- ACL injury
- Torn meniscus
- Knee bursitis
- Patellar tendinitis
- Loose body within knee
- Iliotibial band syndrome
- Dislocated kneecap
- Rheumatoid arthritis
- Septic arthritis.
- Chondromalacia patellae (patellofemoral pain syndrome)
A look at one’s history of the complaint, their activities (or lack of!), diet and family background are critical in finding the cause; examination and additional tests such as blood work, x-rays and MRI can provide further information that will enable the doctor to properly and expediently manage the case.As a practitioner of manual medicine, via chiropractic care, the spine is not the only joint or tissue area that I address. According to a 2006 National Health Interview Survey, approximately 30 percent of adults reported experiencing some form of joint pain during the previous 30 days, and knee pain was a leading complaint.
When infection or other presentation (that needs a more critical care approach) is ruled out, my job is to sort out which structure(s) are the pain generators. It is important to consider the body’s kinetic chains that can fall victim to a sequence of events involving tissues along a line of tension that are necessary to complete a task (such as throwing a ball, completing a golf or tennis stroke, or simply walking). Think of the muscles and other tissues at the back of your foot and ankle. They don’t just stop there; they continue northward up the calf to the thigh and buttock and back. This is why just treating the area of pain may prove frustrating and, in a number of situations, futile. For example, if one is suffering with pain on the medial, or inside of the knee, it may be as a result of a direct trauma, or, possibly due to a deep buttock muscle group known as the external hip rotators being overly tightened and not allowing the femur (thigh bone) rotate properly, causing stress on the knee area. Also, hyper-pronation of the foot can lead to internal rotation or twisting of the lower leg bone named the tibia, and lead to significant stress on the medial meniscus of the knee joint. The iliotibial band on the lateral side of the knee may also be affected. The point is that there are connected “chains” that are only as strong as there weakest link. The problem sometimes is that our bodies are excellent at compensating for movement deficiencies (to a point) and convince us to ignore it until it becomes unbearable or activity preventing.So, what do you do for your knee? As I have often stated in previous articles, there first is a need to take responsibility for the things you have control over and:
- Assess the pain and recount what the possible mechanism of injury is to rule out need for meds or other crisis care (think gout, infection or torn ligaments).
- Have a chiropractic examination to determine restrictions around the knee as well as along the kinetic chains involved, including up to the pelvis and spine. The surrounding fascia should be examined as well. Also, determine if there are any weak or inhibited muscles involved.
- Fix the restrictions to diminish or resolve the pain, increase the range of motion and then engage (via electric stimulation or exercise if possible) any weak muscles to strengthen.
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