Causes of Knee Pain You Had No Idea Existed

Not all knee pain is created equally. Knee pain can be a symptom of a problem in another part of the body. Valley Sports and Spine finds the cause of the pain.

People complain of knee pain every day. In fact, knee pain is one of the most common complaints among active adults over the age of 30. While most people chalk up their discomfort to ‘getting old,’ it can actually be a symptom of a problem in the ankle or hip joints. If untreated, the ankle, hip, and knee can all suffer long-term damage that may require surgical repair, but if diagnosed and treated by an osteopathic physician early on, surgery can be completely avoided.

Common Causes

All of the joints on the leg work together, starting at the ankle and reaching all the way to the hip. This system of movement is designed to support one another to promote a smooth action, like walking. Unfortunately, due to a culture of poor body mechanics, it is becoming commonplace to see stiffening in hip and ankle joints. This stiffening can often be attributed to prolonged periods of sitting or inactivity as well as footwear that promotes poor alignment of the spine.

Knee pain is often a late symptom of limited range of motion in the hip or ankle joints. When considering a runner, as the runner attempts to stride, if the ankle is stiff, the knee is forced to bend at a greater angle. As a result the hip is unable to fully rotate which causes a shorter stride and harder impact on the knee. While the runner is feeling the hard impact on the knee, the real problem is the stiff ankle.


Rehabilitative medicine is ideal for treating knee pain that may not have an obvious cause. Rehabilitative physicians, more commonly referred to as physiatrists, do more than examine the aching knee, they examine your body mechanics. With consideration for the systems of the body all working together, physiatrists evaluate the whole person and then investigate possible causes for atypical pain. Once the cause of the pain has been identified, a personalized treatment plan is created to fit the patient’s needs. Under most circumstances, a regiment of exercises that focus on stretching and strengthening specific muscles groups, while lubricating the joints, can correct the problem in no time.

For more information about knee pain, please visit our website at and learn how Valley Sports & Spine Clinic can get you moving!

What Your Hip Pain is Trying to Tell You


Pain in your hip can be a symptom of an injury in another location of the body. The kinetic chain links the joints of the body together to keep the body moving.  



Are you suffering with hip pain? Does your hip ache day and night for no apparent reason? Do you remember a specific activity that initially brought on the pain, or did it seem to come out of nowhere? The truth is that the pain you are feeling in your hip may not signify that anything is actually wrong with your hip. What you may be experiencing is something called referred pain, and you can blame the kinetic chain. Referred pain is pain felt in one area of the body that has actually originated in a completely different area of the body. You may not feel pain, or any symptoms at all, in the point of origin, but your hip sure feels something!

What is the kinetic chain?

The simplest way to describe the kinetic chain is to think about the division of responsibility. If you have a job to do and four workers to do it, the job will get done efficiently as everyone knows their role and works together. If you take away one of these people and now only have three people to complete the task, the job will still get done but not as quickly and with a greater burden placed on each worker. Now let’s put that in terms of the body. The joints are an interconnected system that all work together to allow the body to move. If one joint suffers a set-back such as stiffness or injury, the other joints will absorb the extra stress in order to keep the body moving.

How does pain relate to the kinetic chain?

When speaking in terms of the kinetic chain and your pain, try imagining a pebble dropped into a pool of water. Think of how the ripples in the water are larger where the pebble hit the water and smaller the further away they get until they disappear. This is what many physiatrists, or function specialists, call the kinetic chain ripple effect. The body spreads out the stress that it endures as it compensates for the area actually experiencing complications.

What this means for you?

The next time that you go to see your physiatrist do not expect the examination to be focused solely on your hip. You can expect your provider to ask you several questions about your daily activities and what aggravates the pain or makes it better. You can also expect radiological imaging of your hip as well as your entire back and possibly a knee.  Through the use of x-ray, your doctor can identify any underlying stressors or injuries along the kinetic chain.

It’s hip to be informed.

For more information about the kinetic chain and how it relates to your pain, please see our webpage at  Asking questions and getting involved in your care are great ways to get your pain under control because knowing what causes your pain can also help you prevent it.

Good Luck!

