Skin Rolling for Inner Knee Pain in Runners

You're listening to the Restoring Human Movement Podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. Hey there, everybody. It's Sebastian, your host or co-host with the Restoring Human Movement Podcast. Thanks for joining the show. Today, I'm going to cover some of debriefing knee pain, especially inner knee pain associated to running, and something simple that you guys can do about it that you would probably not even expect. Like, it's a thing that most people do not even try, but surprisingly, it works super well. So in the video, or sorry, in the podcast, I'm going to put in the description a link to the video that I'm going to reference.

The video is one that I made, I want to say, five years ago. On YouTube, I think it has two to three million views, I don't recall. And it was based upon a concept called skin rolling. Now, it was a second video that I made because the first video was so popular, but I think the information was pretty poor. I tried to organize better about maybe what other steps may be because unfortunately, when people use a technique like this to try to solve some of their knee problems, they're misled. It's not a solution they'll get. They'll get a Band-Aid. But Band-Aid's do have a purpose and it helps give better insight of other ways to manage your problems.

So the conditions that it would work really well with would be pezanserine bursitis that's unresolved with other things like physical therapy and tissue work, or even taping. It's going to be medial meniscus that's not locked in place because that's a whole different scenario. Knee osteoarthritis. So if you've been told you have that, don't worry. This one may actually work out pretty well for you. And the last thing is going to be Pleka syndrome. Pleka syndrome is kind of an oddity out there. I think it's overly diagnosed oftentimes, most of the time. And so this is going to be a gateway into figuring out if you really had Pleka problems or not.

So the questions I get about this a lot of times is why, what is it instead of those diagnosis? I will cover that in this podcast. So if you wanted to, you can pause this or I'll just describe what skin rolling is. And you can try it right here on the video. I want to take about a minute or two. So skin rolling, if you can imagine it in your mind's eye, if you had a t-shirt on right now, it's like you're grabbing your t-shirt, not pinching your t-shirt, but grabbing and lifting your t-shirt off of your body. And then you're tractioning or trying to pull the t-shirt away at the other ends of the t-shirt.

So you're using the t-shirt as a handle and you're pulling and kind of stretching the t-shirt in other directions. And you can stretch it in all directions, up and down, side to side. You can even twist it a little bit. So this is, imagine your skin is that t-shirt. Underneath your skin is fascia, nerves, vessels, and things of that nature. So this is something that if you do around the inner part of the knee first, it's going to be hard to grab. So you may have to actually find your way from the upper part of the knee, which is like where the adductors are, kind of like high knee, but not middle adductor.

You grab that area and you grab and lift, not pinch, and try to roll that wave of skin into the area where your knee hurts, which is the inner part in this scenario. You can grab and lift and change directions. You can start from the bottom where the shin is and move up into the area. But my point is, if you try to lift only at the part where it hurts, you may be like everybody else on the YouTube comments that says, why can't I lift my skin? It's because there's a technique involved. Like you need to make sure that you get creative about how to get in there. But if the intention is to lift the skin and pull it away from the other tissues, you need to find a way to do it.

Another way is with a, like a cup, like a silicone massage cup that's kind of just suction-y. It doesn't matter if you're sucking chi or aligning chi or whatever. By the way, I don't know anything about that, but I'm just saying it's not that. You're basically lifting, you're using as a suction device to pull it off in the underlying tissue. And if your mind's eye are trying to separate it, you have to actually physically scruff it up. You can't just like pinch it and let it go. So you would do this, the inner part of the thigh around the adductors all the way down to the knee, to the front of the knee, to the top of the knee cap, all the way down about two inches below the front and the inner part of the knee.

What you would do after this is you would actually just move around and test see how your knee feels. A lot of people, if you read all the YouTube comments, you'll see that people said, what the heck? How did that work? Is this witchcraft? That worked for me. Yeah, I've had knee pain for 10 years. So what does it mean? Which is why I made that second video. And this is why I'm making this podcast now. Because in my experience, and I am no different when it comes to YouTube, if people talk too much on it, I kind of just fast forward. So if you, if it helps you, please stick around for the last part of this podcast.

In worst case, you can call us and discuss it with us on a consultation as well. But here's the basics of how things work. Okay. First off, I should say that I reserve the right to change my mind on this because I, I think when we've gotten into the weeds about how and why things work with things like manual therapy over the years, from a clinical perspective, a lot of people end up being proven wrong. And it's because I think that people are forced into feeling that like they need to give an explanation of why something works. Sometimes things just work. And it may be for a different reason than we think, but if it works, it works.

