Physical Therapist & Medical Doctor For Best Knee Pain Rehab
Have you been told you need surgery for knee osteoarthritis or tendinopathy? What if there were cutting-edge, non-surgical treatments that could help you stay active, pain-free, and avoid the operating room altogether? In this podcast episode, Colin Rigney, PT, DPT and I will uncover the latest advancements in musculoskeletal conditions, including how rehabilitation, ultrasound diagnostics, and regenerative therapies are transforming patient outcomes.
If you're looking for real solutions beyond painkillers and surgery, this conversation is a game-changer. Don't miss out—your joint health depends on it! Dive in now and take control of your recovery.
Episode Video
Many people who receive a diagnosis of knee osteoarthritis or tendinopathy immediately fear the worst—believing that their only option is surgery. However, as Colin Rigney, PT, DPT explains, non-surgical interventions have come a long way. This episode is packed with insights that can help patients take control of their joint health and mobility, avoiding unnecessary surgeries and optimizing their quality of life.
Understanding the Stages and Treatment Options for Knee Osteoarthritis
What is Knee Osteoarthritis?
Knee osteoarthritis (OA) is a degenerative joint condition that occurs when the protective cartilage in the knee breaks down over time. This process can lead to pain, stiffness, and reduced mobility. While aging plays a role, factors such as previous injuries, obesity, and muscle imbalances can speed up its progression.
One common misconception is that an OA diagnosis automatically means a knee replacement is necessary. Many patients assume that their condition will only worsen, leading them straight to surgery. However, as Dr. Rigney points out, pain levels do not always match the severity of osteoarthritis seen on imaging. Some individuals with significant cartilage loss experience little to no pain, while others with mild arthritis suffer from persistent discomfort.
The Stages of Knee Osteoarthritis
Knee OA develops in four stages. In the early stages, symptoms may be mild and easily managed. However, as the condition progresses, joint function becomes more limited.
Stage 1 (Mild OA): Minor wear and tear with no significant pain or discomfort.
Stage 2 (Moderate OA): Some cartilage thinning with mild pain, especially after physical activity.
Stage 3 (Severe OA): Increased joint pain, stiffness, and inflammation as cartilage loss becomes more prominent.
Stage 4 (End-Stage OA): Bone-on-bone contact, leading to severe pain and significant mobility restrictions.
Many patients are diagnosed at Stage 2 or 3, when symptoms start affecting daily activities. At this point, non-surgical treatments such as physical therapy, targeted exercises, and joint injections can help delay or even prevent further deterioration.
How to Manage Knee Osteoarthritis Without Surgery
Rehabilitation and Strengthening Exercises
One of the most effective ways to manage knee osteoarthritis is through strengthening the muscles that support the knee joint. The quadriceps, hamstrings, and glutes play a key role in stabilizing the knee and reducing stress on the joint. Strengthening these muscles can help improve function and decrease pain.
Dr. Rigney explains that many patients with knee OA develop weakness in the hips and thighs, which can cause abnormal joint loading. Simple exercises like backward walking, tibial raises, and cycling can significantly improve knee stability. Additionally, working on hip strength and endurance is crucial, as hip weakness contributes to poor knee mechanics and pain.
Weight-Bearing X-Rays and Ultrasound for Accurate Diagnosis
Accurate diagnosis is essential for developing an effective treatment plan. Many traditional approaches rely on non-weight-bearing MRI scans, but these images do not always reflect how the knee functions in real life.
Weight-bearing X-rays provide a true representation of joint space narrowing and alignment, showing how gravity impacts the knee. Additionally, musculoskeletal ultrasound allows for real-time, dynamic assessment of soft tissue injuries, such as synovitis (joint inflammation) and tendon damage. This imaging technique provides clearer insights than MRI alone, making it an essential tool for diagnosing knee OA.
Platelet-Rich Plasma (PRP) and Other Adjunct Therapies
For those looking to avoid surgery, adjunct therapies like platelet-rich plasma (PRP) injections and shockwave therapy offer promising results. PRP involves using a patient’s own blood to promote tissue repair, while shockwave therapy stimulates blood flow and collagen production.
