Knee pain is one of the most common orthopedic ailments treated by chiropractic physicians. This isn’t too surprising when you stop to think about it. After all, the knee absorbs an enormous amount of stress and is designed to bend in only one direction. At the same time, though, many of the movements we make (particularly in sports) force the knee to bend slightly in other directions while still requiring it to support the full weight of the body in motion above it. If the biomechanics are off or the joint and surrounding muscles aren’t strong enough, this is a recipe for potential knee pain and injury.
But athletics don’t account for as much of today’s knee pain as you might suspect. The larger culprits are obesity and sedentary lifestyles. You may not realize it, but this combination isn’t just bad for cardiovascular and metabolic health. It’s also bad for musculoskeletal health! All that extra weight adds to the daily wear and tear on the body’s frame—bones, muscles and joints. But especially the knees! We suspect this is one of the key reasons we’re seeing a dramatic increase in some types of knee surgery as well as full knee replacements among patients who are still relatively young.
- In cases involving torn knee cartilage, many patients undergo a minimally-invasive surgery called a “partial meniscectomy” that trims and removes the torn pieces so that they don’t interfere with the knee’s function. About 700,000 people undergo this procedure in the US every year at an estimated cost of roughly $4 billion.
- Over the past decade, there has been a major increase in the rate of total knee replacements (also called “knee arthroplasties”), with rates expected to rise by as much as 670% by 2030, amounting to a staggering 3.48 million procedures.
That’s the bad news. The good news is that it doesn’t have to come to this. The chiropractic approach to knee pain starts with prevention and favors early, conservative treatments that don’t involve the risks associated with surgery and drugs.
Wear the proper shoes for your needs and use custom orthotics if appropriate. If your feet are overpronated (roll to the inside) or supinated (roll to the outside), or if you have fallen arches, it can affect your biomechanics when you stand, walk or run. Over time, this can lead to compensation higher in the body that produces uneven wear and tear on your knees and increases the risk of injury. The same thing is true for your hips and back.
Your chiropractor can analyze the structure of your foot as well as your posture and gait (the way you move when you walk and run) to assess your biomechanics. If necessary, he or she may recommend custom orthotics as well as exercises or changes to your biomechanics in order to relieve pain, prevent future problems and (if you’re an athlete) improve performance.
Be smart about how you exercise and listen to your body. This can be a particular problem for “weekend warriors.” Many middle age adults (more men than women) overestimate the physical condition they’re in. They often can’t or don’t exercise regularly during the week but still want to go all-out in weekend competition. This can contribute to an overloading of the muscles, tendons and ligaments in knees that aren’t strong enough to handle the sudden surge in physical demands. It’s not surprising that acute knee injuries and/or an accumulation of micro-tears are frequently the result.
Lose weight if you need to—and the sooner the better. Any high-impact activities are extra hard on the knees if you’re overweight, but exercise is clearly critical to burning more calories and reversing the situation. What can you do? The answer is to focus on lower-impact activities that burn lots of calories while saving your joints until you achieve a more normal weight. Swimming, rowing and cycling are all good candidates.
It’s important to recognize and get ahead of this issue early, since being overweight or obese can lead to chronic joint problems, which can reduce your ability to be active. This in turn increases the risk that you’ll gain even more weight in the future. One of the best ways to reduce unnecessary wear-and-tear on your knees, hips and back and to avoid the vicious cycle of weight gain, musculoskeletal pain and inactivity is to lose extra pounds EARLY!
Increase your strength and flexibility. Concentrate on strengthening and stretching the hamstrings, quadriceps, hip flexors and the vastus medialis oblique (VMO) muscles, since these provide the greatest support to the knees and ensure that the patella tracks properly. Women are especially prone to improper patellar tracking, which places more stress on the ligaments of the knee. This creates a popping or grinding sound when you bend the knee, often accompanied by pain. Yoga and Pilates are good ways to keep the muscles, tendons and ligaments of the leg and knee strong and flexible.
Get regular chiropractic treatment. A well-trained and experienced chiropractic physician will be able to perform a variety of specialized adjustment, manipulation and mobilization techniques that can relieve pain and improve function in the knees. In certain cases, manual therapies such as chiropractic care may offer just as much benefit to knee injury patients as arthroscopic surgery. A group of researchers who recently published their findings in the Canadian Medical Association Journal looked specifically at the effectiveness of a common procedure called “arthroscopic meniscal debridement” for age-related meniscus tears in middle-aged patients and concluded that more conservative (non-surgical) treatment should actually be the preferred first-line option.
Know your options. All of this is NOT to say that surgery isn’t sometimes necessary or helpful to relieve pain and help people lead an active, healthy lifestyle. Knee replacement surgery offers new mobility to patients whose joints have been compromised and has allowed millions of people to be active once again, when previously they would have had to be confined to a wheelchair.
However, we believe that patients should explore more conservative options before deciding on surgery. Chiropractic care and other manual therapies have many advantages over treatments that involve surgery and drugs. This has been pretty well established when it comes to relieving chronic back and neck pain and restoring mobility. Now there’s new evidence that this may apply to a common knee injury as well. For instance, a recent study conducted in Finland found that patients who underwent a partial meniscectomy to address problems related to torn knee cartilage were actually no better off than patients in a control group who received a “simulated” surgical treatment (the surgical equivalent of a placebo). And another recent study demonstrated that physical therapy was just as effective as knee surgery for patients with both a meniscal tear and osteoarthritis.
So—in our view—the best thing you can do is to take good care of your knees NOW, before the need for surgery arises. Remember—the things you do today can prevent serious problems tomorrow. Call or visit our office today to learn more!