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Knee Pain

What causes knee pain?

Why do I have knee pain?


At some point in their lives, the majority of people will have a bout of knee pain. Sports, exercise and other activities can cause ligament and muscle strains, tendinitis and more severe injuries.

Knee pain severity can vary widely and depends on factors such as cause and age. Knee pain can be so extreme for others, that it restricts everyday activities. For others, mild knee pain may constitute a chronic impediment to the active lifestyle they desire. The location of knee pain can vary as well.




Can Overloading the Quads cause Knee pain


The quads are the muscles that are responsible for straightening the knee across the front of the thigh and helps to extend the leg forward.

When looking at the muscle balance around the knee, quads are considered as one force, and the glutes and hamstrings as the other. Ideally these two groups of muscles should be in balance, not relying too heavily on either one when you perform a movement that uses both groups.

The most common shortfall we see is something called quad dominance, or using the quads heavily for actions which would ideally use both groups. For instance, when someone squats, it’s ideal for them to push their hips back first, bending their knees as required to get a good depth without making their knees move too far past their big toes. Generally speaking, when someone can squat with proper form, the demand is imposed on all three muscle groups, offering less pressure on any specific body part. If you bend at the knees when you squat, or if your knees move excessively past your toes, then you may be quad dominant.

Both the hamstrings and quadriceps play a major role in stabilizing the knee. The knee consists of the femur (head leg bone), tibia and fibula (lower leg bones), and patella (knee cap). To achieve optimum and long-term health, proper functioning of all these is essential. It will certainly help to get your hamstrings stronger in relation to your quads, but resolving problems on the ankle and hip is also crucial to overcoming knee pain, enhancing performance and reducing the risk of injury.




Can Stiff Hips and Ankles affect the knees


The problem with ignoring your ankles is that, eventually, it will also affect how your knees move. The foot is our body’s foundation and if the ankle can not move as it should optimally, it also forces the knees to move improperly. This will result in knee pain, which will lead to hip pain, too.

The hip is a ball and socket joint, and is also an important body weight-bearing joint. There are many ligamentous attachments which add to your hip's stability. There are also several muscle attachments across the hips that help regulate joint and leg motion. The gluteus medius is a big hip stabilizer that also controls the position of your knees when you walk, run or jump. When your gluteus medius muscle is stiff or weak, your thigh is abnormally rotatable and pulls inwards. This is called a collapsed kinetic chain. This abnormal thigh position can put excessive stress and strain around your knee joint and kneecap (patella)




How do Poor Stability/Proprioception affect the knee?


During weight bearing, the knee joint acts as a stabilizer for the lower extremity and allows for a wide range of mobility for various functional activities. Knee ligaments ensure the knee's stability and every ligament has a particular role to help maintain optimum stability in the knee.

The pair of collateral ligaments prevent the knee from moving side to side too far. The cruciate ligaments at the center of the knee criss cross one another. They allow the tibia to "swing" back and forth under the femur without the tibia sliding under the femur either too far forward or backward. The 4 ligaments, working together, are the most important structures in controlling knee stability.

You know what your knee does when you close your eyes and bend your leg, even if you don't "see" it. This ability allows us to know where our limbs are in space, without looking. The proprioceptive system consists of receptor nerves, which are positioned around joints, muscles and ligaments. The receptors can identify tension and stress, and transfer this information to the brain where it is processed. The brain then responds by signaling muscles to contract or relax to produce the movement desired. This coordinated movement is a result of the proprioceptive system functioning normally.

The receptors are also damaged following injury to joints and ligaments, meaning the information that is usually sent to the brain is impaired. The lack of sense of position puts the joint at increased risk of damage because of the loss of stability. You can do certain balance training exercises to get the other receptors to do more, recovering what was lost to the receptors that were damaged. It allows you to stabilize and protect unintentional reflexes by maintaining posture and balance while you move.




Muscle Spasms


Muscle spasticity, or spasms, causes your muscles to become stiff or rigid. It can also cause exaggerated, deep tendon reflexes, like a knee-jerk reaction when your reflexes are checked.

