Besides spinal conditions, knee pain is one of the most
common ailments of the musculoskeletal system. Problems with the
knee can be classified into three categories:
Poor mechanics or overuse of the knee joint,
Traumatic injury from events such as sports and falls, and
Problems due to arthritic changes in the joint.
Patella Femoral Syndrome (Knee Cap Pain)
Poor
mechanics of the knee joint and the associated stress upon the
soft tissues of the knee is by far the most common cause of
non-traumatic pain. The kneecap, or patella, is the most
commonly affected area of the knee in these cases. Often the
patella does not move smoothly or does not move sufficiently on
the femur during bending of the knee causing abnormal stresses
upon the tendons cartilage and ligaments. This condition is
often called chondromalacia patella (CMP), though a better term
is patella femoral syndrome. The problem usually originates when
there are imbalances in the quadriceps, which attach to and move
the patella.
The associated pain is experienced during activity,
especially stair climbing, running, jumping and after getting up
from prolonged sitting. Women are more predisposed to this
problem for anatomical reasons and also the use of high heels.
Repetitive Knee Strain - Overuse Injury
Imbalances in other muscle groups that attach to the knee can
also lead to pain and dysfunction. For example, the muscles on
the inside of the thigh can cause pain on the medial or inside
side of the knee when strained.
Lower back problems, especially in the sacroiliac joints, are
one of the main reasons for imbalances in the muscles associated
with knee movement and subsequent knee problems. Foot problems
that cause gait abnormalities, such as pronation, are another
cause of mechanical knee pain.
The main treatment for mechanical or overuse injuries to the
knee is to re-establish proper balance of the muscles, restore
proper movement to the patella and other joints of the knee, and
correct any subluxation of the sacroiliac joints and foot
problems. In certain cases, a brace is used to help with the
alignment of the patella or to stabilize the joint.
Chiropractors are ideally trained to provide the proper
diagnosis and management of these problems.
Trauma
Traumatic
injuries often occur during sports that involve running and
jumping, such as football and basketball, and with activities
such as skiing. When the knee is stretched or twisted beyond the
strength of the ligaments that hold the joint together, these
tissues can tear, causing a sprain. The muscles that move the
knee can also be torn during injury causing a strain or pull of
the muscle. As with a sprain, a muscle strain can vary from a
minor injury that requires little care to a severe injury
requiring surgery. The knee also contains two special
"cartilages" - the menisci - between the tibia and the femur
that provide for smooth movement and cushioning. These
cartilages can also be torn during trauma and often require
surgical repair or removal if damaged severely. Traumatic knee
injuries can cause severe pain and swelling and require
immediate evaluation and attention. In most cases a qualified
chiropractor can manage these conditions, though there are some
injuries that do need the expertise of an orthopedic surgeon. In
any case, it is important to stabilize the injured joint and ice
if possible until you can get the injury evaluated. Please see
the section on sports injuries for additional information
regarding this topic.
Treatment
If poor mechanics or traumatic injuries are not corrected at
an early age, the tissues of the knee joint, especially the
cartilage, will eventually begin to wear out. As a result the
bones rub upon one another and bone spurs can occur. This
painful condition is known as degenerative joint disease or
osteoarthritis and is often progressive with age. Common
treatment often involves medications such as NSAIDS
(non-steroidal anti-inflammatory drugs) though conservative
treatment such as chiropractic can be helpful in alleviating
some of the pain. There is some evidence that nutritional
substances such as Glucosamine and Chondroitin can be helpful in
the long-term management. People can often help themselves by
keeping their weight down, doing exercises – especially in the
pool – and wearing cushioned shoes or insoles.
Poor
mechanics of the knee joint and the associated stress upon the
soft tissues of the knee is by far the most common cause of
non-traumatic pain. The kneecap, or patella, is the most
commonly affected area of the knee in these cases. Often the
patella does not move smoothly or does not move sufficiently on
the femur during bending of the knee causing abnormal stresses
upon the tendons cartilage and ligaments. This condition is
often called chondromalacia patella (CMP), though a better term
is patella femoral syndrome. The problem usually originates when
there are imbalances in the quadriceps, which attach to and move
the patella.
Traumatic
injuries often occur during sports that involve running and
jumping, such as football and basketball, and with activities
such as skiing. When the knee is stretched or twisted beyond the
strength of the ligaments that hold the joint together, these
tissues can tear, causing a sprain. The muscles that move the
knee can also be torn during injury causing a strain or pull of
the muscle. As with a sprain, a muscle strain can vary from a
minor injury that requires little care to a severe injury
requiring surgery. The knee also contains two special
"cartilages" - the menisci - between the tibia and the femur
that provide for smooth movement and cushioning. These
cartilages can also be torn during trauma and often require
surgical repair or removal if damaged severely. Traumatic knee
injuries can cause severe pain and swelling and require
immediate evaluation and attention. In most cases a qualified
chiropractor can manage these conditions, though there are some
injuries that do need the expertise of an orthopedic surgeon. In
any case, it is important to stabilize the injured joint and ice
if possible until you can get the injury evaluated. Please see
the section on sports injuries for additional information
regarding this topic.
