist can review your workouts with you to ensure they are safe and effective, as well as modify your routines, as needed, to help you reach your fitness goals without pain.

Hip pain and knee pain are common concerns, especially with age. The pain can be caused by a wide variety of problems. In some cases, pain may relate to issues within the joints themselves, while, in other situations, pain may result from problems with the muscles, ligaments, tendons and other soft tissue that surround the hip and knee joints. Sometimes, hip and knee pain can be triggered by back issues. This should be considered if an exam of your leg doesn’t reveal any concerns, and your history of pain doesn’t point to a problem within the hip or knee.

Imaging tests, including MRIs, X-rays and CT scans, often can reveal injuries, such as a sprain or strain, as well as other issues like joint damage or inflammation that could contribute to pain. But imaging alone may not always be enough to uncover what’s causing knee and hip pain.

If you haven’t done so already, talk to your health care provider about getting a comprehensive assessment of your condition to make sure there isn’t an underlying medical concern that must be addressed. A thorough history and physical exam often reveal the cause of many musculoskeletal pains. But if an evaluation doesn’t identify a specific problem, then physical therapy likely would be a good treatment option to reduce pain.

Because the intermittent pain is affecting both your hip and knee, and because it seems to be associated with your exercise routine, it’s possible that the way you’re exercising could be contributing to the problem. A physical therapist can work with you to evaluate your routines and see if you need to make changes.

For example, when done correctly, weight training can help you increase strength and muscle tone, improve bone density and lose fat. If it’s done incorrectly, though, weightlifting can lead to pain and injury. A physical therapist can check your lifting technique and guide you on proper form. The better your form, the better your results will be and the less likely you will hurt yourself.

The same is true for aerobic workouts. If you’re running, swimming or cycling using improper technique, that could trigger pain. Your physical therapist can assess your exercise technique to see if there are ways you can adjust your form to reduce the likelihood of pain and injury.

It’s also important to talk with your physical therapist about how often you’re working out to ensure you aren’t exercising too much or too strenuously. More is not necessarily better when it comes to workouts, especially if you’re experiencing pain as a result. If you notice pain during exercise, ease back or stop what you are doing. People often are told to “push through pain” when exercising. That’s not good advice. While feeling fatigue or some mild discomfort during exercise is normal, pain is not. Ignoring pain can lead to serious injury.

Ask your health care provider to recommend a physical therapist who has training and experience in sports medicine. He or she can help you evaluate your fitness goals, assess your routines and create a plan to maintain the benefits of your workouts, while avoiding pain. – Daniel Montero, M.D., Orthopedic Surgery, Mayo Clinic, Jacksonville, Fla.

(Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. E-mail a question to MayoClinicQ&A at mayo.edu. For more information, visit www.mayoclinic.org.)

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