Knee Pain

Definition

What is knee pain?

Knee pain is pain that occurs in the knee area. It can have various causes, including injury, overloading, inflammation or degenerative diseases such as osteoarthritis. Knee pain can be assessed according to various pain characteristics. A distinction is made between the following characteristics, among others:

• Duration: acute knee pain, chronic knee pain
• Occurrence: Knee pain at rest, knee pain on exertion, knee pain after exertion
• Localization: front knee pain (e.g. pain under the kneecap), back knee pain (e.g. pain in the hollow of the knee), lateral knee pain on the inside, lateral knee pain on the outside
• Intensity: from mild pain to severe knee pain to severe, almost unbearable pain
• Quality: dull, stinging, burning

The different types of knee pain

This section provides a brief description of the various types of knee pain. It includes a selection of the most common forms, but the list is not complete or conclusive.

• Cruciate ligament rupture / cruciate ligament injury

  There is an anterior and posterior cruciate ligament in the knee. A cruciate ligament rupture or injury is usually caused by sudden twisting movements (knee twisted) or direct force. Typical symptoms are knee joint pain, a swollen knee and instability of the knee. The anterior cruciate ligament is usually affected much more frequently.
  

• Meniscus tear / meniscus injury

  A meniscus tear or meniscus injury affects the crescent-shaped cartilage discs in the knee that act as shock absorbers. These injuries are often caused by sudden twisting movements or heavy loads. Symptoms include knee joint pain, a swollen knee and blockages in the knee joint. Those affected often complain of knee pain when stretching.
  

• Medial collateral ligament tear / Medial collateral ligament injury

  A torn medial collateral ligament or medial collateral ligament injury affects the medial collateral ligament of the knee, which is responsible for the stability of the joint. This injury is often caused by external force, as occurs in sports accidents. Symptoms include pain on the inside of the knee and limited mobility. In some cases, the inside of the knee may be swollen.
  

• Lateral ligament tear / Lateral ligament injury

  A torn collateral ligament or collateral ligament injury affects the outer collateral ligament of the knee, which helps to stabilize the joint. This injury is usually caused by sudden twisting movements or strong external force, as often occurs in sports with rapid changes of direction. Symptoms include pain on the outside of the knee when weight is applied, swelling and instability of the joint.
  

• Cartilage injury

  A cartilage injury in the knee affects the protective cartilage covering of the joint surfaces and can be caused by overloading, accidents or wear and tear. Symptoms include pain, swelling and limited mobility of the joint. Those affected often complain of knee pain during exercise.
  

• Dislocation of the kneecap (patellar luxation)

  A dislocation of the kneecap, also known as a patellar luxation, occurs when the kneecap jumps out of its normal position in the knee joint. This usually occurs as a result of sudden rotational movements or direct force. Symptoms include severe pain in the front of the knee, swelling and a visible misalignment of the kneecap.
  

• Kneecap fracture (patella fracture)

  A kneecap fracture (patella fracture) is an injury to the kneecap that is often caused by a direct blow or fall on the knee. The kneecap can break into several pieces or only have one tear. This fracture leads to severe pain, swelling and limited mobility of the knee.
  

• Patellar tendon rupture

  A patellar tendon rupture is an injury to the tendon that connects the kneecap to the shinbone. This injury often occurs during sporting activities, particularly sudden jumps or landings. A rupture of the patellar tendon leads to severe pain in the knee, limited mobility and the inability to straighten the leg.
  

• Quadriceps tear

  A quadriceps tendon rupture is an injury to the tendon that connects the thigh muscle (quadriceps) to the kneecap. This type of injury often occurs during explosive movements, such as sudden jumps or quick changes of direction. A rupture of the quadriceps tendon leads to severe pain, swelling and a considerable restriction in the flexion of the knee.
  

• Knee osteoarthritis

  Knee osteoarthritis is a degenerative disease in which the cartilage in the knee joint wears away over time, leading to knee joint pain, swelling and limited mobility. It often occurs with increasing age, but can also be caused by injury or overloading of the joint. The symptoms often worsen over time, making walking and other activities more difficult. Knee pain can occur during exertion as well as at rest.
  

