Knee Pain
Knee pain is a common complaint seen in our clinic. As a major weight bearing joint, the knee is subjected to constant wear and tear. Sports injuries, falls, overuse, repetitive strain and older age deterioration are common contributing factors to knee pain.
Knee Joint Structure
The knee is a complex joint that relies on ligaments and muscles for stability. The joint is composed of:
• The tibio-femoral joint (between the thigh bone and lower leg bone);
• The patello-femoral joint (between the knee cap and the thigh bone);
• The muscles and ligaments that provide support to the knee. For example, the quadriceps muscle (“quads”) at the front of the thigh encases the kneecap (patella) and is a major knee stabiliser; the collateral ligaments bind the femur and tibia together externally, as well as the cruciate ligaments that provide internal stability for the knee.
• Two crescent shaped cartilage discs on the joint surfaces of the knee provide cushioning and a smooth surface for movement. These are called the medial and lateral meniscus.
Causes of Knee Pain
Local Causes:
• Trauma – causing injury to cartilage, ligaments (instability), muscles and tendons;
• Overuse – repetitive movements causing muscle strain and tendon inflammation eg: Osgood Schlatter disease (OSG), or tendinitis at the insertion of the quads tendon below the knee;
• Inflammatory conditions (inflammatory arthritis);
• Wear and tear causing osteoarthritis, common in older age.
Referred Pain from:
• Low back pinched nerve, ie: sciatica;
• Imbalance of muscles supporting the hips and knees.
Biomechanical Dysfunction of Adjacent Joints:
• Feet e.g. flat feet, ankle pronation, ankle instability following injury;
• Hip and pelvic joint issues causing biomechanical imbalance.
Chiropractic Treatment of Knee Pain
Treatment is individually tailored to suit each person and their specific condition. Broadly the approach is:
Stage 1: Reduce pain, joint inflammation and swelling.
• Ice for the first 48 hours after injury to reduce inflammation, muscle spasm and pain;
• Dry needling (optional), a technique similar to acupuncture that promotes healing and pain relief;
• Use of a brace, elastic wrap or sports tape to provide support, stability and compression (limits swelling).
Stage 2: Normalise joint function
• Specific chiropractic manipulation and mobilisation techniques to areas of restricted movement in the knee and surrounding joints, to increase movement, improve function and reduce discomfort;
• Deep tissue massage, trigger-point therapy and cross-fibre friction to the muscles to relieve tension, improve mobility and muscle tone; • Check and correct alignment issues in the pelvis, ankles and feet, all of which can affect the knees.
Stage 3: Rehabilitation exercise programme.
• When appropriate introduce exercises to build strength, stability and endurance. This will help a faster return to normal and also prevent new injuries.
Preventing Knee Pain and Injuries
Sports and exercise training:
• Use appropriate equipment;
• Don’t push yourself beyond your ability;
• Don’t participate if you are injured;
• Warm up before starting the activity.
Overuse Injuries:
As a general rule, if you are new to an activity or haven’t done it for a long time,
• don’t do it more than twice a week to begin with;
• do half the distance or time/repetitions you were planning to do; • build up your activities gradually.
As with all orthopaedic conditions involving the muscles and joints, it is important not to ignore issues. The longer an injury or problem is left to deteriorate the more difficult it will be to help and treat.
For consultation, diagnosis and treatment of knee pain, contact us at Blue Vista Health Centre.
Our service area includes Bullaburra, Wentworth Falls, Leura, Katoomba, Blackheath, Lawson, Hazelbrook, Woodford and the greater Blue Mountains.