Your knee or hip hurts. Let’s figure out why and what to do next.
Most people wait longer than they want to do something about a knee or hip. Usually they’re not sure who to see, or whether anything short of surgery can help. This page answers both questions.
First, we figure out what is actually hurting.
A hip that aches at night might be the joint itself, a tendon on the outside of the hip, or your back sending pain downward. The same is true at the knee. Pain after a tennis match is a different problem from stiffness every morning. Each one needs a different plan. So before we decide what to do, I test each possibility and see which one actually fits.
We start with what happened, what makes it worse, and what you have already tried. Then I watch you walk, use the stairs, and do the movement that brings the pain on. I test strength, motion, balance, and the nearby joints. Most of the time, the picture is clear that day. If it is not, I tell you that and use the next visit or two to see how the joint responds. You leave knowing what we are working on and why.
Then we decide what to do about it.
Most plans have three parts. First we calm the joint down without shutting your life down. Then we rebuild the strength and movement it has lost. After that we practice the thing you actually want to return to. Feeling fine around the house is not the same as being ready for a full round of golf, a tennis match, or a hard gym session.
Visits happen at your home, gym, or club.
Visits are an hour, one on one. We use your actual stairs and your actual equipment because that is what the joint has to handle. Between visits, you have work to do on your own. I set the amount based on how the joint feels that evening and the next morning. That tells us whether the amount was right, whether we need to back off, or whether you are ready for more.
Already have a diagnosis?
Arthritis or “bone on bone.”
An X-ray can show real wear in the joint. It cannot tell you by itself how strong the leg can become, how far you can walk, or whether you can return to the activities you miss. Surgery is sometimes the right choice. Before treating it as the only choice, it is worth seeing what a few months of proper strength work changes.
Meniscus tears.
Meniscus tears are common, including in people with no pain. An MRI does not automatically mean surgery. The exam and the way your knee behaves help sort out whether rehab is the right place to start.
Labral tears in the hip.
A labral tear on a scan can matter, but it is not the whole answer. How the hip moves, what loads it tolerates, and what activity you want back all shape the plan.
Kneecap pain.
This usually means the knee is being asked for more than it is currently strong enough to give. Rest calms it down but changes nothing, so it comes back. Building the strength is what helps it stay gone.
Tendon pain.
Tendons do not recover with rest, and they do not tolerate sudden big jumps in activity. They recover with the right amount of work, increased a little at a time. Finding that amount for your tendon is the treatment.
Pain that continued after surgery or a prior round of rehab.
Usually one of two things happened: the program ended as soon as the pain settled, before the leg got strong, or it was too generic for what you were trying to get back to. I measure where your strength and motion actually are now, and that shows what the last program missed.
Hip pain that may involve the back.
Pain around the hip can come from the back or a nerve. I check both, because a good program aimed at the wrong place will feel like nothing works.
About me.
I am Zakaria Nadif, a Doctor of Physical Therapy and Board-Certified Orthopedic Specialist. Knees and hips are most of what I treat.
I built Argan around one-on-one mobile visits because a full hour in the place you live and train gives me a clearer view of what the joint is being asked to do.
The practice is direct-pay, which is how visits stay a full hour with one person. HSA and FSA cards are accepted, and I can provide a superbill to submit to your insurance.