• Runner's knee

  Runner's knee, also known as patellofemoral pain syndrome, is a painful condition caused by incorrect or excessive strain on the knee. It usually manifests itself as pain on the front of the knee, particularly during activities such as running, climbing stairs or squatting. It is often caused by poor alignment of the kneecap or overuse of the muscles around the knee.
  

• Patella tip syndrome (jumper's knee)

  Patellar tendinopathy, also known as jumper's knee, is a painful inflammation of the knee at the attachment point of the patellar tendon at the lower tip of the kneecap. This injury often occurs in sports that require repeated jumps or quick changes of direction, such as basketball or volleyball. It is therefore also a case of incorrect or excessive strain on the knee. Those affected complain of severe knee pain under strain, especially when jumping or climbing stairs.
  

• Rheumatoid arthritis

  Rheumatoid arthritis, also known as chronic polyarthritis, is a chronic inflammatory disease in which the immune system attacks the joints, particularly in the hands and feet. The knee joint can also be affected. This autoimmune disease leads to knee joint pain, swelling and stiffness in the affected joints, which can severely restrict mobility. As the disease progresses, joint damage and deformities can occur, which can lead to knee pain during exercise and knee pain at rest.
  

• Baker's cyst

  A Baker's cyst is a fluid-filled swelling in the hollow of the knee caused by increased production of joint fluid. Those affected often complain of pain in the hollow of the knee. The Baker's cyst often occurs as a result of knee diseases such as osteoarthritis or inflammation in the knee and can cause feelings of tension, swelling and restricted movement.

Causes of knee pain

There are many causes of knee pain - from acute injuries and chronic illnesses to incorrect or excessive strain on the knee, many things can lead to knee pain. The most common causes can be roughly divided into three categories: Injury-related causes, degenerative diseases and inflammatory processes. With the exception of injury-related causes, which are often caused by increased force (e.g. impact of opponents, rapid changes of direction, stop and go movements, etc.), lifestyle and environmental conditions have a decisive influence on degenerative diseases and inflammatory processes.
In the past, our ancestors had to move more holistically and significantly more in order to obtain food. Hunting, foraging for berries or farming are just a few examples. For long stretches, this movement was carried out barefoot and on natural ground. The surface of the ground and the extent of the movement meant, among other things, that the foot and leg muscles were well developed and naturally strained. Lifestyle has changed considerably over the millennia. Modern civilization is often characterized by a lack of movement and a sedentary lifestyle. However, when we do move, it is on hard, flat floors such as concrete or asphalt and in immobile, supportive shoes due to the changed environmental conditions. Consequently, the altered quantity and quality of movement leads to physical adaptations. The effects of this on the development of knee pain are described below.

Lack of exercise and a sedentary lifestyle

The modern way of life, which is characterized by a lack of exercise and a sedentary lifestyle, places incorrect strain on the musculoskeletal system. The lack of exercise and sedentary lifestyle lead to physical changes that can promote knee pain. The following changes play a significant role in the development of knee pain:

• Weakened muscles

  Lack of exercise and a sedentary lifestyle cause essential muscles to atrophy. The foot and leg muscles play a crucial role in knee health. The muscles around the knee, especially the quadriceps (front thigh muscle), the hamstrings (back thigh muscles) and the calf muscles, provide stability. If these muscles are weakened, the knee lacks the necessary support, which can lead to uncontrolled movements and incorrect loading. This increases the risk of injuries such as ligament sprains or meniscus damage. Furthermore, strong muscles relieve the knee joint by absorbing the impact load when walking, running or jumping. Weak muscles, on the other hand, cannot perform this task adequately, so the joint surfaces press more heavily against each other. This promotes cartilage wear, for example, and can lead to osteoarthritis of the knee. A muscular imbalance, for example between the quadriceps and hamstrings, can change the position of the kneecap and cause misalignments. This can lead to runner's knee (patellofemoral pain syndrome) or jumper's knee (patellar tendinopathy), for example, as the kneecap is no longer optimally guided in its gliding path.
  