Dr. Rigney explains that combining physical therapy with these cutting-edge treatments can significantly enhance recovery. Instead of simply treating pain, these therapies work to stimulate natural healing processes, allowing patients to stay active and mobile without undergoing invasive procedures.
Understanding Chronic Tendon Pain
What is Tendinopathy and How Does It Develop?
Tendinopathy is a chronic condition that affects tendons, leading to pain, stiffness, and weakness. Unlike acute tendonitis, which is a short-term inflammatory response, tendinopathy is a degenerative condition where the tendon structure itself begins to break down.
This condition is common in active individuals, particularly those who engage in repetitive movements such as running, cycling, or weightlifting. However, tendinopathy is also seen in aging populations, where tendons weaken over time.
Diagnosing and Treating Tendinopathy with Ultrasound
Musculoskeletal ultrasound is the best tool for diagnosing tendinopathy, as it provides a high-resolution image of the tendon’s structure. This allows clinicians to grade the severity of the condition and determine the best course of treatment.
Once diagnosed, treatment typically involves eccentric strengthening exercises, which help rebuild tendon integrity. Other effective approaches include shockwave therapy and PRP injections, both of which accelerate healing by stimulating blood flow and tissue repair.
Can Tendinopathy Require Surgery?
In most cases, tendinopathy does not require surgery. However, in rare instances where there is a significant tendon tear or detachment, surgical intervention may be necessary. Dr. Rigney emphasizes that 95-99% of tendinopathy cases can be managed conservatively through rehabilitation, proper loading strategies, and adjunct treatments.
Strengthening, Prehabilitation, and Lifestyle Changes Through Preventing Surgery
How Prehabilitation Can Delay or Prevent Knee Surgery
For individuals in the early stages of knee osteoarthritis or tendinopathy, prehabilitation can make a significant difference. Prehabilitation focuses on building strength and mobility before symptoms worsen, reducing the need for surgical intervention.
By incorporating targeted strengthening exercises, endurance training, and functional movement patterns, patients can often halt or slow the progression of their condition. Dr. Rigney recommends exercises such as single-leg movements, sled training, and squats, tailored to each individual’s abilities and goals.
The Role of Nutrition and Sleep in Recovery
While exercise is crucial, nutrition and sleep also play a major role in tendon and joint health. A diet rich in protein, essential fats, and vitamins provides the building blocks necessary for tissue repair. Likewise, quality sleep is essential for recovery, as it allows the body to repair damaged tissues and reduce inflammation.
About Colin Rigney, PT, DPT
With over 16 years of experience in orthopedic physical therapy and musculoskeletal ultrasound, Colin Rigney, PT, DPT is a recognized leader in non-surgical solutions for joint and tendon conditions. A Board-Certified Orthopedic Specialist and Registered in Musculoskeletal Ultrasound (RMSK), Colin serves as Co-Director of Education for Advanced Musculoskeletal Ultrasound Center and is an Adjunct Faculty member at A.T. Still University. As a managing partner at Modern Physical Therapy & Sports Medicine, he combines advanced imaging with targeted rehabilitation to help patients regain mobility and avoid unnecessary surgeries.
Connect with Colin Rigney
Want to learn more from Colin Rigney, PT, DPT or explore how musculoskeletal ultrasound and cutting-edge physical therapy can benefit you? Connect with him through the following platforms:
Final Thoughts
Dr. Rigney emphasizes the importance of finding a healthcare provider who listens to your concerns and tailors treatments to your specific needs. Many patients feel rushed through the medical system, receiving a diagnosis without a thorough explanation or treatment plan.
Patients should feel empowered to ask questions, seek second opinions, and explore non-surgical options before considering invasive procedures. With the right approach—including physical therapy, advanced imaging, and regenerative treatments—it is possible to manage knee osteoarthritis and tendinopathy effectively, keeping you active and pain-free.
If you're ready to take control of your knee pain, click here to discover more about these five effective knee pain home treatments. With these simple steps, you can start your journey towards pain-free knees and a more active lifestyle.
