Direct answer: Chronic knee pain, including diagnosed osteoarthritis, often has an adhesion component layered on top of the joint changes — restricted, poorly organized tissue in the joint capsule, quadriceps, and iliotibial band that limits normal glide and adds mechanical stiffness beyond what cartilage changes alone would explain. Generic advice to "strengthen around it" doesn't address tissue that has already lost its ability to slide and lengthen. At Novo Soft Tissue in the Denver Tech Center, an exam determines how much of the presentation is adhesion-driven and whether EMTT, focused ESWT, or manual work fits.
By the time someone reaches out about chronic knee pain, they've typically already tried physical therapy focused on quad strengthening, cortisone injections, glucosamine or other over-the-counter supplements, and bracing. It's common to have been told by an orthopedist that once X-rays show osteoarthritis, there's "nothing more to do besides a replacement" — without the soft tissue surrounding the joint ever being examined separately from the joint space itself.
The joint capsule, quadriceps tendon and muscle, and iliotibial band around the knee are common sites for adhesion to form, often after an old injury, a period of reduced activity, or simply the mechanical stress of an arthritic joint compensating for years. Adhesion here compounds osteoarthritis's stiffness by adding a soft-tissue restriction on top of the joint-space changes — on exam, this shows up as localized areas around the capsule or quad that feel noticeably less mobile than the rest of the tissue when tested directly, not just generalized joint stiffness.
Because this is a joint and deep-compartment problem, EMTT paired with focused ESWT is the combination used most often here — EMTT for its effect on the joint and enthesis tissue, focused ESWT to reach a specific deep band or attachment point precisely. Manual work is added where the capsule or surrounding muscle is accessible enough to confirm the tissue can actually move once the device work is done.
A 2026 double-blind, sham-controlled randomized trial by Hollander and colleagues assigned 126 patients — including a group specifically diagnosed with knee osteoarthritis — to eight weekly EMTT sessions or sham treatment. Physical-function scores rose and pain fell significantly more in the EMTT group at both 6 and 12 weeks (VAS pain scores of 2.2 versus 4.2 at 12 weeks). That's pain and function evidence from a trial that directly included knee osteoarthritis patients, not a mechanism study extrapolated from a different joint.
A new-patient comprehensive exam is $270 and includes a full history, physical examination, and an explanation of the diagnosis; no treatment is performed on the first visit. Follow-up visits are $90 and typically run 10-15 minutes. Novo Soft Tissue does not bill insurance directly, but accepts cash, check, major credit cards, HSA, and FSA, and provides documentation you can submit for possible reimbursement.
Request an appointment to have the knee evaluated for adhesion, or read the full EMTT explainer and the four tools used across all conditions.
Last reviewed: September 2026