  However, functioning muscles are not only important around the knee joint. The feet, which are the first point of contact when weight is applied, also play an important role in knee health. On the one hand, functional foot muscles support the longitudinal arch of the foot, which is the first instance of reducing the force exerted on the knee when standing and walking. On the other hand, intact foot muscles ensure that the foot rolls naturally and thus protects against uncontrolled foot drop after heel strike. Due to uncontrolled rolling of the foot, the knee is hit with every step instead of being guided physiologically. This incorrect and excessive strain leads to overloading in and around the knee joint.
  

• Foot malpositions

  The weakened musculature can also lead to foot misalignments. Foot misalignments can have a considerable influence on the development of knee pain, as they change the entire leg axis and the load distribution in the knee joint. The feet form the basis of the musculoskeletal system and any misalignment can have an upward effect on the knees, hips and even the back. For example, foot misalignments often lead to a change in the position of the lower leg and knee joint. This can cause the leg axes to shift inwards (knock knees) or outwards (bow legs), which puts uneven strain on the knee joint. In the long term, this can lead to pain and joint wear (osteoarthritis).
  
  Weakened foot muscles can cause the longitudinal arch to collapse, which can lead to flat feet or fallen arches. This deprives the foot of its natural shock-absorbing function when walking and standing. The force exerted is therefore transmitted directly to the knees via the feet with every step. The increased load can therefore lead to pain in the knee.
  

• Restricted blood flow

  Restricted blood flow can have a significant impact on the development of knee pain, as the knee joint and surrounding structures are dependent on a good supply of oxygen and nutrients. A lack of blood flow can slow down healing processes, weaken tissue and promote inflammation in the knee.the knee joint is surrounded by cartilage, tendons, ligaments and muscles, among other things, all of which require sufficient blood flow to remain healthy. If the blood flow is disturbed, these structures do not get enough oxygen and nutrients, which can lead to a deterioration in tissue quality. This increases the risk of cartilage damage, tendon irritation and degenerative diseases such as knee osteoarthritis.
  After injuries or overuse, good blood circulation and the associated oxygen transport is essential for healing. Poor circulation can delay regeneration and mean that minor damage to the knee does not recover properly. In the long term, this can lead to chronic pain and persistent discomfort, and restricted blood flow can also result in metabolic waste in the tissue being removed more slowly. This can promote inflammatory reactions in the knee joint, which can increase pain and swelling. Blood circulation plays a particularly important role in diseases such as rheumatoid arthritis or gout, as inflammatory processes are often exacerbated by poor blood circulation.
  

• Fascia dysfunction

  Fasciae are connective tissue structures that envelop and connect muscles, tendons, ligaments and organs. Fasciae change their original structure and can become brittle, stick together or harden if they are subjected to irregular and unphysiological strain. As a result, the fascia network loses its elasticity, which impairs its function. Fasciae play a central role in the body's movement, stability and power transmission. The loss of elasticity increases the tension around the knee joint. The increased tension pushes the upper and lower leg bones closer together and brings the kneecap closer to the knee joint. This additional pressure from the closer bones wears down the cartilage layer excessively and also leads to unnatural tension, which can promote injury and inflammation.
  Hardened or adhered fascia can negatively affect the blood vessels and thus lead to poor circulation, which slows down the regeneration of muscles, tendons and cartilage. Furthermore, hardened or adhered fascia can restrict the mobility of the knee and lead to incorrect loading. More on this in the next section.
  

• Joint stiffness

  Due to a lack of exercise and a sedentary lifestyle, the joints are not moved to the maximum possible range of motion. The result is a natural stiffening of the joints. Immobile joints, especially in and around the foot, prevent a natural rolling movement and thus increase the force exerted on the knee joint. Knee joint pain can be the result. The knee joint can also stiffen naturally due to inactivity. This reduces freedom of movement, which results in an unphysiological load. As a result, surrounding structures such as muscles, tendons and ligaments have to work harder, which encourages incorrect and excessive strain and causes pain. In addition, the limited mobility reduces the supply of nutrients to the cartilage, which increases the risk of osteoarthritis and joint damage in the long term. Natural stiffening also means that the muscles around the knee joint are used less and break down. As the muscles stabilize the knee joint, weakening leads to more instability and a higher risk of injury. As a result of joint stiffness, those affected often resort to unhealthy movement patterns to compensate for the restrictions. This can overload other joints such as the hip or ankle and cause additional discomfort there.

