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The knee is a complex joint with several gliding surfaces, cartilage pads and strong ligaments.  Due to the complexity the knee is often injured.  Here are some common knee problems and treatments I perform in the office.

1. Acute knee strain/sprain.
   This usually involves a twisting injury and may involve hyperextension where the knee goes back too far.  Immediate application of ice for swelling and an elastic bandage for compression and support is recommended.  In fact, it's a good idea to use the R.I.C.E. technique with any strain/sprain.  Rest, Ice, Compression, and Elevation.  If your knee injury was accompanied by a popping noise, it may indicate that you have torn a ligament.  Especially likely for those who hear a very loud pop.  I nearly always recommend Pro-Infla-Zyme in cases of acute inflammation.  This product contains the enzyme protease which acts at the site of inflammation to break down inflammatory agents.  In a study on the enzyme protease and it's effect on inflammation following knee surgery the enzyme group took only 7 days to be able to bend their knee 90 degrees after surgery compared to the placebo group which took 9 days.  In addition, the enzyme group showed a significant drop in postoperative edema and pain. (7) In another study (double blind) of post operative inflammation the enzyme group had only 8 days of hospital stay compared to fourteen for those in the placebo group.  (8)
   
   A thorough knee examination will help determine if your strain/sprain includes damage to the meniscus (cartilage pads) or major ligaments (collateral or cruciates).  I send patients for a MRI (soft tissue scan) if I suspect a torn ligament or a badly damaged meniscus.  In cases where a ligament is torn or a meniscus is badly damaged, I refer to an orthopedic doctor for a surgical consultation.
   
   
2. Knee subluxation (misalignment)
   After even a mild knee injury, the tibia, fibula or femur may be misaligned and cause soft tissue irritation and track incorrectly; often times causing an inner or outer knee joint pain that persists and worsens with activities like hiking, long walks, or bike riding.  One to several adjustments are necessary to realign the knee.  Once the knee is realigned with manual adjusting techniques, the knee can repair in the correct position and joint surfaces can track correctly.  Supporting exercises with resistance bands or riding a stationary bicycle backwards may be necessary.
   
   Supplementation with sulfate products is helpful as well.  The sulfate helps the cartilage to repair.  Glucosamine and chondroitin sulfate are good choices.  Shark cartilage is a large sulfate molecule and due to low absorbency, I do not recommend it alone.  N-acetyl glucosamine appears to have the greatest ability to be assimilated in the body.  I recommend taking Glucosamine Plus starting with 3 tablets a day for the first bottle, two tablets a day for the second bottle, and then one a day for another bottle.  That generally is enough.  Although some with associated conditions like arthritis, or those who are very active choose to continue on with regular sulfate supplementation.  I personally use sulfate supplementation when I am training heavy in the gym or when I am running more than ten miles a week.
   
   
3. Osgood-Schlatters Disease.
   This is a condition where the patellar ligament pulls out of the tibia from over-activity during the adolescence years.  It's actually an avulsion fracture of the tibial tuberosity.  During our growth and development years our bones and ligaments are softer and growing rapidly.  If kids are very active they can cause the ligament to pull out of the bone and displace a bone segment.  This causes a great deal of pain and inflammation at the bump below the kneecap on the lower leg bone.  This is something I see come up more and more as many kids and parents take sports very seriously these days.  I have a great treatment plan that has worked very well for many kids.  I adjust the tibial bone to re-set the displaced segment back into the tibia.  Then, I will make a splint with tape and a modified tongue depressor.  In addition, I may recommend an osgood brace to be worn during play.  Generally this means a few days off sports at first and then a splint or brace worn during high activity.  Kids will grow out of this problem as their bones mature, but it is very painful and will keep kids from play.
   
   This treatment will get them back into the game, and best of all, alleviate the majority of the knee pain very quickly.  Generally two to four treatments are all that is necessary.  Post game treatments may be necessary if kids are re-injuring themselves in sports.  I also show the kids how to make their own tape and tongue depressor splint and to use the brace if necessary.  In addition, I recommend Pro-Infla-Zyme for the inflammation.
   
   
4. Post operative knee pain.
   People who get knee surgery, often end up with a residual, ongoing, nagging, little knee problem and some times a it's a bigger problem.  What the Orthopedist and Physical Therapist usualy miss, and do not treat is any misalignment that may exist in the joint.  In these cases, adjusting the knee to correct misalignment is necessary.  Three months of sulfate supplementation with Glucosamine Plus also makes a big difference for most.