While unfortunate to note, knee pain has become all too common and is oftentimes just ignored. In many cases, everyone—from competitive athletes to everyday office workers—choose to just “power through the pain,” thinking it’s something they need to deal with as they age.
Even the most basic of activities like climbing stairs, bending down to pick something up, walking from your car to the office, and getting out of bed can become extra challenging when you are experiencing knee pain. Undoubtedly, knee pain can have a massive impact on your ability to function normally.
At Elite Spine we see a growing number of people with pain at the back of the knee. These are not only older folks or former athletes who might expect more wear and tear on their knee joints, but we are seeing younger people and office workers with back of knee pain pain as a growing trend.
Often, people with pain here might have an x-ray with normal, or close to normal findings. Meaning there is little to no Osteoarthritis (OA) of the knee joint, yet you still feel frequent pulling, tightness or pain at the back of the knee. These patients generally have various forms of soft tissue abnormalities with muscle weakness, imbalances and even scar tissue build up. Various forms of tendonitis and inflammation may also be present that requires a combined approach of therapeutics and exercise to treat properly. [please see the bottom section below]
Other common conditions which may cause knee pain are:
- Patellar tendonitis
- Anterior cruciate ligament (ACL) injury
- Osteoarthritis (OA)
- Knee bursitis
- Meniscus injury
Sometimes patients will tell us that they experience knee pain after they run. Whereas others may notice more knee pain when bending, or knee pain when walking. Both the specific locations of the knee pain and the types of activities which aggravate it can tell us useful information about which tissues may be causing the pain.
For example, runners may often experience pain at or around the kneecap which may be due to irritated soft tissues attaching at or near the kneecap, worn or torn cartilage, or strained tendons. Knee pain when bending may also be a sign of “runner’s knee” or patellofemoral syndrome (PFS). This can be aggravated by overuse, misalignment of your kneecap, or muscular weakness/imbalances in the legs.
Knee pain when walking may also be from the above mentioned issues. Other common factors which may lead to these knee pains can be:
- Poor support in the arches of your feet and/or improper footwear
- Chondromalacia patella (damaged cartilage behind the kneecap)
- Tendonitis / Tendonosis
- Lumbar spine and nerve problems
- Pelvic imbalance
Knee injuries are commonplace among those who are athletic and those who exercise on a routine basis. The knee often absorbs the force of many of our movements. Since the knee joint is flexible, one can end up hyperextending or over-rotating it when you make the wrong move.
Direct injury to the knee secondary to falls or accidents can also lead to chronic knee pain down the road. Other degenerative or systemic conditions like osteoarthritis or rheumatoid arthritis may be factors for some as well.
However, many cases of knee pain that we commonly see are usually a result from the combination of several factors, some of which are often ignored or not included in the investigations by other doctors or therapists. Beyond examining the immediate knee and surrounding tissues for signs of damage, degeneration, or improper movement…a more complete approach must involve examining the entire lower kinetic chain.
This means examining and correcting (when necessary) problems that often may surface in areas away from, but still impacting our knees. Common areas patients with knee pain might also have issues can include:
- Poor foot and/or ankle mechanics (such as over-pronation or “flat feet”)
- Possible instability due to history of ankle sprains
- Hypertonic (tight) muscles or scar tissue development in tissues which have attachments near the knee (such as muscles of the thigh or lower leg)
- Pelvic rotation or misalignment
- Lumbar spine misalignments causing nerve irritation to areas supplying the legs
If you notice the following symptoms in your knee or knees, consider it best to seek a proper evaluation right away.
● Pains or soreness in and around the knee
● Stiffness and swelling
● Instability and weakness
● Inability to straighten your knee fully
● Limping or uneven gait when walking
● Popping noises during movement
It is reassuring to know you don’t have to live with pain, take pain medications, or reduce your activity level for an extended period of time to deal with your knee pain. Our chiropractors in Singapore can effectively assess and treat the underlying issues that are causing the pain in many cases. A combination of techniques may be used to help ease the pain and rehabilitate the underlying dysfunction.
Typically we will use a multifaceted approach to knee pain at Elite Spine Centres. Common treatments we may use for this condition may include:
- Instrument assisted soft tissue mobilisation (IASTM) - special designed tools which allow our chiropractors to find and break up hardened scar tissue in and around the knee joints.
- Radial Shockwave Therapy (RSWT) - An advanced therapy designed to also address scar tissue and stimulate the healing process to begin and accelerate.
- Low Level Laser Therapy (LLLT) - Another advanced therapy useful for reducing inflammation, decreasing pain, and speeding up the healing process.
- Manual adjustments to the knee, foot/ankle, hips and lower spine. Improper alignment or movement in any of these areas may lead to knee pain.
- Physiotherapy to restore proper flexibility and stability to the lower body and keep pain from coming back again.
Our chiropractors will investigate if alignment issues in other areas of the body may be causing or contributing to the pain. For instance, tightness in the lower back or limited range of motion in the hips can place excessive strain on the knees and cause pain. Thankfully with our customised chiropractic care and therapy programmes, similar issues can be addressed effectively at the same time as your knee treatment so you can live pain-free and enjoy your life to the fullest.
Don’t settle for a partial solution which may not fully address the underlying reasons for your knee pain, or worse, maybe allow it to degenerate more rapidly. Allow our expert chiropractors at Elite Spine to help you fully understand your condition, and teach you how to resolve it for good.
Author: Dr. Michael Bryant