Hard, flat floors and stiff, restrictive footwear

Hard, flat floors and immobile, supportive shoes have a significant impact on the knee joints and can cause or exacerbate knee pain. The following factors play a significant role in the development of knee pain.

• Reduced shock absorption and increased force effect

  Reduced shock absorption and increased force impactWhen walking on hard, flat floors and in immobile, supportive shoes, higher forces act on the musculoskeletal system, especially when the heel strikes the ground. Due to the firmness of industrial floors and the stiffness of conventional shoe soles, the forces that occur cannot be absorbed, which leads to increased strain on the body. This increased force hits the feet first and is then transferred to the knees. The less able the feet are to absorb the forces, the more strain is placed on the next joint up, the knee, which increases the risk of osteoarthritis, overuse pain or inflammation in the knee.
  Furthermore, the increased and early application of force shortens the possible reaction time of the responsible muscles. If the muscles cannot tense up in time, the joint in question is insufficiently stabilized, which also leads to incorrect and excessive strain. Insufficient muscular tension in the feet results in uncontrolled folding of the midfoot after heel strike. This results in what is known as a hinged foot and leads to an additional impact on the knee joint, which places incorrect and excessive strain on it. The lower leg and thigh muscles that stabilize the knee are also unable to react quickly enough due to the early and increased application of force. The reduced muscular tension leads to an unstable knee joint, which increases the load on the knee and the surrounding structures.

• Limited foot function and muscle weakness

  The human knee joint is part of a complex system that coordinates movement from the foot to the leg to the hip. Flexible, natural movements are crucial in order to distribute the load evenly and minimize pressure on the knee. Inflexible, supportive shoes can significantly impair this natural movement. Such shoes artificially stabilize the foot and restrict the mobility of the ankles. As a result, important muscles and tendons that help to stabilize the leg are less activated. This can lead to increased stress on the knee joints and surrounding structures, which increases the risk of injury, inflammation and wear and tear in and around the knee.
  Studies show that immobile, supportive shoes are often associated with reduced muscle activity in the calf and thigh muscles. However, these muscles play a crucial role in relieving pressure on the knee joint. Weakness in these muscle groups increases the risk of incorrect and excessive strain on the knee.
  

• Unnatural sequence of movements

  Natural movement sequences are designed to react dynamically to changing surfaces. Hard, flat floors and immobile, supportive shoes make a physiological sequence of movements much more difficult. On the one hand, the lack of muscle activation during heel strike causes the foot to fold downwards in an uncontrolled manner. The folding foot and its consequences on the knee were described in the previous section. On the other hand, the hardness and inflexibility of industrial floors and the stiffness of conventional shoe soles prevent the foot from rolling naturally. Due to the lack of rolling, the knee joint is not moved through its maximum range of motion, but is loaded in the same area with every step. On the one hand, this leads to certain structures being overloaded and others underloaded. Overloaded structures are prone to injury, inflammation and wear and tear. Underloaded structures can lead to degeneration. Furthermore, immobile, supportive shoes reduce the sensory feedback from the foot, which leads to a reduction in the exchange of information and therefore a reduction in adaptability. If the foot is not correctly positioned, the direction of pull of the muscles and tendons that stabilize the kneecap also changes. Among other things, this can lead to a misalignment of the patella and promote complaints such as runner's knee (patellofemoral pain syndrome) or jumper's knee (patellar tendinopathy).

Knee pain symptoms

It is important to note that the following are the most common symptoms of knee pain. However, the list of symptoms is not complete and exhaustive. Atypical symptoms are also possible and are not listed here. The symptoms often depend on various factors such as pain perception, cause of the injury, degree of injury, physical constitution, etc. In order to obtain a clear diagnosis, a doctor should be consulted.

