“I have pain in my knee, but my doctor told me there’s nothing that can be done. Just ice and rest and ibuprofen. Is that true there’s nothing that can be done about knee pain? What can a chiropractor do to help knee pain? I thought chiropractors were back pain doctors.”
This is a good question, one that I frequently hear when talking with active people in my community. Fortunately, there is something that can be done about knee pain! There are several things that will help alleviate knee pain! It’s not always an easy fix, and these things may require quite a bit of your time and effort. But there is hope!
Obviously there are several causes for knee pain, and the treatment is going to depend on the diagnosis, which depends on the cause. If we are talking about an acute injury (falling off a bicycle, getting kicked in the knee in a soccer game, a spill down some slippery stairs), ice and rest may still be your best course of action. If things don’t heal up on their own after a few days to weeks, then we’re looking at a sub-acute or chronic condition. Other than acute injuries, knee pain is often caused by overuse. It’s either loaded too much or too soon, or a combination of the two. Structures surrounding the knee (quad muscles, hamstring muscles, calf muscles, and all of the knee ligaments) have a certain capacity for load. If the load on that tissue exceeds the capacity of that tissue, there will be a failure. This can be illustrated with a simple balance beam or see-saw.
On the left, the load is too heavy, and the balance of the system gets thrown out-of-whack.
On the right, the load is kept lighter than the capacity, thus we have a healthy system.
To prevent and/or alleviate knee pain, we have to work on decreasing the load (losing weight if overweight, reducing mileage and/or frequency of long runs, focusing on fixing bad posture, etc.) and also on increasing the capacity! How do we increase the capacity? Well that’s a good question! Before we dive into that, we need to develop an understanding of why a muscle or ligament loses capacity in the first place.
How does a muscle or tissue lose capacity?
Any time a muscle is overworked (repetitive motions, repeated contractions) or acutely injured (fall or collision causing a tear or crush), it receives a decreased amount of bloodflow (read: oxygen flow). If this condition continues, the hypoxia (lack or oxygen flow) causes adhesions to form in the muscles. These are sticky areas, almost as if someone poured glue into the muscle, which limit range of motion, alter your biomechanics, and cause knee pain. Adhesions remain until they are treated. Rest, ice, stretching, and ibuprofen will not make them go away! You may get some temporary relief, but once you resume your activities, the issue will make itself known once again.
How do we restore that capacity?
So in order to increase a muscle’s capacity, we need to reduce the adhesions! Active Release Techniques is one manual therapy technique that is effective in reducing the adhesions so that you can get you back to your activities! This is the primary method an Oakland sports chiropractor will use to increase the capacity of the injured tissues, so that you will have less knee pain. There are several auxillary methods for increasing tissue capacity, most of which are holistic and systemic, rather than focusing on the knee in particular. These methods include eating an anti-inflammatory diet, getting adequate sunlight, sleeping for a solid 8 hours, and avoiding cigarette smoke and other toxins.
Your sports chiropractor will examine your knee to determine exactly which structures are the cause of your pain, and then perform the treatment accordingly. Sometimes the knee itself is just fine, and the problem is actually coming from somewhere else! In this case, we need to look at other parts of the body such as the hip and the foot, to determine whether improper biomechanics are causing the muscles that control the knee to work harder than they need to. Active Release Techniques also has protocols to treat dysfunction that is found in the hip or the foot, so that correct bio-mechanical function may be restored to those areas, alleviating the pain in the knee.