If you have knee pain from an anterior cruciate ligament injury, Chiropractic can provide relief! This post is about Knee Pain and Chiropractic Treatment: A.C.L. Injury.

 

Acute Phase of  the Anterior Cruciate Ligament (ACL) Injury

If you are in the acute phase, you may have sudden knee pain after a “contact injury”.  Your knee may  get hit very hard on the side. In addition, it may get hit while in a hyperextension (knee bent backwards) position.  Furthermore, you may have heard a “pop” during the injury.  Next, your joint will swell and you won’t be able to weight bear. 

 

Chronic Phase of the Anterior Cruciate Ligament (ACL) Injury

If you are in the chronic phase, you may have had the above happen in the past.  Of course, it may have resolved gradually after some swelling and pain.  Finally, you may feel more of an instability than pain in your knee.  Moreover, you may not even remember what happened. So this would be a noncontact/ nontraumatic ACL injury.  And this often occurs when an athlete slows down, pivots while running, and lands from a jump. Typically, these movements are common in sports, especially in soccer, basketball, and football.

 

Anatomy: Femur (thigh bone), Tibia (shin bone), Fibula (thin, outer long bone of the leg), and the Patella (kneecap)

There are three “articulations” (joint or juncture between bones or cartilages) at the knee: the tibiofemoral, patellofemoral, and tibiofibular articulations. However, only the tibiofemoral and patellofemoral articulations participate in knee joint activity. The tibiofibular articulation/joint does not actually contribute to the actions of the knee. Instead, it is part of the ankle joint complex moving the ankle in all the various ranges of motion. However, dysfunctional processes in the proximal tibiofibular articulation/joint can affect other knee functions and can be a source of knee pain.

So the tibiofemoral and tibiofibular are synovial articulations.  These are freely movable joints. And the bony surfaces are coated with hyaline cartilage.  It is unified by a fibrous articular capsule. However, the third articulation, patellofemoral, is a functional joint (non-synovial joint).   

 

More Anatomy of the Knee: About the ACL

First, the knee is supported by the joint capsule, its cartilage “thickenings”, and the collateral-ligamentous system.  And the collateral ligaments (band of tissue that connects a bone to another bone) are located on either side of your knee outside your knee joint.

Second, internally the knee is stabilized and the control of rotation is provided by the meniscocruciate system. There are two C-shaped cartilage like structures, each one called a meniscus. The menisci aid in shock absorption and help govern rotational movement at the knee.

Third, the cruciates, capsule, and collateral ligaments connect the femur to the tibia. The cruciates are a pair of ligaments that cross each other in the knee, connecting the tibia and the femur. The Anterior Cruciate Ligament (ACL) is smaller (size of the little finger) than the Posterior Cruciate Ligament.  It’s usually more readily injured than the Posterior Cruciate Ligament (PCL) (size of the thumb). The cruciates allow tension to develop through most ranges of motion. 

 

Complications and Causes of Knee Pain from the ACL Injury

An anterior cruciate ligament injury is the over-stretching or tearing of the anterior cruciate ligament (ACL) in the knee.

As mentioned previously, ACL damage can be from a noncontact injury or a sudden traumatic contact event.   Usually, excessive contraction of the quadriceps muscle with insufficient hamstrings co-contraction occurs with sudden stopping or cutting manuevers.  Also, contact injury with a rotary component is more likely to damage the ACL and other structures such as the menisci or MCL (medial collateral ligament).

When the ACL tears, it usually occurs in the mid substance of the ligament. And because of the closeness of the vasculature, blood vessel rupture often occurs.  Lastly, this causes quickly developing joint swelling that is both tense and painful. 

 

ACL injury Grade 1-3

Sprain is grade 1– microscopic tears that stretch the ligament.

Partial ACL tear is grade 2– stretched and partially torn.

Complete ACL tear or an avulsion is grade 3- the Tibial spine avulsion ACL injury occurs in teens. The ACL hasn’t torn, but the attachment of the ligament to the tibia has pulled off partially or entirely.  With a complete tear you may need surgery.  However, you should always try conservative therapy/treatments such as chiropractic first.