• Knee pain on exertion: mild to severe knee pain when walking, running or other activities. Knee pain when climbing stairs. Knee pain can also occur when bending, knee pain when stretching and knee pain when bending, even though this is a minor strain. Typically, knee pain occurs so frequently when jogging that this activity is no longer possible.
• Pain at rest: mild to severe knee pain at rest or at night. Knee pain at rest is often an indication of inflammation or osteoarthritis in the knee joint. Start-up pain: knee pain when getting up after a long period of rest.
• Weather-dependent complaints: Pain and stiffness can increase in damp or cold weather.
• Pressure pain: The knee is sensitive to touch or pressure, e.g. on the kneecap or the tendon insertions.
• Swelling: Swollen knee with visible or palpable accumulation of fluid in the knee, often due to irritation or injury.
• Overheating & Redness: The knee feels warm and is reddened, which may indicate inflammation in the knee.
• Joint effusion: Fluid collects in the knee joint, which leads to feelings of tension and limited mobility. Knee joint pain can be the result.
• Restricted movement: The knee can no longer be fully flexed or extended, often due to swelling or cartilage damage. In this case, knee pain often occurs when stretching beyond the possible range. Knee pain when bending can also be a consequence of restricted mobility.
• Blockage sensation: Sudden obstacles to movement in the knee, often caused by meniscus damage or free joint bodies. Movement in the knee joint often leads to pain.
• Instability: feeling of buckling or giving way, usually due to ligament injuries or muscle weakness.
• Stiffness: Feeling of an immobile knee, especially after sitting for a long time or after getting up in the morning. Often associated with knee pain when getting up.
• Protective posture: unconscious avoidance of certain movements, which can put additional strain on other joints.
• Muscle tension: hardening of overused muscles.
• Pain: Depending on the cause, you may experience a stabbing, dull or throbbing pain in your knee.
• Numbness or tingling: Nerve irritation can lead to numbness or "formication".
• Radiating pain: Knee pain can radiate into the thigh or lower leg.

What helps with knee pain? Conventional therapy

There are several approaches to treating knee pain. Some therapies for knee pain are listed below. The list of these therapies is not exhaustive. Various measures can also be combined to treat knee problems. A medical consultation is recommended to determine the appropriate therapy for knee problems.

• Rest and stress reduction: Temporary relief to avoid overloading and irritation.
• Physiotherapy: Special exercises and forms of therapy are used to improve mobility, strengthen the muscles and relieve the joint so that knee pain is reduced when the knee is under strain and when it is at rest.
• Targeted strength and mobility training: Regular and targeted strength and mobility training can alleviate pain in the knee.
• Exercise therapy: Gentle training (e.g. swimming, cycling or yoga) promotes mobility and musculature without overloading. It also promotes blood circulation.
• Weight reduction: Relieves the knee joints and surrounding muscles by reducing body weight.
• Fascia training: loosening of adhered fascia to improve mobility and relieve pain.
• Massages: Massages to relieve tension and blockages.
• Cold and heat applications: Cold (e.g. ice packs) to reduce inflammation, heat to relax muscles.
• Magnetic field or electrotherapy: stimulation of blood circulation and pain relief.
• Dietary adjustments and supplements: Anti-inflammatory diet (e.g. omega-3 fatty acids) and supplementation of cartilage-building substances (e.g. glucosamine, chondroitin).
• Orthopaedic aids: supports or orthoses to support and stabilize the knee joint. Shoe insoles to correct misalignments and relieve pressure on certain joint areas.
• Treatment: Pain and anti-inflammatory medication.
• Alternative forms of therapy: Acupuncture, taping or osteopathy to relieve pain and promote blood circulation.
• Joint injections: Hyaluronic acid to improve joint lubrication and relieve pain. Cortisone to reduce inflammation during acute flare-ups and relieve pain.
• Autologous blood therapy: This method uses the healing properties of the body's own blood to regenerate joint cartilage and relieve pain.
• Surgical measures: Arthroscopy with minimally invasive cleaning of the joint, e.g. removal of cartilage remnants. Osteotomy to correct misalignments through bone cuts. Knee prosthesis (partial or full prosthesis) with replacement of the knee joint in cases of very advanced osteoarthritis.

Unfortunately, the majority of these measures often do not lead to a long-term reduction in knee pain, as the causes of knee problems are not eliminated. The aim of any treatment for knee pain should therefore be to eliminate the causes. As described above, the lack of exercise, sedentary lifestyle, hard, flat floors and immobile, supportive shoes should be addressed. The kybun mode of action proves to be a suitable therapy for knee pain, which can eliminate the causes mentioned.

