Direct Physical Therapy


Osteoarthritis is a common condition that causes pain in the knee joint. This is a degenerative condition where the articular (surrounding) cartilage of the knee joint gradually breaks down. Osteoarthritis of the knee is characterized by:

  • Morning stiffness
  • Swelling
  • Pain
  • Decreased range of motion

In addition, the development of osteoarthritis results in a corresponding decrease in range of motion; a weakened, shortened, and fibrotic musculature; and a decreased ability to absorb the shock caused by daily weight bearing (walking, standing, kneeling, hopping and running).


Articular cartilage of the knee is quite different from other soft-tissue structures in that it does not receive nourishment directly from the arterial blood flow. Instead, the articular cartilage of the knee is completely dependent upon the pumping actions generated by physical movement to supply its nourishment. As you move, the ligaments and tendons surrounding the knee joint work to pump nutrients and blood (oxygen) to the cartilage of the knee. Degeneration of the cartilage starts to occur when anything disrupts this flow.


Adhesions within the soft-tissues create compressive internal forces that then become a contributing factor in the development of osteoarthritis of the knee. Any restriction in muscle or soft-tissue structures exerts a compressive force internally, which then inhibits fluid exchange.


In the initial stages of osteoarthritis, the cartilage of the knee and the synovium (capsule) often become inflamed and swollen. Soft-tissue techniques such as, Active Release Techniques®, work to break up the restrictions in the knee capsule and allow for efficient fluid exchange within the joints.


Active Release Techniques® (ART®) improves knee function by removing biomechanical stresses on your knees. It does this by removing soft-tissue restrictions that weaken the supporting structures. A short, contracted muscle is a weak muscle that cannot properly support your knees. Your muscles act as shock absorbers and weak muscles make poor shock absorbers.


ART® also helps to correct muscle imbalances. Muscle imbalances cause numerous alterations to walking/running form. This alteration in ambulatory mechanics creates problems such as connective tissue friction syndromes, increased inflammation, and the break down of articular cartilage. By removing adhesions from a muscle, the muscle no longer has to compensate for its weakness, thereby decreasing stress on the knee joint.


Once these compensations are removed with ART® procedures, the patient usually experiences immediate functional improvements. They will be able to perform a multitude of daily activities that they may not have been able to perform before – such as climbing stairs or going for long walks. Though the degree of improvement varies based on the amount of degeneration, it is normal to see significant functional changes after treatment in combination with a home exercise program.

Lance Cooper is the only full-body certified Active Release Techniques® provider in the Rogue Valley.

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Direct Physical Therapy LLP

Direct Physical Therapy, LLP, was started by Scott L. Brown, PT, and Lance D. Cooper, PT in 2012. Our clinic is located in Ashland, Oregon and we provide quality, one on one treatment sessions.

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