These things may make your spasticity worse:

  • Being too hot or too cold

  • The time of day

  • Stress

  • Tight clothing

  • Bladder infections and spasms

  • Your menstrual cycle (for women)

  • Certain body positions

  • New skin wounds or ulcers

  • Hemorrhoids

  • Being very tired or not getting enough sleep

Your chiropractor can teach you and your caregiver stretching exercises you can do. These stretches will help keep your muscles from getting shorter or tighter.

Being active also helps keep your muscles loose. Aerobic exercise, such as swimming, and strength-building exercises are helpful as are playing sports and doing daily tasks. Talk with your health care provider or chiropractor first before starting any exercise program.

Your provider may place splints or casts on some of your joints to keep them from becoming so tight that you cannot move them easily. Make sure to wear the splints or casts as your provider tells you to.

Be careful about getting pressure sores from exercise or being in the same position in a bed or wheelchair for too long.

Muscle spasticity can increase your chances of falling and hurting yourself. Be sure to take precautions so you do not fall.





How do Chiropractors treat Knee Pain?

Treatment Options

Electrical Muscle Stimulation Therapy


Electrical Muscle Stimulation Therapy or EMS is a comfortable current that is used to:

  • Helps you hold your adjustments longer because the muscles are relaxed
  • Improve joint pain and swelling.
  • Prevents and reveres muscle atrophy (loss of muscle mass/tissue)
  • Enhances rehabilitation of muscles.
  • Increases range of motion for tense muscles or tendons.
  • Reduces stress and discomfort.
  • Improves blood flow and circulation.
  • Decreases pain
It is commonly used by Chiropractors and Physical Therapist. Even some sports team use it as part of their trainers therapy.




Rehabilitative Exercises


Rehabilitative Exercises not only strenthen your muscles, improve your posture, increase range of motion it also reduces pain. Rehabilitative Exercises can be done for all parts of the body. Depending on your injury or your conditioning we start with the exercises where you are at and then progress from there. To make sure we have the appropriate exercise for you we first perform a Funcational Movement Screen. This checks your upper and lower body strenght and flexibility. Every person is unique and different in their need to expercise after a injury or chronic pain. Your progess is measured monthly by repeating the Funcitonal Movement Screen. Check out our 10 Minute Posture Improvement. Watch the video now. https://vimeo.com/202990443 Getting enough movement and physical activity on a regular basis provides a wide range of benefits to our musculoskeletal and overall health. Adults should get 150 minutes of moderate-intensity aerobic activity each week – that’s about 30 minutes of activity five days a week. Children and teenagers should be physically active for at least 60 minutes each day. People over 65 should strive for 150 minutes of moderate-intensity aerobic activity each week in addition to two days a week of muscle- and balance-strengthening activities. Research shows that physical activity helps to alleviate pain and improve function and symptoms in a wide range of musculoskeletal conditions. Physical activity helps to strengthen our muscles, bones and joints. Physical activity reduces our risk of cardiovascular disease and diabetes even beyond what weight loss alone can do. Along with physical activity, a healthy lifestyle includes balancing what you eat and drink, getting adequate sleep and managing stress.