What helps with knee pain? How kybun works

Kybun products aim to eliminate the harmful effects of hard, flat floors and immobile, supportive shoes and actively tackle the lack of exercise and sedentary lifestyle. The elastic, springy properties of kybun products relieve and activate the musculoskeletal system. The relief ensures that the pain in the knee is reduced as a first step. Activation is intended to tackle the causes of knee problems so that the complaints become a thing of the past in the long term. This makes kybun shoes ideal for knee pain, as they help to treat knee pain through the following modes of action:

• Muscle activation and stabilization of the knee joint

  When walking in kybun shoes, the heels can sink deep into the elastic, springy material thanks to the compression sole. This allows the load to build up slowly and in a controlled manner, giving the body more time to activate the relevant muscles. The tensed leg muscles stabilize the knee joint and relieve both the joint itself and the surrounding structures. In contrast, walking on hard, flat floors in immobile, supportive shoes leads to an undamped impact on the feet. As the load is applied abruptly, the muscles have too little time to react, which means that the necessary stabilization of the knee joint is not achieved, which can result in incorrect and excessive strain on the knee and the surrounding structures.

• Reduction of the force exerted by hard, flat floors due to damping effect

  When the heel strikes the ground in kybun shoes, the elastic, springy material of the sole is compressed so that the rear foot can sink in deeply. This controlled cushioning reduces the impact force and reduces the load on the knee joint and surrounding structures. Similar to an airbag in a car, the kybun sole absorbs the impact forces and ensures a gentle, joint-relieving movement. This can significantly reduce knee pain from the very first steps.

Furthermore, as the heel slowly sinks into the elastic, springy material, the body has more time to tense the relevant muscle groups. The improved basic tension in the muscles stabilises the individual joints and thus reduces the force exerted on the spine and surrounding structures.

• Activates and strengthens the muscles thanks to its elastic and springy properties

  When walking and standing on the elastic, springy kybun surface, the body continuously makes small compensatory movements to maintain balance. The targeted instability of kybun products activates the stabilizing deep muscles, which are crucial for posture and joint stability.
  This provides better support and relief for the knee joint and surrounding structures. At the same time, coordination skills are improved as the interaction between the nervous system and muscles is optimized. This leads to an improvement in body awareness and the precision of each individual movement.

Equilibrium and EMG

The ability to maintain balance was measured with a force plate by moving the body's center of gravity from front to back (ant-post) and sideways (med-lat) when standing. At the same time, muscular activity was recorded using electromyography (EMG).

By activating and strengthening the foot muscles, foot misalignments such as splayfoot, flat foot or fallen arches, which are often caused by muscular deficits, can be counteracted. As an intact longitudinal arch reduces the forces generated during heel strike, the individual vertebrae and soft tissue are also relieved. As the foot is also prevented from bending inwards or outwards, the leg axis remains in its physiological position and the back and adjacent structures are protected from additional incorrect and excessive strain. The slow and controlled sinking of the heel into the elastic, springy material creates myofascial pretension in the muscles involved. This pretension and the improved muscular activity allow the spine to be stabilised and guided at an early stage, which also reduces the force exerted on the back and the surrounding soft tissue.

• Natural foot roll and increased range of motion thanks to the rebound effect

  The elastic, springy kybun shoes with the rebound effect enable a controlled heel strike thanks to the muscular pretension and reduced acceleration. This avoids uncontrolled foot drop, which would put strain on the knee joint and surrounding structures with every step. Active rolling on the elastic kybun material utilizes the entire range of movement of the foot - from the heel to the toes. This natural movement also puts more dynamic strain on the knee joint instead of always being subjected to the same range of motion. This prevents inflammation, injuries and cartilage degradation, as the point load is reduced. At the same time, the knee joint remains flexible and is protected from tension and blockages. The physiological movement sequence activates and strengthens the muscles, promotes blood circulation and can therefore alleviate knee pain.