 

Dr. Natalie Meiri adjusts a patient's knee
Dr. Natalie Meiri adjusts a patient’s knee

 

Evaluation, Tests and Management

After examining your knee, your doctor may order imaging such as an x-ray or/and M.R.I. Grade 1 ACL injuries may not require bracing.  However, second to third grade tears (without involvement of the meniscus) may require a month of restricted bracing.

 

Knee Pain and Chiropractic Treatment: A.C.L. Injury Treatment at Meiri Chiropractic

First, the knee and associated spine and extremity (limb) joints are adjusted.

 

Second, manipulation of muscle contractures with soft tissue techniques is utilized.  Some Techniques include gentle PNF/PIR (e.g. post isometric relaxation) and/or myofascial release techniques. 

 

Finally, Therapeutic exercises for rehabilitation/ strengthening are prescribed. 

 

Getting regular chiropractic treatment at a chiropractic center in West Palm Beach can help naturally relieve the pain and dysfunction of the knee. Chiropractic is a holistic and natural way to not only treat existing conditions, but to keep your body in its best working condition.

Contact Meiri Chiropractic today at 561-253-8984  to make an appointment on Knee Pain and Chiropractic Treatment:  A.C.L. Injury or/and other ailments.

 

 

If you have knee pain from osteoarthritis (wear and tear arthritis), Chiropractic can provide relief! This post is about Knee Pain and Chiropractic Treatment: Knee Arthritis

You may have stiffness and knee pain. Your knee pain may be worse with prolonged sitting and walking.  Moreover, you may have a history of trauma or surgery to your knee.  Additionally, you may have recurrent bouts of swelling and “bowlegged” appearance to the knee.

 

The Femur (thigh bone), Tibia (shin bone), Fibula (thin, outer long bone of the leg), and the Patella (kneecap)

There are three “articulations” (joint or juncture between bones or cartilages) at the knee: the tibiofemoral, patellofemoral, and tibiofibular articulations. However, only the tibiofemoral and patellofemoral articulations participate in knee joint activity. The tibiofibular articulation/joint does not actually contribute to the actions of the knee. Instead, it is part of the ankle joint complex moving the ankle in all the various ranges of motion. However, dysfunctional processes in the proximal tibiofibular articulation/joint can affect other knee functions and can be a source of knee pain.

So the tibiofemoral and tibiofibular are synovial articulations.  These are freely movable joints. And the bony surfaces are coated with hyaline cartilage.  It is unified by a fibrous articular capsule. However, the third articulation, patellofemoral, is a functional joint (non-synovial joint).  Nevertheless, many of the same problems such as arthritis arise here.

 

More Anatomy of the Knee

First, the knee is supported by the joint capsule, its cartilage “thickenings”, and the collateral-ligamentous system.  And the collateral ligaments (band of tissue that connects a bone to another bone) are located on either side of your knee outside your knee joint.

Second, internally the knee is stabilized and the control of rotation is provided by the meniscocruciate system. There are two C-shaped cartilage like structures, each one called a meniscus. The menisci aid in shock absorption and help govern rotational movement at the knee.

Third, the cruciates, capsule, and collateral ligaments connect the femur to the tibia. The cruciates are a pair of ligaments that cross each other in the knee, connecting the tibia and the femur. The Anterior Cruciate Ligament (ACL) is smaller (size of the little finger) than the Posterior Cruciate Ligament.  It’s usually more readily injured than the Posterior Cruciate Ligament (PCL) (size of the thumb). The cruciates allow tension to develop through most ranges of motion.

 

Causes of Knee Pain from Osteoarthritis

Degeneration of articular (joint) cartilage is often secondary to meniscal tearing or degeneration. Unfortunately, this occurs with age. Additionally, single trauma events or a past knee surgery (including ACL or meniscal surgeries) predispose you to early degeneration.

 

What is Osteoarthritis (Degenerative Joint Disease)?

