Conditions

Knee Pain

Knee pain is mostly caused by sudden or repetitive trauma, though some postural strains are possible with holding long positions at deep ranges of motion. Most types of knee pain have pre-existing risk factors that can be managed to reduce your risk of developing knee issues (or reduce your risk of it returning once it has).

Common issues with sudden trauma include muscle strains, ligament sprains, and meniscus issues. Common repetitive issues involve irritation of tendons attaching around the knee, the knee cap joint, and the knee joint itself such as arthritis.

Knee pain is associated with a significant reduction in quality of life and functional ability. Significant risk factors for knee pain include muscle strength around the knee and hip joints, activity pacing, and overall body weight. Since most knee issues develop over time if risks are not managed, keeping healthy knee joints is key to prevention. It is common for smaller knee sprains, strains, and meniscal issues to lead to larger problems if not addressed early on.

Chiropractors are well positioned to help diagnose and treat existing knee issues, as well as building a rehabilitation plan to address weaknesses and reduce risk of issues going forward.

Chiropractor knee brace on athlete resting

Causes of Knee Pain

A tear to one or more of the quad muscles on the front of our thigh. These tears can range from small microtears and overstretching (grade 1) to full ruptures (grade 3).
Treatment depends on the grade of the strain and phase of healing. Usually this involves soft tissue therapy to the muscle(s) to relieve pain and speed up recovery, and a graded re-strengthening program to restore full strength and prevent future issues.
A strain to one or more of the hamstring muscles on the back of our thigh. A mild strain involves overstretching of the muscle, a moderate strain small tears, and a severe strain a complete tearing or rupture of the tissue.
These are common injuries that Chiropractors treat. Treatment involves soft tissue therapies and strengthening exercises that are done based on the severity of the strain and the phase of healing.
Our IT band attaches to the outside of our knee just below and toward the outside of our knee cap. It comes from a muscle in the hip (the TFL), and the bands attachment point can become irritated or inflamed. This can happen with overuse, but is also more common when knee and hip control or muscle weakness issues are present. Since the IT band is not a muscle but connective tissue, direct treatment over the area is often ineffective.
Chiropractors that work with athletes commonly treat this issue.
Treatment involves soft tissue work on the muscle in the hip that the band comes from, but mainly emphasizes exercise therapies to improve knee and hip strength and control, as well as walking or running gait modifications and activity pacing strategies.
Patellofemoral pain syndrome, or runners knee, is a very common cause of knee pain on the front of our knee. It is usually on or around the knee cap joint, sometimes near the top and sometimes on the bottom or the sides.
It is a repetitive overuse injury, and although it is known as runners knee, many activities cause this issue.
This is a very common knee issue that Chiropractors working with athletes treat. Treatment involves soft tissue therapy to the quadriceps muscles (usually myofascial release or instrument-assisted therapies) to reduce compressive and tensile force on the knee cap joint. Joint therapies such as joint mobilizations / joint glides to the knee cap joint (patellofemoral joint) are also very helpful. Exercise therapies may be needed for persistent cases to improve knee and hip muscle strength and control.
Our patellar tendon attaches just below the knee cap to the tibia bone. This tendon can become inflamed (tendinitis), or wear down over time (tendinosis) if chronic. Unlike runners knee, this often has more to do with dynamic loads and movements such as jumping or quickly accelerating / decelerating. These movements require more tendon capacity, since our tendons help us to perform dynamic movements by their elastic properties.
We tend to lose this elasticity as we age, but also if the area is weak or underused. It is common to have this issue develop soon after starting a new dynamic activity, such as jumping sport or a new workout plan.
Treatment involves soft tissue therapies to the quad muscles to reduce the tensile force of the tendon pulling on its bony attachment, then certain exercise therapies that are chosen depending on whether it is a tendinitis or a tendinosis.
Bursitis is inflammation to one or more of our bursae, which are fluid-filled sacs that help to lubricate tendon motion near their attachment point.
The knee has several bursae, some of which are irritated with direct pressure such as kneeling on a hard surface, and others with repetitive knee motion where the knee tissues themselves irritate the burase.
Types of knee bursitis include:
Prepatellar bursitis
Pes Anserine Bursitis
Infrapatellar Bursitis
Baker’s Cyst