Acupuncture


Acupuncture is a treatment based on Chinese medicine — a system of healing that dates back thousands of years. At the core of Chinese medicine is the notion that a type of life force, or energy, known as qi (pronounced “chee”) flows through energy pathways (meridians) in the body. Each meridian corresponds to one organ, or group of organs, that governs particular bodily functions. Achieving the proper flow of qi is thought to create health and wellness. Qi maintains the dynamic balance of yin and yang, which are complementary opposites. According to Chinese medicine, everything in nature has both yin and yang. An imbalance of qi (too much, too little, or blocked flow) causes disease. To restore balance to the qi, an acupuncturist inserts needles at points along the meridians. These acupuncture points are places where the energy pathway is close to the surface of the skin. How does Acupuncture Work? The benefits of acupuncture are complex. Research suggests that the needling process may produce a variety of effects in the body and the brain. One theory is that stimulated nerve fibers transmit signals to the spinal cord and brain, activating the body’s central nervous system. The spinal cord and brain then release hormones responsible for making us feel less pain while improving overall health. In fact, a study using images of the brain confirmed that acupuncture increases our pain threshold, which may explain why it produces long term pain relief. Acupuncture may also increase blood circulation and body temperature, affect white blood cell activity (responsible for our immune function), reduce cholesterol and triglyceride levels, and regulate blood sugar and hormone levels. What is Acupuncture Good for? The benefits of acupuncture are complex. Research suggests that the needling process may produce a variety of effects in the body and the brain. One theory is that stimulated nerve fibers transmit signals to the spinal cord and brain, activating the body’s central nervous system. The spinal cord and brain then release hormones responsible for making us feel less pain while improving overall health. In fact, a study using images of the brain confirmed that acupuncture increases our pain threshold, which may explain why it produces long term pain relief. Acupuncture may also increase blood circulation and body temperature, affect white blood cell activity (responsible for our immune function), reduce cholesterol and triglyceride levels, and regulate blood sugar and hormone levels. Acupuncture is particularly effective for pain relief, and chemotherapy-associated nausea and vomiting. In addition, both the World Health Organization and the National Institutes of Health recognize that acupuncture can be a helpful part of a treatment plan for many illnesses. A partial list includes addiction (such as alcoholism or drug abuse), asthma, bronchitis, carpal tunnel syndrome, constipation, diarrhea, facial tics, fibromyalgia, headaches, irregular menstrual cycles, polycystic ovarian syndrome, low back pain, menopausal symptoms, menstrual cramps, osteoarthritis, sinusitis, spastic colon (often called irritable bowel syndrome), tendonitis, tennis elbow, and urinary problems such as incontinence. You can safely combine acupuncture with prescription drugs and chiropractic care. The American Academy of Medical Acupuncture also lists a wide range of conditions for which acupuncture is appropriate. In addition to those listed above, they recommend acupuncture for sports injuries, sprains, strains, whiplash, neck pain, sciatica, nerve pain due to compression, overuse syndromes similar to carpal tunnel syndrome, pain resulting from spinal cord injuries, allergies, tinnitus (ringing in the ears), sore throat (called pharyngitis), high blood pressure, gastroesophageal reflux (felt as heartburn or indigestion), ulcers, chronic and recurrent bladder and kidney infections, premenstrual syndrome (PMS), infertility, endometriosis, memory problems, insomnia, multiple sclerosis, sensory disturbances, depression, anxiety, and other psychological disorders.​




Massage


Massage therapy is a manual manipulation of soft body tissues (muscle, connective tissue, tendons, and ligaments) to enhance a person’s health and well-being. People seek massage therapy for a variety of reasons: to reduce stress and anxiety, relax muscles, rehabilitate injuries, reduce pain, and promote overall health and wellness. Our massages are performed in a warm comfortable room that allows you to relax and recover the battle of daily stresses. Massage is not purely a luxury you get when on vacation it is a necessity for your overall healing and wellness. To show how important massage is to your overall wellness we may include it as part of your care plan to help not only reduce muscle spasms and soreness but also to promote relaxation and stress reduction. Massage may also be used together with Chiropractic Care and even acupuncture or weight loss. Our massage therapist has extensive schooling and years of experience in treating people who have a musculoskeletal issue that goes beyond an occasional sore muscle. Because we view massage as therapy we incorporate it into our patient's care plans along with Chiropractic, exercise, and nutrition. We like to say the massage is the reward for all the hard work you have done. Types of Massage Relaxation Massage - also known as Swedish massage; this is for pure relaxation and reduction of stress and anxiety. The Therapist uses light pressure and longer strokes. Relaxation massage is perfect for stress, tension, depression, a busy mind, or people who prefer a lighter touch or are sensitive. Deep Tissue Massage – also known as therapeutic tissue, or medical-massage. This type of massage is targeted to rehabilitate an injury, reduce pain, release deep muscle tension that is produced by exercise. The Therapist uses firm pressure along with stretches that release deeply help spasms, trigger points, and metabolic waste in the muscles. Therapeutic massage helps with back pain, neck pain, sports injuries, or people who prefer a firmer touch. Sports Massage - Sports Massage is a must for both weekend warriors and elite athletes. It is an essential part of any recovery routine. Sports massage can help improve performance, prevent injury and speed recovery from muscle and soft tissue soreness and the everyday aches and pains associated with sports. This massage focuses on the muscles that the athlete's sports rely on the most and is individualized for each person and sport. If you are looking for enhanced athletic performance, recovery or increased range of motion and flexibility this is a great massage for you. Hot Stone Massage - Hot Stone Massage is a relaxing massage experience. The heated stones are used to gently massaged into your muscles to relieve all of your stress and tension. The stones are soothing and relaxing while providing a penetrating heat that encourages your muscles to relax and loosen. Hot Stone Massage is wonderful for deep relaxation, fibromyalgia, tension, muscle spasms, back, or joint pain. Cupping Therapy with Massage - Cupping Therapy creates a pressure on the skin with the suction of a small cup. The suction is created by a hand pump attached to the cup. This form of therapy has been practiced for thousands of years and is safe, effective, and very relaxing. Cupping therapy releases muscle spasms and soft tissue irritations, draws out excess fluid and toxins, loosens adhesions, lifts connective tissue, and brings relief and blood flow to skin and muscles




