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Knee Rehabilitation Considerations

                Patella knee support Royalty Free Stock Photos

Dear Dr. Caraotta,

I have knee pain and have been going through physical therapy for about 9 weeks now and it does not seem to be getting better. Can Chiropractic help this?

Dr. Caraotta's Response

Joint manipulation to the knee as well as the spine could be very helpful in knee problems. Knee pain is often associated with weakness and inhibition of the knee extensors, that is, the muscles that cause the leg to “kick out” commonly known as the quadriceps.

Traditional treatment protocols have included physical therapy/rehabilitation programs and even surgical intervention. However, the lack of full recovery has been related to strength deficits and the inability to achieve full recovery of the affected structures is often associated with nerve pressure.

Recent research has suggested that the nerve pressure needs to be overcome before significant improvement in muscle strength and function can be achieved. There was a pilot study performed to establish whether quadriceps inhibition (nerve pressure to the quadriceps) in patients with anterior knee pain was affected by spinal (sacroiliac) joint manipulation.

18 subjects with chief complaints of anterior knee pain participated in this study. After following a series of correction of spinal (sacroiliac) adjustments, it was shown to decrease the nerve pressure going to the quadriceps muscles which controls the knee. It was also evidenced that patients who were treated this way, had an increase in knee extensor power.

This could explain why some individuals who do not have the benefit of spinal and knee joint manipulation have knee problems in spite of a long course of rehabilitation.

Sincerely,

Dr. Jacob G. Caraotta