Our MCL (medial collateral ligament) supports the inside of our knee joint. Sudden or repetitive forces where the knee deviates inward (toward your other leg) cause this tissue to get injured.
Sprains are graded from grade 1 (mild) to grade 3 (full rupture). MCL sprains are treated by supporting the torn ligament through it’s healing process. This is done by supportive soft tissue therapies and exercise therapy to speed up recovery and improve muscular support to the area. It is common that balance and knee control also need to be trained after a ligament sprain, this is especially true if a repetitive knee control issue led to the sprain to begin with.
MCL sprains that are not treated may lead to uneven distribution of stress on the knee (including the joints) over time, and can accelerate knee arthritis.
Our LCL (lateral collateral ligament) supports the outside of our knee joint. Sudden or repetitive forces where the knee deviates outward cause this tissue to get injured.
Sprains are graded from grade 1 (mild) to grade 3 (full rupture). MCL sprains are treated by supporting the torn ligament through it’s healing process. This is done by supportive soft tissue therapies and exercise therapy to speed up recovery and improve muscular support to the area. It is common that balance and knee control also need to be trained after a ligament sprain, this is especially true if a repetitive knee control issue led to the sprain to begin with.
LCL sprains that are not treated may lead to uneven distribution of stress on the knee (including the joints) over time, and can accelerate knee arthritis.
Our ACL (anterior cruciate ligament) is located deep in our knee joint. It helps to prevent the lower part of the knee (the tibia), moving forward on the upper part of the knee (the femur).
This ligament functions to help control sudden forward and backward motions of the knee, and as a result can be sprained in these motions. This happens especially with sudden unguarded motions at higher speeds, and with poor knee muscle control or weakness.
Symptoms include a sudden pain and sometimes audible pop. Often there is swelling inside the knee joint, and giving way of the joint when trying to weight bear.
Treatment depends on the severity of the sprain, and typically involves gentle range of motion exercises, balance and gait retraining, and a graded re-strengthening program as the ligament heals.
The PCL (posterior cruciate ligament) is located inside the knee joint. Like the ACL, it functions to help the knee tolerate backward and forward motions. It can also be sprained with sudden motions, usually when the knee is bent and the lower bone is moved backwards on the upper bone.
Like the ACL, sprains to the PCL can be felt as a sudden pain that limits activity with a sometimes audible pop. There is often swelling inside the knee joint, and the joint may give way in certain motions.
Treatment depends on the severity of the sprain, and typically involves gentle range of motion exercises, balance and gait retraining, and a graded re-strengthening program as the ligament heals.
Our meniscus is knee’s our shock absorber located on the bottom of the knee joint. It can be torn or injured with sudden trauma, or as a result of accumulative issues over time. Though some meniscal injuries may need surgery, most do not (depending on the severity of injury and location of the tear).
Symptoms can include knee pain, limited range of motion, swelling, and in particular a locking or “catching” of the knee during motion.
Treatment involves an initial inflammatory management period, followed by a graded rehabilitation protocol to restore mobility, modification of walking and other biomechanics, improving knee control and posture, and graded re-strengthening.
Like ligament sprains, untreated meniscal issues can lead to uneven and inefficient biomechanics over time that leads to additional knee issues.
Knee osteoarthritis is a common issue, estimated to effect at least 10% of adults. It is a gradual onset issue that involves risk factors such as activity levels, knee strength and control, and weight over time. The best way to treat knee arthritis is through prevention - identifying and managing risk factors. One helpful way to do this is to make sure that other knee issues are addressed early on and do not lead to improper joint mechanics. Once arthritis is present, however, treatment can still help to relieve symptoms and improve function. How well treatment works depends on the severity of arthritis. Mild-moderate arthritis responds well to exercise therapies that improve joint mobility, control, and strength. Modifying biomechanics with activities and learning to pace activities may also be helpful. Severe knee arthritis may need full joint replacement, and this also requires pre and post-surgical rehabilitation.