Degenerative arthritis or degenerative joint disease is also referred to as osteoarthritis.  It is a “wear and tear” arthritis. This serious, painful condition can affect any joint of the body (e.g. hands, knees, hips, shoulders, back and neck). It is by far the most common form of arthritis, affecting more than 32.5 million adults in the United States, according to the Centers for Disease Control and Prevention.

Firstly, osteoarthritis is a disease of the entire joint, including bone, cartilage, ligaments, menisci (e.g. knee meniscus) and the tissues lining the joint (the synovium). There can also be changes in periarticular (around the joint) muscles, nerves, bursa, and local fat pads that may contribute to the symptoms of osteoarthritis.

Secondly, it degrades cartilage, changes bone shape and this causes inflammation. 

Thirdly, the result is pain, stiffness and loss of mobility.

Lastly, pain and other symptoms of osteoarthritis may lead you to feel tired, have problems sleeping, and possibly feeling depressed.

 

Options for managing Osteoarthritis along with chiropractic care:

-Exercise is an effective management approach to OA of the knee with significant reductions in pain and improvements in function. 

– Taping and bracing may also be effective management approaches. A recent blinded, randomized controlled trial was conducted to evaluate the effectiveness of knee tape. Those who were given therapeutic taping had significant improvement in pain.These effects were maintained after three weeks. Another study designed to evaluate the effectiveness of an elastic knee brace produced results that indicate small, short-term beneficial effects with acute exacerbations.

-Use of glucosamine and chondroitin supplementation appears to have both an effect on symptoms and structural changes in the knee. The results from a recent meta-analysis indicate that both glucosamine and chondroitin demonstrated improvements in joint space narrowing.

 

Dr. Natalie Meiri adjusts a patient's knee
Dr. Natalie Meiri adjusts a patient’s knee

 

Research on How Chiropractic Adjustments Can Help With Arthritis

A 2017 review in the Journal of the American Medical Association, found that spinal manipulation reduces lower back pain. And a 2013 study published in Osteoarthritis and Cartilage found that patient education combined with 12 chiropractic treatments (twice a week for six weeks) were more effective for hip Osteoarthritis than a daily stretching program or patient education alone. 

Chiropractic Care of Degenerative Arthritis of the Spine and Extremities at Meiri Chiropractic:

Typically, our program includes Chiropractic Manipulative Therapy to the spine and extremity (arms and legs) joints for 2-3 months. Then “maintenance of normal joint motion and function of the spine and extremities may be facilitated by adjusting/manipulation” (1).  

Also, manipulation of muscle contractures with soft tissue techniques may be accomplished with gentle PNF/PIR (e.g. post isometric relaxation) and/or myofascial release techniques. Next, therapeutic exercises for strengthening of the joint will help for active care at home.   Finally, recommendations on an anti-inflammatory diet will be of benefit for you.

Getting regular chiropractic treatment at a West Palm Beach chiropractic center can help naturally relieve the pain and dysfunction of degenerative arthritis of the knee. Chiropractic is a holistic and natural way to not only treat existing conditions, but to keep your body in its best working condition.

Contact Meiri Chiropractic today at 561-253-8984  to make an appointment on Knee Pain and Chiropractic Treatment: Knee Arthritis or/and other ailments.

 

References:

(1) Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011

 

 

 

 

When thinking of chiropractic, people always think it’s only for the spine.  Moreover, the question people ask often is, “can a chiropractor adjust knees?”  The answer is, yes. In fact, it is an effective natural treatment option for those suffering from many conditions leading to knee pain.  Chiropractic adjustments can help with knee pain by improving joint function, thereby providing relief.

Is knee pain affecting your life and causing discomfort and limiting mobility? In this post we will explore 3 Common Knee Injuries Chiropractic Knee Adjustments Can Help.

 

1.  Knee Meniscus Tears

The knee meniscus is the rubbery knee cartilage that cushions the tibia (shinbone) from the femur (thighbone).

You may have knee pain usually following a rotational injury to the knee. Next, there may be swelling in your knee that developed over a number of hours. And since the injury, you may have episodes of knee locking wherein you experience significant pain.  Also, you may not be able to move the leg for a few seconds until the injured knee is forcefully extended (straightened). Furthermore, you may complain of the knee “giving way”.

