Knee X-ray

Individuals over 65 years of age with knee osteoarthritis (OA), that practice Tai Chi, improve their physical capability and encounter decreased pain, according to a new Tufts University School of Medicine study. Osteoarthritis is a common form of arthritis that brings about a breakdown of joint cartilage. Chiropractors treat many individuals who suffer with OA in a number of regions of the body, including the knee joints. Second only to spinal problems, knee pain and disability is one of the most widespread afflictions of the musculoskeletal system. In fact, an astounding 4.3 million individuals in the U.S. over age 60 have been diagnosed with knee OA, according to the CDC, and it anticipates that by age 85, half of the people in America may incur symptoms of OA. The consequences of knee osteoarthritis are pain, mobility limitations, functional disabilities, and a decreased quality of life.

Are you wondering why so many men and women develop OA? As with nearly all of the musculoskeletal conditions that we develop as we get older, undue stress to a joint over the years is a major element. That is why as people get older they are more susceptible to developing OA in their knees, as well as other joints. Improper mechanics of the knee, irregular gait, compensatory foot mechanics as the result of foot pain, and repetitive use of the knee joint all produce excessive stress on the knees. Eventually arthritic changes in the knee joint develop. As an adjunct to chiropractic therapies, chiropractors enthusiastically advocate natural, drug-free practices, such as Tai Chi (Chuan), that can mitigate knee pain. A traditional style of Chinese martial arts,Tai Chi features slow, rhythmic movements that create peace of mind, as well as an enhancement of balance, an increase in strength, and more flexibility.

The 40 participants in the Tufts study were, on average, 65 years of age, overweight, and with confirmed osteoarthritis of the knee. Otherwise they were healthy. Individuals were selected at random to participate in 60-minute “Yang style” Tai Chi sessions twice weekly for 12 weeks. Each session included a 10-minute self-massage and a review of Tai Chi principles, 30 minutes of Tai Chi movement, 10 minutes of breathing technique, and 10 minutes of relaxation.

Tai Chi incorporates many of the current exercise protocols for OA, such as range of motion, flexibility, muscle conditioning, and aerobic workout. Furthermore, researchers found that the “mental aspect” of Tai Chi stimulated a sense of well-being, life contentment, and perceptions of health that helped the participants to deal differently with chronic pain. Compared with the control group, the group practicing Tai Chi exhibited a substantial decrease in knee pain.

Full findings of the study are published in the November 2009 issue of Arthritis Care & Research, a journal of the American College of Rheumatology.

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Non-trauma knee problems: The most prevailing cause of non-traumatic pain is deficient mechanics of the knee joint and the corresponding stress on the soft tissues of the knee. Normally, the part of the knee implicated is the patella or knee-cap. Many times the patella does not move smoothly or does not move efficiently on the femur during bending of the knee causing too much stress on the tendons, cartilage and ligaments. This particular condition is frequently called chondromalacia patella (CMP) or Patella Femoral Syndrome (Knee Cap Pain). This problem is due to imbalances in the quadriceps muscles of the thigh that attach to and move the patella. Lower back conditions, especially in the sacroiliac joints, are one of the primary reasons for imbalances in the muscles associated with knee movement, and subsequent knee problems. Pain and dysfunction can also be generated by imbalances in the muscle groups that attach to the knee. For example, pain on the medial or inside of the knee occurs when the muscles on the insides of the thigh are stretched and taut.   Mechanical knee pain is also produced by gait deviations such as pronation.

Evidence of overuse includes pain during activities such as climbing stairs, running, jumping, as well as pain upon getting up after prolonged sitting. Some women appear to be predisposed to painful overuse problems for anatomical reasons, although such problems are many times related to wearing high heels on a regular basis.

The main treatment for mechanical or overuse injuries to the knee is to re-establish proper balance of the muscles, restore proper movement to the patella and other joints of the knee, and to correct any subluxations of the sacroiliac joints and bones of the foot.  In some cases, a brace is required to aid with the alignment of the patella or to stabilize the joint. Chiropractors are completely trained to provide the proper diagnosis and management of these problems.

Knee problems due to trauma: Traumatic injuries often occur during physical exertion that involves running and jumping, particularly. Sprains take place when tissue is torn due to the knee being stretched or contorted beyond the facility of the ligaments that hold the joint together. The muscles that give motion to the knee can also be torn during injury creating a strain or pull of the muscle. As with a sprain, a muscle strain can range from a slight injury that needs little care to a extreme injury necessitating surgery. The knee also has two special “cartilages” – the menisci – between the tibia and the femur that facilitate smooth motion and cushioning. These cartilages can also be torn during trauma, and frequently need surgical repair, or even removal if damaged severely.

Traumatic knee injuries can create severe pain and swelling and require immediate diagnosis and attention. In the majority of cases a competent chiropractor can take excellent care of these conditions, however there are some injuries that require the dexterity of an orthopedic surgeon. In any event, it is very important to stabilize the injured joint as soon as possible and to ice the injured area, if possible, until the injury can be assessed.

If poor mechanics, overuse problems, or traumatic injuries are not eliminated at an early stage, the tissues of the knee joint, particularly the cartilage, will begin to wear out eventually. If tissue and cartilage deteriorate, the bones will rub together unprotected and changes such as bone spurs can take place. This painful affliction, known as degenerative joint disease or osteoarthritis, is commonly progressive with age. General treatment may involve medications such as NSAIDS (non-steroidal anti-inflammatory drugs). Fortunately, there are natural anti-inflammatory supplements that are very effective such as rosemary, glucosamine sulfate, chondroitin sulfate, bioflavinoids, curcumin. Conservative treatment, such as chiropractic, can be extremely helpful in alleviating the pain. Your chiropractor is very knowledgeable about anti-inflammatory supplements. In addition, people can frequently aid themselves by keeping their weight down, doing exercises (especially in the pool), and wearing cushioned shoes or insoles.

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