Class IV Low Level Laser


Biological affects of the Laser Clinical studies and research using laser therapy technology indicate the following beneficial effects of laser therapy on tissues and cells. Anti-Inflammation Laser therapy has an anti-endemic effect as it causes vasodilation, but also because it activates the lymphatic drainage system (drains swollen areas). As a result, there is a reduction in swelling caused by bruising or inflammation. Anti-Pain (Analgesic) Laser therapy has a high beneficial effect on nerve cells which block pain transmitted by these cells to the brain and which decreases nerve sensitivity. Also, due to less inflammation, there is less edema and less pain. Another pain blocking mechanism involves the production of high levels of pain-killing chemicals such as endorphins and enkephalins from the brain and adrenal gland. Accelerated Tissue Repair and Cell Growth Photons of light from lasers penetrate deeply into tissue and accelerate cellular reproduction and growth. The laser light increases the energy available to the cell so that the cell can take on nutrients faster and get rid of waste products. As a result of exposure to laser light, the cells of tendons, ligaments and muscles are repaired faster. Improved Nerve Function Slow recovery of nerve functions in damaged tissue can result in numbness and impaired limbs. Laser light will speed up the process of nerve cell reconnection and increase the amplitude of action potentials to optimize muscle action.





Frequently asked questions about knee pain

Treatment Options

Electrical Muscle Stimulation Therapy


Electrical Muscle Stimulation Therapy or EMS is a comfortable current that is used to:

  • Helps you hold your adjustments longer because the muscles are relaxed
  • Improve joint pain and swelling.
  • Prevents and reveres muscle atrophy (loss of muscle mass/tissue)
  • Enhances rehabilitation of muscles.
  • Increases range of motion for tense muscles or tendons.
  • Reduces stress and discomfort.
  • Improves blood flow and circulation.
  • Decreases pain
It is commonly used by Chiropractors and Physical Therapist. Even some sports team use it as part of their trainers therapy.




Rehabilitative Exercises


Rehabilitative Exercises not only strenthen your muscles, improve your posture, increase range of motion it also reduces pain. Rehabilitative Exercises can be done for all parts of the body. Depending on your injury or your conditioning we start with the exercises where you are at and then progress from there. To make sure we have the appropriate exercise for you we first perform a Funcational Movement Screen. This checks your upper and lower body strenght and flexibility. Every person is unique and different in their need to expercise after a injury or chronic pain. Your progess is measured monthly by repeating the Funcitonal Movement Screen. Check out our 10 Minute Posture Improvement. Watch the video now. https://vimeo.com/202990443 Getting enough movement and physical activity on a regular basis provides a wide range of benefits to our musculoskeletal and overall health. Adults should get 150 minutes of moderate-intensity aerobic activity each week – that’s about 30 minutes of activity five days a week. Children and teenagers should be physically active for at least 60 minutes each day. People over 65 should strive for 150 minutes of moderate-intensity aerobic activity each week in addition to two days a week of muscle- and balance-strengthening activities. Research shows that physical activity helps to alleviate pain and improve function and symptoms in a wide range of musculoskeletal conditions. Physical activity helps to strengthen our muscles, bones and joints. Physical activity reduces our risk of cardiovascular disease and diabetes even beyond what weight loss alone can do. Along with physical activity, a healthy lifestyle includes balancing what you eat and drink, getting adequate sleep and managing stress.