• Improved circulation through increased movement activity

  Improved blood circulation plays a crucial role in knee complaints, as it has a positive effect on the joint and surrounding structures. It transports nutrients and oxygen efficiently to the cartilage, ligaments, tendons and muscles, which are essential for the stability of the knee joint. As the blood supply to the cartilage in particular is limited, increased blood circulation can promote regeneration and support the healing process. Better blood circulation also helps to remove metabolic waste and inflammation-promoting substances more quickly. This reduces swelling and can alleviate pain, especially in the case of chronic complaints such as osteoarthritis. Inflammatory processes that damage the joint in the long term can be slowed down in this way. The production of synovial fluid is also stimulated, which improves mobility and protects the cartilage from wear and tear. The muscles around the knee also benefit: muscles that are well supplied with blood are more efficient, more relaxed and less susceptible to tension that could strain the knee. This promotes natural movement and can reduce pain caused by incorrect loading. The elastic, springy kybun materials promote movement and thus activate the muscles around the knee joint. This increases blood circulation, which in turn promotes the benefits mentioned above.
  

• Promoting physical activity and reducing sedentary behavior

  The elastic-springy kybun products increase the pleasure of movement, as their unique material relieves the knee joints and surrounding structures. At the same time, the movement activates and strengthens the muscles while promoting blood circulation - both with the positive effects already described. In addition, the use of kybun products can reduce the time spent sitting, which prevents harmful shortening and blockages of the myofascial structures. Increased walking and standing stretches the often shortened hip flexor muscles in particular, as well as the posterior chain of calf and thigh muscles. This improves mobility and supports natural, healthy movement of the knee joint and its surrounding structures.
  

• Care and protection of the facia

  The fasciae stabilize the knee joint and ensure that the load is evenly distributed with every step. They therefore protect against inflammation, injuries and wear and tear. Healthy fasciae are elastic and free of adhesions and tension. This elasticity promotes the mobility of the knee joint and supports blood circulation, which is crucial for the nutrient supply and regeneration of the knee and surrounding structures. The kybun shoes enable a natural sequence of movements that maintains the elasticity of the fasciae.
  

• Optimized pressure distribution

  When walking and standing in kybun shoes, the entire sole of the foot is surrounded by the elastic, springy material, which leads to an even distribution of pressure. This reduces the punctual pressure on the knee joints. In addition, the constant slight movement in kybun Joya products increases the load-bearing surface, which also reduces pressure points.

Application tips for knee pain

Before you wear kybun shoes for the first time, you should consider a few tips on how to use them. Correct use can help to alleviate knee pain. You can also treat knee problems with targeted therapy, which is explained in the next section.

• To begin with, only wear kybun shoes for as long as your body allows. Take breaks if the pain increases or if your musculoskeletal system becomes tired. Treatment for knee pain takes time. The activating properties of the kybun products train the muscles, which can lead to so-called initial reactivity, especially at the beginning.
  
• Press your heel slowly and in a controlled manner into the elastic, springy material so that the knee joint is relieved. Try to find a load point at which the pain in the knee joint and surrounding structures is reduced or does not occur. At the beginning, make sure that you do not roll too much over your heels.
  
• Take small, controlled steps at the beginning, reducing the amount of rolling over the forefoot so that less movement is generated in the knee joint. Increase the range of motion of your feet over time, if possible.
  
• Try the following exercises to boost the effectiveness of kybun shoes and increase the chances of recovery. These are intended as a complementary therapy for back pain and should form part of the treatment for back pain.

How to treat knee pain, helpful exercises

To enhance the effectiveness of kybun shoes and increase the likelihood of recovery from knee pain, we recommend the following exercises for knee pain. The selection of exercises is not exhaustive and can be supplemented by other exercises. The basic rule for all exercises is that the pain in and around the knee should not get worse. If one of the exercises increases the pain, it must be discontinued. Soothing and relieving "pain" outside of the pain point is desirable.

The exercises are divided into the following areas: "Correct walking in kybun shoes", "Muscle length training", "Fascia rolling" and "Strengthening". Ideally, the different areas are used as complementary therapy for knee problems.

Walking the right way in kybun shoes

The quality of each individual step is crucial in the treatment of knee pain in order to reduce discomfort and eliminate incorrect and excessive strain. The kybun shoes therefore offer ideal therapy for knee pain.

Controlled heel strike

• Press the heel carefully and in a controlled manner into the elastic, springy material to determine the load strength and load point without causing pain in the knee joint.
• Controlled foot position so that the foot does not tilt inwards or outwards. This keeps the knee joint in a straight position.
• Lower the midfoot and forefoot slowly and in a controlled manner so that the knee joint is not hit.
• Slow exercises help to rebuild the stabilising muscles around the knee joint.

