You've been told it's arthritis. Or a meniscal tear. Or just wear and tear. You've done the physical therapy, maybe had an injection, possibly even had surgery, and the pain keeps coming back. There is a very real possibility that a specific, classifiable, treatable mechanical problem has been missed in your knee every single time. It's called a Knee Derangement. And nearly half of all knee pain patients have one. In this podcast, Stefani Crowley, physical therapist and McKenzie Institute Diplomate at mPower Physical Therapy in Dallas, TX, explains exactly what a Knee Derangement is, how it presents, why it is so frequently mistaken for arthritis or a meniscal tear, and — critically — why your MRI is almost certainly showing findings that are pointing your care in the wrong direction. Plus the complete treatment progression: from unloaded to loaded extension and flexion mobilizations, and why the more arthritic your knee looks on imaging, the more likely flexion is the answer. What you'll learn: ✔ What a Knee Derangement is and its defining clinical feature — Directional Preference ✔ The 7 symptoms of a Knee Derangement that mimic arthritis and meniscal tear exactly ✔ Why MRI findings in people over 40 are almost always misleading — and the research that proves it ✔ The Rosedale et al. 2014 RCT: 40% of knee OA patients referred for joint replacement had a Derangement ✔ Why patients with the MOST severe arthritis on imaging had MORE Derangements than those with mild changes ✔ The 2024 RCT: pain from mean 6.1 to 2.9 in 10 weeks with Directional Preference exercises ✔ The 60/40 Flexion/Extension split — and why arthritic knees often respond best to flexion loading ✔ The full treatment progression: unloaded extension, loaded extension, unloaded flexion, loaded flexion ✔ Two real patient cases — same anterior knee pain location, completely different classification, completely different treatment Research referenced: Rosedale R et al. 2014 JOSPT (MDT RCT in knee OA — 40% Derangement, Ottawa Panel "strongly recommended"); Silva DR et al. 2024 (directional preference RCT — pain 6.1→2.9 at 10 weeks, 68% knee Derangement, 32% lumbar Derangement); Englund M et al. 2008 NEJM (35–56% meniscal tears on MRI in asymptomatic adults over 50); McKenzie Institute International Part E Extremities Manual 2026 (60/40 flexion/extension prevalence, force progression data). 🎁 FREE KNEE PAIN REPORT — Why Your Knee Still Hurts... And What to Do About It: https://www.mpower-pt.com/knee-pain-report/ 📅 Book a Free Discovery Visit — no charge, no pressure, just answers: https://www.mpower-pt.com/free-dv 🗓️ Free Knee Pain Masterclass — July 23 at 6 PM, Dallas TX: https://info.mpower-pt.com/knee-arthritis-masterclass Physical Therapy is a Dallas, TX physical therapy clinic specializing in chronic knee pain, knee osteoarthritis, and musculoskeletal conditions using Mechanical Diagnosis and Therapy (MDT) and regenerative technologies including radial shockwave, focused shockwave, and EMTT. Founder Stefani Crowley, MSPT, Dip. MDT, has over 20 years of clinical experience helping active adults resolve chronic knee pain, avoid surgery, and return to the activities they love. 214-538-2559 | www.mpower-pt.com