Acupuncture


Acupuncture is a treatment based on Chinese medicine — a system of healing that dates back thousands of years. At the core of Chinese medicine is the notion that a type of life force, or energy, known as qi (pronounced “chee”) flows through energy pathways (meridians) in the body. Each meridian corresponds to one organ, or group of organs, that governs particular bodily functions. Achieving the proper flow of qi is thought to create health and wellness. Qi maintains the dynamic balance of yin and yang, which are complementary opposites. According to Chinese medicine, everything in nature has both yin and yang. An imbalance of qi (too much, too little, or blocked flow) causes disease. To restore balance to the qi, an acupuncturist inserts needles at points along the meridians. These acupuncture points are places where the energy pathway is close to the surface of the skin. How does Acupuncture Work? The benefits of acupuncture are complex. Research suggests that the needling process may produce a variety of effects in the body and the brain. One theory is that stimulated nerve fibers transmit signals to the spinal cord and brain, activating the body’s central nervous system. The spinal cord and brain then release hormones responsible for making us feel less pain while improving overall health. In fact, a study using images of the brain confirmed that acupuncture increases our pain threshold, which may explain why it produces long term pain relief. Acupuncture may also increase blood circulation and body temperature, affect white blood cell activity (responsible for our immune function), reduce cholesterol and triglyceride levels, and regulate blood sugar and hormone levels. What is Acupuncture Good for? The benefits of acupuncture are complex. Research suggests that the needling process may produce a variety of effects in the body and the brain. One theory is that stimulated nerve fibers transmit signals to the spinal cord and brain, activating the body’s central nervous system. The spinal cord and brain then release hormones responsible for making us feel less pain while improving overall health. In fact, a study using images of the brain confirmed that acupuncture increases our pain threshold, which may explain why it produces long term pain relief. Acupuncture may also increase blood circulation and body temperature, affect white blood cell activity (responsible for our immune function), reduce cholesterol and triglyceride levels, and regulate blood sugar and hormone levels. Acupuncture is particularly effective for pain relief, and chemotherapy-associated nausea and vomiting. In addition, both the World Health Organization and the National Institutes of Health recognize that acupuncture can be a helpful part of a treatment plan for many illnesses. A partial list includes addiction (such as alcoholism or drug abuse), asthma, bronchitis, carpal tunnel syndrome, constipation, diarrhea, facial tics, fibromyalgia, headaches, irregular menstrual cycles, polycystic ovarian syndrome, low back pain, menopausal symptoms, menstrual cramps, osteoarthritis, sinusitis, spastic colon (often called irritable bowel syndrome), tendonitis, tennis elbow, and urinary problems such as incontinence. You can safely combine acupuncture with prescription drugs and chiropractic care. The American Academy of Medical Acupuncture also lists a wide range of conditions for which acupuncture is appropriate. In addition to those listed above, they recommend acupuncture for sports injuries, sprains, strains, whiplash, neck pain, sciatica, nerve pain due to compression, overuse syndromes similar to carpal tunnel syndrome, pain resulting from spinal cord injuries, allergies, tinnitus (ringing in the ears), sore throat (called pharyngitis), high blood pressure, gastroesophageal reflux (felt as heartburn or indigestion), ulcers, chronic and recurrent bladder and kidney infections, premenstrual syndrome (PMS), infertility, endometriosis, memory problems, insomnia, multiple sclerosis, sensory disturbances, depression, anxiety, and other psychological disorders.​