Controlled rolling

• Slight rolling motion in the forefoot without actively pushing off with a lot of force via the big toes. The stronger the rolling movement, the greater the range of motion in the knee joint. If the knee joint is tight and locked, increasing the range of motion can lead to an increase in pain. In this case, the tension and blockages must first be released.
• Test the possible range of movement of the feet without causing pain. Increase the range of movement if possible.

Muscle length training

Muscle length training is of crucial importance in the treatment of knee problems, as the complaints are often caused by shortening, tension and blockages in the myofascial structures. Targeted stretching exercises can actively tackle the shortening, tension and blockages and are therefore an ideal therapy for knee pain.

Front thigh muscles

• Slight rolling motion in the forefoot without actively pushing off with a lot of force via the big toes. The stronger the rolling movement, the greater the range of motion in the knee joint. If the knee joint is tight and locked, increasing the range of motion can lead to an increase in pain. In this case, the tension and blockages must first be released.
• Test the possible range of movement of the feet without causing pain. Increase the range of movement if possible.

Calf and hamstring muscles

• Begin in an all-fours position.
• Stretch your buttocks upwards into the air.
• If possible, push your heels towards the floor to increase the stretch.
• Hold the exercise for 3 x 30 seconds.
• Perform 1-2 times daily.

Fascia roller

Fascia training with the fascia roller is important in the treatment of knee pain, as this is often caused by shortening, tension and blockages in the myofascial structures. By regularly rolling out the shortened and tense myofascial chains, the fascia roll is suitable as an active therapy for knee problems.

Front thigh muscles

• Commence in a prone position.
• Place the large roller under the thigh of the outstretched leg. Place the other leg at an angle to control the movement.
• Actively roll out the front thigh from the hip to above the knee joint.
• Perform exercises slowly and in a controlled manner. Adjust the pressure to your personal sensation, but go to the tolerable pain threshold.
• Roll out any localised adhesions or hold the position at this point.
• 3 minutes each side.
• Perform 1-2 times daily.

Lateral thigh muscles

• Starting position in side-lying position.
• Place a large roller between the outer thigh area and the floor.
• Position the upper leg at a right angle for stabilisation and to guide the movement.
• Actively roll out the lateral thigh from the hip to above the knee joint.
• Perform exercises slowly and controlled.
• Adjust pressure to personal feeling, but go up to the tolerable pain threshold.
• Roll out any localised adhesions or hold the position at this point.
• Exercise can be strengthened by straightening the upper leg.
• 3 minutes each side.
• Perform 1-2 times daily.

Strengthening

Targeted strength training helps to strengthen the leg muscles and thus relieve the knee joints and their surrounding structures. Strengthened muscles can better absorb the forces acting on the knee joints with every movement. Furthermore, the muscles stabilize the knee joints and thus protect them from incorrect and excessive strain. Strengthening exercises are an effective therapy for knee problems and help to alleviate pain in the long term.

Squats

• Starting position: standing, feet slightly wider than hip width and slightly rotated outwards.
• Squat down slowly and in a controlled manner. Push your buttocks back and shift your weight onto your heels.
• Ensure that strength comes from the buttocks. Stabilise your knees so that they do not bend inwards or outwards.
• Slowly straighten up again in a controlled manner.
• If you have balance problems, you can hold on to a stable object with your hands.
• 3 sets of 8 - 12 repetitions.
• Perform 2 - 3 × weekly.

Leg lift in lateral position

• Starting position: Lateral position.
• Feet, knees, hips and head are in a straight line. An object can be placed under the head for support.
• Actively lift the upper leg and then actively brake and move it down again.
• At the lowest point, do not put the leg down completely, but move it back up again so that the muscles are always active. If this is not possible, the leg can be put down briefly.
• Make sure your torso is stable during the exercise and perform the movements slowly and in a controlled manner. The upper body should not move with you.
• To make the exercise more challenging, place a resistance band (fitness band) around the knees. The band should be placed just above the knee joint.
• 3 sets of 8 - 12 repetitions.
• Perform 2 - 3 × weekly.