So use it. Now, what people think happens with this is one option is going to be that you're actually doing local nerve decompression of nerves that go through that fascia and innervate the front and inner part of the knee right around the meniscus and around the patellar tendon and down into the peasant serine area. It doesn't do anything to the tendon. It doesn't do anything to the muscle. It doesn't change the bursa. It doesn't change what the medial meniscus is doing. It doesn't do any of that. And so remember, this does, this is not a test or a treatment that concludes that you have anything in particular, but it more so excludes other things.

Like if you can move better afterwards, it means that your pain is not from the osteoarthritis or the meniscus, but it doesn't mean you don't have that either, but it means your pain is not from that because pain can be a little bit more convoluted than that. So option one is that it's actually a nerve tractioning type of approach. Option two is that you're treating the fascia. You're trying to actually manipulate the fascia in the area, or you're trying to decrease the amount of stickiness or adherence or trigger points or whatever you want to call it in the fascia. I'm being very, very, very loose with words here again, because I don't think anyone really knows, but we all make up these reasons why we think we know.

And that could be a, it could be an option. The third thing is that there's, there's an odd scenario, what's called a fair and input, a fair and input. And I've seen this many times on feet with people like with a hammer toes is so when they have hammer toes, sometimes you make them walk on rocks and their hammer toes go away within literally minutes. They may come back, but they go away within minutes. And so part of the thought with that is that it's a stimulus effect. Like you're stimulating the bottom of the foot. That's what I think reflexology of the foot is based upon. They're saying that the brain innervates parts of the foot and that's why it helps.

So people go to reflexology. So they must believe in some form of a fair and input, right? Or sensory input. And so there is not as many sensory fibers in the knee as the bottom of the foot, but you can still like, you can still feel pressure and light touch. And so those are all sensory things. So you can actually make that area sensory input be stimulated by just creating like a pain response by the, this will hurt for a lot of people or you create movement there, which also creates sensation responses. So, and that would travel up to the brain, which may block pain signals in the area. In that case, it hurt less.

So there's three, three basic options, but I'm sure there's many, many more. But what this typically means is that the symptoms can be managed with non-surgical methods, skin rolling. And then we can load and challenge the knee and the hip and the foot to make it so these symptoms stop. And what I said in the beginning about it's misleading to think this is going to have a long-term effect. It's mainly because if you're only focusing on pain as being the solution or whatever solves the pain is the solution, you're very misled. Pain is sometimes an effect of a different problem. And we know from many, many years of research that knees are severely affected by instability from old trauma, or they're affected by mechanics of the foot or the hip or core support.

And so those are, those are all things that will make force that is not necessarily desired at the knee go into the knee. And then you end up creating a long-term effect, such as meniscal injuries and osteoarthritis and patel tendinopathy and stuff like that. So treating the pain, yeah, it's all good. But managing it and reducing the amount of load that goes into it or offloading the tissue is a big, big part. And that's where the actual exercise and programming magic starts to happen. So we don't have any necessarily books on this, but we do have a great book on plantar fasciitis, which covers some of the basic strength training that we use for lower quarter conditions.

And we have a ton of YouTube videos on patellofemoral pain syndrome, which is a common knee condition on runners. I may link that in here because I think that would give you best insight. And that's where Dr. Mandy talks about the current research associated to that, which is also associated other different types of knee conditions as well. But establishing a first aid and feeling better is a big part, but it is far from having a long-term effect. So if you guys would like to talk to us about this, we do have consultations that are very reasonable in price. They're 30 minutes. Currently, they're $29.

We can't say that's going to happen forever. But you can speak with me or Mandy or Dawne Costantino, and we can see maybe if we can help you provide some insight of maybe some other directions that you should go. And everybody's a little bit different in regards to what creates their problems in their storyline. Some people have old knee injuries. Some people have old hip injuries and so on. Some people have poor exercise programming or poor mileage load management, we call it. So there's things that we can talk about in there. And if we can help you, we may propose that you work with us. And if we can't, we'll suggest maybe we can't.

So you can call us, 714-502-4243, or you can email us, info at p2sportscare.com. Subscribe to the show. Give a thumbs up if you learned anything at all. And check out that YouTube channel for the video. See you guys next time.