• Dr. Brandon

5 ways to ease "bone on bone" knees


One of the biggest questions when it comes to knee pain is “What can you do for my knees, my doctor says they’re bone-on-bone." And that is a great question. One of the things that we’ve all been taught is that if your knees are bone on bone or have arthritis, the only answer is steroids, painkillers, or a knee replacement. If you are looking for a natural and holistic solution, fortunately, now there are so many more options. But…what does it mean to be “bone on bone” and what can you do about it. Need personalized answers now? Request your free consultation today.


If you've been told that you have bone on bone knees, it can mean several things. Usually, if you’ve had an X-ray or your knees, the radiologist has found that the spacing between 2 of the 3 bones that make up your knees has less space in between them than what they would normally expect to find. For some, it is minor narrowing and for others there is actual damage to either the femur or tibia (2 of the 3 bones that make up the knee joint). These changes are some of the ways that the knee naturally ages. For some, they’ve had an injury in their past that caused some of the damage and what your doctor sees on an X-ray is some of the leftovers from that injury. For others it is the result of having a lifestyle that makes it so that the muscles around our knee aren’t strong enough to carry the load we’re putting on them. For others, the finding that they are “bone on bone” may be something picked up while they were getting imaged for some other reason. In fact, over 50% of people with these changes have no pain as a result of and in professional basketball players with significant knee arthritis, only one third have any knee pain. Want to learn more? Get our free knee pain guide and learn not only the 5 things you can do today to ease your knee pain but more importantly, what not to do!


How can this be? One reason is that x-rays and MRIs only tell one part of the story. They’re really good at showing anatomy but really bad at showing how you feel. In fact, many of the things that we once called degeneration are really how our body shows its age on the inside (and its previous bouts of self-healing ). In addition, many have had very painful knees and when they had an MRI or X-ray, they’ve been told that there’s nothing wrong. Now, think about your own knees. Do they show any change in how they feel (even if it is going from bad to worse)? Do you have good days(or bad days and worse days)? Does it ease up after you’ve been up and about for a few minutes or does it get worse with time on your feet? Those changes in how you feel are often not you causing more damage or “wear and tear” (a term that was originally coined for appliances, not self healing living things). In fact, your joints don’t “wear and tear" your joints “wear and repair” because that’s what your body does, it repairs itself when ever there is something wrong. So, what is really going on when our knees hurt?



First, most things that we do on a daily basis are not enough to cause an injury. What they can do is cause pressure onto the padding of our knees, our meniscus and cartilage. Now, if you are not as active as you’d like to be or have a desk job, your joint is not getting the movement that it needs. When you are up and walking around, you are actually triggering the release of your body’s lubricant for your knees and that compression and unloading (like when you step) causes it to flow between the joints of your knee and oil it. In fact, that is the first thing that you can do to ease achy knees, move it and lube it. This doesn’t mean trying to get a 5k in from the start. Just getting on your feet 5-10 minutes and walking several times a day is enough to start strengthening the muscles around the knees and oiling the joint surfaces. Key takeaway-to fight arthritis and bone-on-bone knees, move it and lube it


Second, since we know that most activities are not enough to damage our knees, something else must be going on when they hurt. That’s why I like teaching about your body’s alarm system. In the case of chronic knee pain, your body has an alarm system that gets stuck on extra sensitive or vigilant. Not only that, it has sensors for more than just tissue damage. Think about a time when your knee hurt but you “didn’t do anything” to make it hurt… Well, in addition to having sensors for possible damage (your nervous system can’t actually tell if you’ve had damage, it just says something might have happened). Your nervous system has sensors for things like change in temperature, pressure, change in blood flow, stress, and immune system. Any one of those can literally press the pain button and your body thinks that it has damaged something. In fact, the longer the pain has gone on, the more likely it is that your sensitive nervous system is more to blame than brand new knee damage. Fun fact, the more you understand about how pain works, the less pain you have (and the more control you can have over it).


Third, choosing the right activities can help your muscles get strong enough to start to support your knees. For some, that means starting with water exercises where you are not lifting as much of your own body weight because the pool is supporting you. For others, it means starting towards the recommended thirty minutes a day of activity (enough to get your heart rate up above 100 beats per minute if that is safe for you). If thirty minutes in one go seems too much for you, you can get the same boost to your health with three, ten minute bouts (but you get a better pain relief boost the longer you are able to go without flaring your pain). This allows for your muscles to both support you and also take some of the load off your joints and put it where it belongs, onto your muscles.


Fourth, fueling for success. This means making sure you are eating the right foods to fight inflammation ,and staying hydrated which are key to your success. Usually, if it comes out of a box or in a wrapper, it is going to be pro-inflammatory or something that causes your body to make inflammation. Now, this doesn’t directly cause pain, but it does make your alarm system more sensitive in addition to worsening other health conditions like high blood pressure and diabetes.


Fifth but probably most important. Having a professional that helps you get to the root of why your knee hurts. I’ve often found that many people’s pain is actually coming from somewhere else than where they are actually feeling it. Get the support of somebody who successfully treats knee pain day in and day out using safe and natural treatments all the while teaching you how to heal yourself while helping you stay mobile and independent. If that sounds like you, you can take advantage of our free in person consultation. During your consultation, you can get your questions answered and together we can start to get to the root of why you are in pain (and often where you hurt is not the cause but the victim) and help you understand what your options are.


About the author

Brandon Alkire, DPT, CSCS, FMS, Cert. DN

Doctor of Physical Therapy and Strength Coach

Dr. Brandon is the owner and a Physio at Body Mechanix Physiotherapy and Fitness. Four of his favorite people call him daddy while he's been married to his other favorite person for over 18 years. He enjoys teaching martial arts and is a Mestrando in Capoeira while in the mornings, he can be found working out with the guys in F3 around town.

He's the author of 4 pain relief guides for neck, low back, shoulder, and knees and the lead contributor to the Active Tallahassee Blog.

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