Dr Ethan Colliver


Sitting is Bad for Your Health


A new meta-analysis shows that sitting too much increases your risk of early death from any cause.  The other important finding is that this increases your risk even if you exercise.  Further, the study showed that the less active you were, the more likely you were to die prematurely.

Previous studies have also showed that you should get get up 35 times a day or get up about every 15 minutes throughout the day.

For many of our patients in the Christiansburg, Radford, and Blacksburg area, the struggle after successfully completing physical therapy has been finding a way to continue to exercise and keep moving afterwards.  Valley Sports & Spine Clinic and Valley Active are committed to finding a personal exercise plan to keep you regularly moving for a healthy lifestyle.


Good Luck!


Dr Ethan Colliver

The cure to low back pain?

BackPainSMRegenerative Medicine may hold the cure to chronic low back.  Low back pain is commonly due to painful lumbar discs.  There are many treatments, but to-date there has never before been a cure.

Regenerative Medicine works to repair, replace, or restore normal function to injured body parts.  For example, mesenchymal precursor cells are throughout the body and can differentiate into bone, cartilage, tendon, and even muscle and nerve cells.  Your body uses these cells after injury to help heal and to avoid scarring.  Researchers have been able to harvest large numbers of these cells from bone marrow and have used them to help heal knee, hip, and other joint injuries.

Mesenchymal stem cell displaying typical ultrastructural characteristics. Robert M Hunt 1997


One study used concentrated precursor cells from patients’ bone marrow to help relieve lumbar disc pain.  Twenty-six patients with disc pain and MRI evidence of early degenerative disc disease had mesenchymal precursor cells injected into 1 or 2 discs and were observed for 12 months.  Researchers found that the average improvement in disability was 56.8% and a 58% improvement in pain.

Another research group separated out mesenchymal precursor cells to inject into patients with painful discs and found that those patients were 3 times more likely to have 50% relief in pain and disability than patients who received a placebo.

Why is this exciting?  Most treatments for low back pain last a few weeks.  This treatment shows improvement for at least 12 months. Most mesenchymal precursor cell research shows improvement out to three years.  Also, these past two research papers show evidence of reversing of disc degeneration. That is like regenerating a degenerated disc. That is exciting!

At Valley Sports & Spine Clinic, we have used Regenerative Medicine techniques for four years with great success and continue to find new applications for Regenerative Medicine techniques for our patients.

We are committed to not just covering up the symptoms but helping to restore your function and truly heal.

Good Luck!

Dr Ethan Colliver

What do I do next?

Rehabilitation is a continuum of care.  As someone goes through the three phases (pre-rehab, rehab, and post-rehab) of recovery from an injury, the goals change and so should the rehabilitation provided.

Pre-habilitation is the exercise, conditioning, and education someone may go through prior to undergoing a hip replacement or other major surgery.  For example, patients who are stronger and more functional before they have a hip replacement will recover quicker and be more active after a their surgery.

Rehabilitation is the phase of training, education, and recovery from an injury or surgery which often occurs with a physical therapist and may last for several months.  This is a very critical time for many patients as it may be the first time they have had a major injury or have participated in a formal exercise program.  The physical therapist and physician work closely to help the patient establish goals, create a home exercise program, and help the patient envision how they will return to their normal everyday activities.

Unfortunately, 75% of patients stop doing their home exercise program within 6 months of stopping physical therapy.

rehabInsurance companies usually only cover physical therapy until a patient can carry out normal activities in the home; however, insurance will not cover rehabilitation aimed at the goals of returning to a sport or to a demanding work environment.

Post-rehabilitation is the phase afterwards, focusing on helping you maintain a home exercise program and establish new goals.  This is important for an athlete who needs to continue getting stronger and faster to meet the demands of his/her sport.  But it is also important for an industrial worker who has a demanding job or for a 65 year old grandmother who needs to pick up her grandchildren.

Having the patient create a personal exercise routine, under the supervision of a therapist helps you successfully stick to a healthy lifestyle and decreases your chance for recurrence of many painful conditions, and improves overall health.

Valley Sports & Spine Clinic and Valley Active help people through all phases of rehabilitation.  We are committed to helping people improve their function and return to their life.