Conservative Care for Knee Pain

Sore knees are most effectively treated with chiropractic adjustments combined with complementary corrective exercise. In the majority of people knee pain is caused by structural misalignment in the knee, ankle, and hip joints, as well as muscle imbalances in these areas. Poor posture, overuse, repetitive stress and trauma most commonly cause these imbalances to occur. Chiropractic adjustments of the spine, hips, and knee will assist to move these joints into their proper alignment. This will in turn help to eliminate stress on the joint, reduce inflammation, and facilitate healing of the joint and surrounding tissue. Corrective exercises and massage can help reinforce the adjustments, making for a very effective treatment.

It is recommended that you talk to your chiropractor about the above mentioned treatments.

All too often people take for granted the importance of the knees in helping us stand, walk or run. However, once there is an injury to the knees, we become very aware of the amount of load the knees are expected to carry.

Due to the fact that the knees are a hinged joint, they bear the majority of a person’s weight, therefore any injury to the knee or chronic condition, such as osteoarthritis, will cause a significant increase in stress to the knees. Excess body weight also increases stress on the knee joint.

With severe cases, many medical doctors recommend knee replacement. This will result in a long, tedious recovery process to regain strength in the knees, lower legs, thighs, feet and ankles. However, chiropractic adjustments to the knees are much less invasive, and should be attempted before surgery is considered. Adjustments are often effective at relieving pain and stiffness in the knee. It should be noted that continuing regular adjustments to the knees even after the pain has gone will maintain the knees working at peak performance.

Iliotibial band syndrome (ITBS) is one of the most prevalent knee conditions present today. ITBS is most commonly seen in runners, athletes those who exercise on occasion or are just starting to an exercise routine. The iliotibial band is a strong fibrous band of tissue traveling from the crest of the hip along the side of the leg to the outer portion of the knee. A muscle near the side of the hip called the tensor fascia lata is the muscular portion of the band that helps control the leg. The iliotibial band passes over the hip and attaches to a bony bump on the outside of the knee called the lateral epicondyle. If this band becomes too tight it can become inflamed as it rubs over the top of the bones. As this happens repeatedly, it can become extremely painful, especially during an activity like running. This condition usually presents as pain on the outside of the knee. The pain becomes worse with repetitive knee flexion or extension. Runners and especially slow “jogger” commonly get pain in the lateral knee due to this condition. Pain normally develops 10-15 minutes into a workout. A “click” may be felt or heard with movement. Symptoms usually subside with rest.

This problem is commonly caused by weak gluteal muscles. If these muscles are weak, the muscles that attach to the iliotibial band must work harder to stabilize the hip. Old worn out running shoes can also contribute to the condition. Unequal leg lengths are another known aggravating factor.

A runner should cut down on downhill running, running on banked roads, wet or icy surfaces. A runner should reverse directions when running on a circular track every mile. Bicyclists should be sure to accommodate their seat to avoid excessive pressure on the toes when pedaling. Stair climbing and deadlifts will also put increased tension on the TFL and knee. Ice massage and over the counter sports creams can be used to assist in relaxing the muscles surrounding the knee.

Joint manipulation (chiropractic adjustments) usually relieves pain in the knee. A chiropractor is highly trained to find joints that are not moving as freely as they are designed to move. Lack of movement can result in tension and discomfort. This can also lead to joint degeneration (arthritis). Your chiropractor will put a gentle force with instruments or hands to restore motion in the restricted joint. A specialized table will often be used to assist in the “adjustment” or movement of a particular joint. As a result of the adjustment pain, flexibility, and joint health should improve. It is often important to adjust the knee, lower back and hips with knee issues. A hip or lower back misalignment can place unbalanced pressure on the knees. This can contribute to knee pain. If the alignment is not corrected, it can lead to degeneration of the knee joint. Misalignment of the hips and spine can lead to an imbalance of muscle tension, especially on the muscles that attach from hip to knee. The TFL is one such muscle, which if it becomes tight can put pressure and tension on either knee.

Therapy

Cold or hot packs are often used to help calm inflammation or relax a muscle spasm. This is often used together with electrotherapy, which produces low voltage electrical current pulsing through electrodes placed at the affected area. Electric modalities are often a comfortable procedure that work to decrease pain, and inflammation, and release muscle spasm.

Myofascial Release

When muscles are overworked, they often become tight and develop knots or “trigger points”. When this tightness becomes chronic it produces swelling and inflammation, which in turn lead to the formation of “adhesion” between tissues. Your chiropractor or an assistant will apply pressure with specialized tools or often hands, in order to release muscle tightness and adhesion. As a result, circulation will improve, flexibility increased, and pain relieved.

Therapeutic Exercise

Tight or weak musculature can cause discomfort that disrupts normal joint function, resulting in more problems. A chiropractor will use specific therapeutic stretching and strengthening to build strength, increase tissue flexibility, and decrease pain. With strong, healthy, and more flexible muscles re-injury can be prevented.

At Home Care

At home stretches to the hips, lower back, hamstrings, and IT band are highly recommended to speed the recovery process, and should be done on a regular basis even after pain subsides and you are back to your full health. Many patients find a foam roller useful to use at home to help reduce muscle tension in the IT band. You may be able to purchase a foam roller from your Chiropractor. If not you can find them at your local sporting-goods store. Here are the steps to using your foam roller to relax a tight IT band: Lie on your side with your thigh to be treated over the roller. Lift your shoulders off the floor with your arm and roll slowly over the side of your mid and lower thigh almost to the knee joint. Roll back and forth over the foam roller. Avoid rolling over the body portion of the hip or the knee joint. Perform this exercise for a duration of one minute twice a day, or as directed by your care provider.

With treatment from a trained health professional, along with at home self-care, knee pain should subside within a few weeks of consistent care. Usually, the more chronic the pain the longer the recovery process. If there is no improvement shown it may be necessary to take do further imaging and testing on the knee, and when all conservative care options have been exhausted, a consult with an orthopedic surgeon may be warranted.