Knee Problems

One the most common physical problems many people suffer from is knee pain. Medicine ad science has made great strides in the information of knee dysfunction or injury. There is lots of studies, and vast amount of knowledge of torn cartilage or meniscus, sprain or torn ligaments, arthritis, and loose bodies in the knee. Applied Kinesiology (AK) has expanded on the information available on why these injuries / conditions develop. The most obvious, is a serious traumatic structure accident. For example, a person being tackled in a football game or from some other direct injury. Often these injuries happen when the football player is running full speed, and cuts suddenly to change direction; or when a person rises from a stooped position. In other words, the problem develops during an activity similar to that done on a day-to-day basis without injury. Suddenly, in one instant, the injury manifests for some unexplained reason from the same activity.

The knee is considered a rather simple hinge-type of joint that is moved through its range of motion by the muscles attached to it, primarily straightening or bending the leg. The joint consist of two pads, called the semilunar cartilages, meniscus. Sometimes the cartilage could be torn and require surgery. Surgery may also be necessary to remove loose bodies from the inside the joint, and to tie torn ligaments back together.

The muscles were once considered simply the motors that move the bones of this joint; however, it has been recognized in AK that the muscles also provide stabilization to the joint, in addition to the ligaments that limit the joint’s range of motion. Many knee problems are the direct result of improper support to the knee joint from the muscles that attach above and below it.

If one or a group of muscles becomes weak, the knee may lose some of its stability in that direction. The knee consists of a group of muscles that lie in the front, back, and sides of the joint. If the muscle(s) on the middle side of the knee is weak, there is little to keep it from bending toward the center. If this condition is present and the individual strains his knee in that direction, it may lead to injury. This can cause something as simple as a trick knee or a much more serious condition, such as a catching of the cartilage as the knee goes through its range of motion, causing a tear.

By testing the individual muscles of the knee, an applied kinesiologist can find the area of limited strength. Further evaluation of the weakened muscle gives the doctor information to improve its function. Usually, the cause of the problem is rapidly found and corrected, providing an immediate strengthening of the muscle(s) at fault.

Total Body Structural Balance

The knee is often involved on a secondary basis. We sometimes tend to think of the body as segmental functioning units; however, this is not the way it works. The body’s structural balance must be in complete harmony for it to work as a total, integrated whole. When the knee is examined by a doctor, it must be examined with this holistic concept in order to avoid treating effects rather than primary causes.

Foot-Ankle

The foot and ankle, when functioning improperly, may cause strain throughout the body. The knee is one of the primary areas receiving strain from the foot. You can observe this by standing and making your foot go into a flat-footed position; watch your knee roll inward. If a person has a pronated or flat foot, the knee receives shock with every step. This is a mechanical strain that may cause leg and knee pain and may eventually cause knee damage.

Within the foot there are nerve endings, call proprioceptors, which transmit information to the muscles of the leg and the rest of the body as a person walks. If the foot is not functioning normally, there is a definite chance these nerve messages will go to the body in a confused manner, resulting in poorly integrated muscle action. If the muscles receiving improper messages are knee-supporting ones, it is logical that there will be poor knee support.

Pelvic Balance

The bones of the pelvis and lower back and their associated muscles contribute to knee balance. If the pelvis and its associated structure are off-balance, a structural strain similar to that from improper foot action will develop in the knee.

Reactive Muscles

All muscles have proprioceptors, which are nerve endings that sense muscle activity. This sensory information goes to other muscles that work in harmony with, or opposite to, the muscles sending the information. This information exchange between muscles is absolutely essential for coordinate, harmonious action. An example of these activities of these nerve endings and the communication between muscles is found when one muscle contracts and the muscle working in the opposite direction relax. This organization between muscles depends on normal nerve function of the proprioceptive mechanism. Sometimes – because of injury – the proprioceptors send improper, disorganized information that may cause a muscle to relax at a time when it is most needed for support. A football player or basketball player might be running and suddenly cuts to the side to avoid an opponent. If a proprioceptor is incorrectly stimulated during the act of cutting, this erroneously causes the medial (inner) muscles of the knee to weaken. The knee may then bend medially (towards the midline of the body), jamming the outside cartilage and possibly causing a tear. The same thing could happen during the innocent activity of rising from a kneeling position in your living room. In this example of reactive muscles involvement, the muscles supporting the knee will all test normal during your AK initial examination.

Arthritis

The most common kind of arthritis in the knee is osteoarthritis (OA), also known as “wear and tear” type. Click to arthritis for more information.

Bursitis

Bursitis is an inflammatory reaction in the bursa (the lubricating membrane) of a joint. Here again, excessive strain increases the potential for development of bursitis. Click to bursitis and Tendinitis for more information.

Gait Evaluation

Correlated with the proprioceptive mechanism and reactive muscles outlined above is evaluation of the muscles as they operate in a normal walking and running gait. Sometimes muscles seem normal when tested individually; when certain gait muscles are tested simultaneously, they become weak. This causes abnormal walking and running pattern, which can contribute to the dysfunction in any of the joints or structures used by the mechanisms of normal gait patterns.

Whenever a knee is involved, even if it appears that there has been a direct injury, Dr. Sahara must do a considerable amount of detective work to be sure the primary problem / cause is being treated. As mentioned earlier, a knee injury can be result of a foot, pelvic, TMJ / jaw joint, supporting muscle, or gait problem. If the primary problem is not treated, it remains as a hidden cause to cause a knee injury in the future. This happens to individuals who are often considered to have “weak knees”. Eventually, they will usually develop a torn ligament or cartilage, necessitating surgery.

As always, effective treatment depends on finding the underlying cause of the problem and directing treatment in that direction.

Written by Systems DC, Pueblo, CO, edited and added to by Darrick E Sahara,D.C.,Inc.

“When educated intelligence can communicate with innate intelligence, a point at which the not too distant future may hold, then a correct diagnosis and treatment will be made and rendered.”

– D.D. Palmer, Chiropractic Founding Father