Knee X-ray

A new study conducted by Tufts University School of Medicine had concluded that men and women 65 years and older who’ve been diagnosed with knee osteoarthritis (OA), and who practice Tai Chi, improved their physical capability and encountered less pain. Osteoarthritis is a prevalent form of arthritis that causes an erosion of joint cartilage. Chiropractors help many individuals who suffer with OA in a number of regions of the body, including the joints of the knee. Knee pain and disability is one of the most prevalent problems of the musculoskeletal system, second only to spinal dysfunctions. In fact, according to the Centers for Disease Control and Prevention (CDC) there are an astounding 4.3 million people in this country over 60 years of ag diagnosed with knee OA, and the CDC predicts that by age 85, half of American adults may incur symptoms of OA. Knee osteoarthritis results in pain, immobility, functional disabilities, and a reduced quality of life.

Why do so many men and women develop OA? As with nearly all of the musculoskeletal dysfunctions that we develop as we get older, undue stress to a joint over the years is a major element. That is why as people get older they are more at risk for developing OA in their knees, as well as other joints. Improper function of the knee, irregular gait, compensatory foot mechanics as an offset of foot pain, and overuse of the knee joint all cause inordinate stress on the knees. Consequently arthritic changes in the knee joint develop. In combination with chiropractic therapies, chiropractors enthusiastically endorse natural, drug-free practices, such as Tai Chi (Chuan), that can mitigate knee pain. A traditional style of Chinese martial arts,Tai Chi features slow, rhythmic movements that create peace of mind, as well as an enhancement of balance, an increase in strength, and more flexibility.

The 40 men and women selected for the Tufts study were on an average 65 years of age, overweight, and with confirmed osteoarthritis of the knee. Otherwise they were healthy. Individuals were randomly picked to take part in 60-minute “Yang style” Tai Chi sessions twice weekly for 12 weeks. Each session included a 10-minute self-massage and a review of Tai Chi principles, 30 minutes of Tai Chi movement, 10 minutes of breathing technique, and 10 minutes of relaxation.

Tai Chi incorporates many of the prevailing exercise recommendations for OA, such as range of motion, flexibility, muscle conditioning, and aerobic workout. Furthermore, researchers observed that the “mental aspect” of Tai Chi encouraged a sense of well-being, life contentment, and perceptions of health that assisted the participants in dealing differently with chronic pain. Compared with the control group, the group practicing Tai Chi experienced a significant decrease in knee pain.

Full findings of the study are published in the November 2009 issue of Arthritis Care & Research, a journal of the American College of Rheumatology.

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Patella Femoral Syndrome ( Knee Cap Pain )

Poor mechanics of the knee joint and the associated stress upon the soft tissues of the knee is by far the most common cause of non-traumatic pain. The most common part of the knee affected by this is the patella or knee-cap. Often the patella does not move smoothly or does not move sufficiently on the femur during bending of the knee causing abnormal stresses upon the tendons cartilage and ligaments. This condition is often called chondromalacia patella or CMP though a better term is patella femoral syndrome. The problem usually originates when there are imbalances in the quadriceps muscles of the thigh which attach to and move the patella.

The associated pain is experienced during activity, especially stair climbing, running, jumping and after getting up from prolonged sitting. Women are more predisposed to this problem for anatomical reasons and also the use of high heels.

Repetitive Knee Strain – Overuse Injury

Imbalances in other muscle groups that attach to the knee can also lead to pain and dysfunction. As an example, the muscles on the inside of the thigh when strained and tight can cause pain on the medial or inside side of the knee.

Lower back problems especially in the sacroiliac joints, are one of the main reasons for imbalances in the muscles associated with knee movement and subsequent knee problems. Foot problems that cause gait abnormalities such as pronation, are another cause of mechanical knee pain.

The main treatment for mechanical or overuse injuries to the knee is to re-establish proper balance of the muscles, restore proper movement to the patella and other joints of the knee, and correct any subluxations of the sacroiliac joints and foot problems. In certain cases, a brace is used to help with the alignment of the patella or to stabilise the joint. Chiropractors are ideally trained to provide the proper diagnosis and management of these problems.

Trauma

Traumatic injuries often occur during sports that involve running and jumping, such as football and basketball, and with activities such as skiing. When the knee is stretched or twisted beyond the strength of the ligaments that hold the joint together, tearing of these tissues can occur causing a sprain. The muscles that move the knee can also be torn during injury causing a strain or pull of the muscle. As with a sprain, a muscle strain can vary from a minor injury that requires little care to a severe injury requiring surgery. The knee also contains two special “cartilages” – the menisci – between the tibia and the femur that provide for smooth movement and cushioning. These cartilages can also be torn during trauma and often require surgical repair or removal if damaged severely. Traumatic knee injuries can cause severe pain and swelling and require immediate evaluation and attention. In most cases a qualified chiropractor can manage these conditions, though there are some injuries that do need the expertise of an orthopaedic surgeon. In any case, it is important to stabilise the injured joint and ice if possible until you can get the injury evaluated. Please see the section on sports injuries for additional information regarding this topic.

Treatment

If poor mechanics or traumatic injuries are not corrected at an early age, the tissues of the knee joint especially the cartilage will eventually begin to wear out. As a result the bones rub upon one another and changes such as bone spurs can occur. This painful condition is known as degenerative joint disease or osteoarthritis and is often progressive with age. Common treatment often involves medications such as NSAIDS (non-steroidal anti-inflammatory drugs) though conservative treatment such as chiropractic can be helpful in alleviating some of the pain. There is some evidence that nutritional substances such as Glucosamine and Chondroitin can be helpful in the long term management. People can often help themselves by keeping their weight down, doing exercises especially in the pool, and wearing cushioned shoes or insoles.

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