 

Imaging and Evaluation

There are examination (e.g. orthopedic/neurologic/chiropractic ) tests that have a positive finding for a meniscal tear. Of course, Meniscal Tears are seen on a magnetic resonance imaging (MRI).  However, clinical correlation (results of the test should be interpreted in conjunction with the patient’s clinical symptoms, medical history, and other relevant diagnostic information) with MRI findings are important.  This is because there may be other pathologies (cause of the disease) causing pain as well.

 

Cause of Meniscus Tears

Firstly, most meniscus injuries are due to combined compression with rotation at the knee. Secondly, there are many types of tears. They are generally divided into horizontal and vertical tears. Thirdly, because of the minor blood supply, meniscus tears do not bleed much into the joint. However, the free edge of the tear may cause irritation along with the synovial (thin membrane of joint) fluid production. Fourthly, the meniscus is often involved when the anterior cruciate ligament (ACL) is torn.

 

 

2.  Popliteus Tendinitis

First, the popliteus muscle lies behind the knee joint. It forms the base of the popliteal fossa (diamond-shaped space behind the knee joint). Second, it inserts at the lateral femur, lateral meniscus and inserts onto the proximal (nearer to the center of the body) tibia (shin bone). Third, the popliteus muscle does lateral rotation of the femur relative to the tibia. And this ‘unlocks’ the knee joint so that the knee can flex (bend). Fourth, Popliteus is a major stabilizing muscle of the knee.  Fifth, tendinitis is a condition in which the tissue connecting muscle to bone becomes inflamed.

You will have pain in the lateral (side away from body) knee following downhill running or walking. Your foot on the injured side may have hyperpronation problems. 

 
3.   ProximaI TibiaI-Fibular Chiropractic Subluxation (chiropractic intersegmental dysfunction/misalignment)

The tibial-fibular joint is formed by the tibia and the fibula (outer of the two bones between the knee and the ankle). The proximal tibial-fibular articulation is a synovial joint (freely movable joint). Synovial joints are the main functional joints of the body.  Synovial joint cavities contain synovial fluid secreted by the synovial membrane (synovium), which lines the articular capsule.

Movement at this joint is influenced by movement at the ankle.  Sudden forced movements (in particular dorsiflexion of ankle) may force the fibula into a fixed position. With hamstring curls, the biceps femoris (one of heads of hamstrings) may draw the fibular head posteriorly (back), leading to a chiropractic subluxation/misalignement.  If left untreated, it may lead to entrapment of the peroneal nerve by the fibula.  So compression or entrapment of the nerve may occur with the result of radiating pain down the outside lower leg.

 

 

3 Common Knee Injuries Chiropractic Knee Adjustments Can Help

The chiropractic approach to the treatment of knee injuries involves a thorough understanding of the anatomy, biomechanics, motor patterns, and kinetic chains of the lower extremity (limb), including the pelvis. Your kinetic chain is a combination of several successively arranged joints. These joints constitute a complex unit, as links in a chain.

By identifying the underlying problem or dysfunction, your chiropractor can implement a multilevel treatment protocol (detailed plan) that involves chiropractic manipulative therapy.  A chiropractic realignment will restore faulty biomechanics. Lastly, your chiropractor can prescribe exercises to strengthen weakened muscle groups and motor pattern re-education.

At Meiri Chiropractic we provide chiropractic adjustments/ manipulation for your knee and any associated regions (e.g. foot, ankle, hip, pelvic or lumbar (low back) indicated.  Additionally, soft tissue therapy (myofascial release, pressure point and various relaxation procedures) and modalities (cold/heat therapy and electric muscle stimulation) are rendered as necessary.

Do you know someone who needs Chiropractic adjustments for a knee injury? Contact Meiri Chiropractic serving West Palm Beach, Jupiter, North Palm Beach, and Palm Beach Gardens today at 561-253-8984 for this or some other ailment.