Massage


Massage therapy is a manual manipulation of soft body tissues (muscle, connective tissue, tendons, and ligaments) to enhance a person’s health and well-being. People seek massage therapy for a variety of reasons: to reduce stress and anxiety, relax muscles, rehabilitate injuries, reduce pain, and promote overall health and wellness. Our massages are performed in a warm comfortable room that allows you to relax and recover the battle of daily stresses. Massage is not purely a luxury you get when on vacation it is a necessity for your overall healing and wellness. To show how important massage is to your overall wellness we may include it as part of your care plan to help not only reduce muscle spasms and soreness but also to promote relaxation and stress reduction. Massage may also be used together with Chiropractic Care and even acupuncture or weight loss. Our massage therapist has extensive schooling and years of experience in treating people who have a musculoskeletal issue that goes beyond an occasional sore muscle. Because we view massage as therapy we incorporate it into our patient's care plans along with Chiropractic, exercise, and nutrition. We like to say the massage is the reward for all the hard work you have done. Types of Massage Relaxation Massage - also known as Swedish massage; this is for pure relaxation and reduction of stress and anxiety. The Therapist uses light pressure and longer strokes. Relaxation massage is perfect for stress, tension, depression, a busy mind, or people who prefer a lighter touch or are sensitive. Deep Tissue Massage – also known as therapeutic tissue, or medical-massage. This type of massage is targeted to rehabilitate an injury, reduce pain, release deep muscle tension that is produced by exercise. The Therapist uses firm pressure along with stretches that release deeply help spasms, trigger points, and metabolic waste in the muscles. Therapeutic massage helps with back pain, neck pain, sports injuries, or people who prefer a firmer touch. Sports Massage - Sports Massage is a must for both weekend warriors and elite athletes. It is an essential part of any recovery routine. Sports massage can help improve performance, prevent injury and speed recovery from muscle and soft tissue soreness and the everyday aches and pains associated with sports. This massage focuses on the muscles that the athlete's sports rely on the most and is individualized for each person and sport. If you are looking for enhanced athletic performance, recovery or increased range of motion and flexibility this is a great massage for you. Hot Stone Massage - Hot Stone Massage is a relaxing massage experience. The heated stones are used to gently massaged into your muscles to relieve all of your stress and tension. The stones are soothing and relaxing while providing a penetrating heat that encourages your muscles to relax and loosen. Hot Stone Massage is wonderful for deep relaxation, fibromyalgia, tension, muscle spasms, back, or joint pain. Cupping Therapy with Massage - Cupping Therapy creates a pressure on the skin with the suction of a small cup. The suction is created by a hand pump attached to the cup. This form of therapy has been practiced for thousands of years and is safe, effective, and very relaxing. Cupping therapy releases muscle spasms and soft tissue irritations, draws out excess fluid and toxins, loosens adhesions, lifts connective tissue, and brings relief and blood flow to skin and muscles




Class IV Low Level Laser


Biological affects of the Laser Clinical studies and research using laser therapy technology indicate the following beneficial effects of laser therapy on tissues and cells. Anti-Inflammation Laser therapy has an anti-endemic effect as it causes vasodilation, but also because it activates the lymphatic drainage system (drains swollen areas). As a result, there is a reduction in swelling caused by bruising or inflammation. Anti-Pain (Analgesic) Laser therapy has a high beneficial effect on nerve cells which block pain transmitted by these cells to the brain and which decreases nerve sensitivity. Also, due to less inflammation, there is less edema and less pain. Another pain blocking mechanism involves the production of high levels of pain-killing chemicals such as endorphins and enkephalins from the brain and adrenal gland. Accelerated Tissue Repair and Cell Growth Photons of light from lasers penetrate deeply into tissue and accelerate cellular reproduction and growth. The laser light increases the energy available to the cell so that the cell can take on nutrients faster and get rid of waste products. As a result of exposure to laser light, the cells of tendons, ligaments and muscles are repaired faster. Improved Nerve Function Slow recovery of nerve functions in damaged tissue can result in numbness and impaired limbs. Laser light will speed up the process of nerve cell reconnection and increase the amplitude of action potentials to optimize muscle action.





Chiropractic, Functional Medicine & Wellness