Knee pain is incredibly common in society whether from acute trauma or from repetitive strain (i.e.: osteoarthritis). Despite the benefits that manual therapy, and acupuncture can have for most cases of knee pain, chiropractors are rarely thought of for treatment of knee pain.
In most cases, chiropractors are the perfect practitioner to assess and treat your knee pain. Because of our ability to accurately distinguish and diagnose the many affections of the knee, send for x-rays when needed and provide effective treatment and rehabilitation exercises. A chiropractic assessment that yields an accurate diagnose and a proper functional assessment of strength imbalances and poor movement patterns, is vital for choosing the correct exercises and the best possible treatment
- Patellofemoral pain syndrome (PFPS) - Osteoarthritis - Iliotibial Band Syndrome (ITB Syndrome) - ACL rehabilitation - Ligament strains (MCL, PCL, LCL, ACL) - Meniscus injuries or rehabilitation - Bursitis (Pes anserine bursitis, prepatellar bursitis, etc) - Patellar tendinopathy - Muscle strains and pains - Nerve Entrapments
Knee injuries should be differentiated based on whether it is a chronic issue or acute injury such as with a fall, blunt force to the knee, pivoting or other acute accidents. While most structures of the knee can be injured with both acute trauma and chronic repetitive strain, certain diagnoses must be ruled out immediately with acute injuries.
Fracture: The Ottawa Knee Rules (OKR) are used by practitioners to determine if a patient requires an x-ray when 1 or more of the following criteria apply after an ACUTE injury. The OKR are nearly 100% sensitive for identifying patients who have had a knee fracture.
●Age ≥55 years
●Isolated tenderness of patella (with no other bony tenderness of the knee)
●Tenderness at the head of the fibula
●Inability to flex the knee to 90 degrees
●Inability to bear weight both immediately and in the emergency department for four steps, regardless of limp (ie, unable to transfer weight onto each lower limb two times)
If one of these applies in your case, seek medical attention.
Swelling: Swelling about the knee can arise from either blood in the joint or accumulation of excess joint (synovial) fluid or edema from the injury. Swelling about the knee can suggest the possibility of serious injury and necessitates a visit to your doctor immediately.
Knee swelling and edema can be the result of injury inside (intra-articular) of the knee-joint (joint cartilage, meniscus, ACL, PCL, dislocation, fracture) or from structures outside (extra-articular) of the knee. Proper examination and diagnoses are important to determine the origin of the swelling even if it goes away by itself.
The movement of the knee is relatively simple, flexing and extending back and forth like a hinge. In the overwhelming majority of cases, as with PFPS, ITB syndrome or other, the problems that caused the knee pain likely originate elsewhere. Both the hips and ankles must be assessed in cases of knee pain:
Like the shoulder determining the placement of the simple elbow hinge joint, the hip greatly influences where and how the knee moves. Relative weakness or tightness in the hip muscles can direct the knee off-centre and produce excessive forces on either the inside or outside of the joint. Likewise, every time the leg comes in contact with the ground, the transfer of forces up the through the foot, then leg to the knee, depend on the movement of the ankle. If you are flat-footed and tend to over-pronate or have a more highly arched foot, either will produce two very different gait patterns and very different force patterns through the knee.
Why is this important? In the end, understanding the hip and ankle greatly influence how the knee moves and effective treatment of most knee conditions often requires treating the entire lower limb. The best treatment and exercise rehab should be comprehensive and understand then joints do not operate in isolation of each other – if your health care provider is not addressing these issues, seek a second opinion
Every case of knee pain if going to be treated specific to the diagnoses and strength / movement imbalances. Nonetheless, there is an overwhelming collection of research demonstrating that multimodal manual therapy treatment including acupuncture, joint mobilization, soft tissue massage like ART, TENS, IFC, and corrective rehab exercise provided by a chiropractor, work quite effectively.
Manual treatments in addition to just rehab exercises is vital to help facilitate tissue healing, proper nervous system function and correct movement of the joints. Manual therapy will help facilitate the body to heal itself and enhance the results from rehab exercises.
Providing the proper education, treatment and rehab based on a great assessment ensures that we can reduce your pain and correct any imbalances that lead to your complaint in the first case.
Effective rehab of the knee must focus on strengthening the hips. The hip musculature works to control the movement of the knee with walking, running and other activities. Hip weakness is implicated in almost all conditions of the knee and can be addressed with the YouTube video linked below. These exercises are an evidenced-based strategy that improve hip strength and control and work to take load off your sore knees
If you want to fix a knee problem and correct it for good, let Dr. Ritza be the one to help