Knee Pain and Injury

Knee injury and pain can arise during sports or daily activities (even gardening and walking the dog). Chiropractors know how serious knee injury can be, and help you get back on your feet and back in the game.

Knee Anatomy

The knee joint is a meeting between three bones, the femur (thigh bone), tibia (shin bone), and patella (knee cap). There are muscles, and ligaments which help move and control motion of the knee joint. Also, the knee has cartilage which cushions the knee, lubricant the joint and prevents damage to the bone.

Diagnosis is Difficult

Knee injuries are hard to see, even with X-Ray equipment. Diagnosing a knee injury can be difficult and since there are different situations which lead to different types of injury, a chiropractor is most likely to take a full history of the accident, and of your use of the joint. You may even be asked if you heard a "popping" sound or felt any sensations during your injury. After getting all of the information, an X-Ray can rule out fractures or chips on the bones. In addition, an MRI can reveal the damage to soft tissues surrounding the joint, including muscle, ligament and cartilage.

Spinal Inbalance and Knee Injury

Vertebral subluxations are dysfunctional areas in your spine caused when spinal movement is restricted and the bones become misaligned. These can cause a spinal inbalance, which in turn can disturb stability in the body’s joints, including the hips, legs and knees. Chiropractors are specially trained to find subluxations and correct alignment.

Injury

Activities involving jumping, running or falling may cause a traumatic injury to the knee. Imagine you have a rubber band and it stretches beyond the point of elasticity, snapping. The same thing can happen to the ligaments and muscles that hold the knee joint together.

If an injury has occurred, it will generate pain and swelling. Stabilize the area and apply ice for 10 minutes on and 10 minutes off. Call your chiropractic office as soon as you can to have an examination. It is best to avoid medication, which mask symptoms and could result in further or re-injury of the area.

Considering Surgery?

In an injury, it is likely your cartilage was torn or frayed. According to a report published in January, 2003, techniques for repairing knee cartilage are only in their infancy (Orthop Clin North Am 2003;34:149-67.) Although recent evidence indicates letting nature take its course may be just as effective as the widely prescribed surgical procedures, many people still choose surgery.

Consider what happened when one surgical procedure, arthroscopic surgery, was studied. Researchers stated that this procedure (during which a pencil thin tube in inserted into the knee and the worn cartilage is removed) was "no better than a sham surgery in relieving pain or improving movement." (Sci Am 2002;287:34.)

The study separated 180 patients with osteoarthritis of the knee into three groups. The first group had a surgical procedure called debridgement, which removes the worn or loose cartilage. The second group’s surgery was a process called lavage, where the bad cartilage is flushed out with liquid. The third group received "sham" procedures, where incisions were made but no cartilage was removed. After two years, all groups reported "equal degrees of reduction in pain and increase in activity level."

In addition, an arthroscopic procedure may actually remove healthy as well as diseased tissue. This could cause the generation of additional lesions within the cartilage. (J Bone Joint Surg Am 2003;85-A Suppl 2:85-92).

While surgery is not always out of the question, it is not always the best option. Chiropractors are committed to teaching a way of life that focuses on preventing health problems rather than masking symptoms with medication or going through needless surgery.

How to Prevent Knee Injury

Avoid high heels. Chunky wider versions or skinny stilettos, both are dangerous. Not only do they increase your chance of tripping and falling, but studies show the consistant use of high heels increases your risk of developing arthritis in your knees.

Improve your balance. Having a good solid sense of balance decreases the likelihood of damage to the knees from a fall or unstable movement. Balance is especially important for older adults, who tend to be less stable. Yoga, T’ai Chi or Pilates can increase your physical sense of balance.

Beware of ballet. A Swedish study of 390 ballet dancers showed that they suffered a higher risk of developing osteoarthritis of the knee. Male dancers were more likely to suffer an injury to the knee joint than women, but women had more injuries of the foot and ankle.

Exercise. It is vital to strengthen and condition the muscles around the knee joint to prevent injury. But remember, don’t overexert the muscles either.

Reduce your odds of an exercise related injury:

• Run on soft tracks versus hard pavement
• Wear supportive running shoes on and off the track
• Mix high and low impact exercises
• Limit step-aerobics to one riser
• Don’t overdo strength training

Never begin an exercise program without first consulting the doctor for a chiropractic checkup.

Glucosamine is found to slow knee arthritis

By Anita Manning, USA Today, November 15, 1999

A clinical study reported Monday suggests that glucosamine sulfate, a nutritional supplement touted in the USA as an alternative therapy for arthritis, works better than expected.

"This is the first long-term study that has shown any drug or compound can effectively delay progression of disease," says researcher Lucio Rovati, director of clinical pharmacology for Rotta Reseach Lab in Milan, Italy. Rotta developed glucosamine sulfiate and holds rights to it in Europe and other countries, where it is sold by prescription only.

The study, lead by Jean-Yves Reginster of the University of Liege in Belgium, involved 212 patients with osteoarthritis of the knee. Osteoarthritis, the most common form of the disease, is the deterioration of joint cartilage. It affects an estimated 12% of the population.

In the study, presented bin Boston at the 63rd Annual Scientific Meeting of the American College of Rheumatology, 106 people took 1,500 milligrams of glucosamine sulfate daily for three years; the other 106 got a placebo.

Radiographs taken one year and three years into the study found that those on the placebo had significant narrowing of the space within the knee joint, indicating disease progression, while on the average, those on glucosamine sulfate had no joint space narrowing.

Those taking glucosamine also had an improvement in symptoms such as pain and stiffness, while those taking the placebo had "a slight worsening of symptoms," the study found. The research involved patients only with arthritis in the knee, but it might hold true for arthritis in other joints, Rovati says. "Reasonably you can say lower limb osteoarthritis will respond the same way," he says. "Extrapolation to other joints is much more difficult."

In the USA, glucosamine sulfate is sold as a nutritional supplement and as such is not regulated as a drug, a fact that concerns Rovati.

"The compound is very safe," he says, but because it’s not regulated, "product quality may vary."