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  • JH Backcountry Health

Strong Knees for Life

Knee pain is one of the most common ailments we treat. Often, it’s that nagging soreness in the back of the knee after a day of skiing that returns a little sharper the next morning. Or it’s the tweak on the front of the knee when bending your knee, whether it’s going up stairs or down moguls. Maybe you landed hard on it and don’t think it’s your ACL, but something just doesn’t feel right. As sports chiropractors, we are here to diagnose and treat, and to guide you in the right direction, whether it be reducing inflammation and allowing the injury to heal, rehab exercises, or a referral for imaging.

IT Band or Pes Anserine Tendonosis. In runners and skiers, knee pain is often associated with the insertion of the IT band on the lateral knee just under the kneecap or the pes anserine tendon where multiple thigh muscles attach on the medially side of the knee. Both of these are typically related to gait dysfunction where the knee deviates towards the center, basically caves in, with weighted knee flexion. Try a one leg squat and watch where your knee goes. It isn’t that the muscles are too tight; you can foam roll them repeatedly and it doesn’t help much. The muscles are getting over stretched as your knee torques in and pulling on their tendinous insertions. As sports chiropractors, our job is to help correct your gait by analyzing your gait mechanics. First, we release what is restricting motion. Often flexion of the big toe is lacking, keeping you from rolling your weight onto that toe and using it to push off in gait. Then we work together on stabilizing and strengthening the weaker areas to restore a functional gait, so you won’t be putting your knee through aberrant patterns.

Post-surgical restrictions in range of motion. Often there is restriction in the knee preventing full flexion or extension after knee surgery, whether it be an ACL repair, meniscus cleanup or total knee replacement. We work through the scar tissue and adhesions with Active Release Techniques, Instrument Assisted Soft Tissue Mobilization/ scraping, or cupping to restore full motion. We will also look at your hips, feet, and gait mechanics, as often those are affected due to compensation patterns during the injury or recovery.

That ache behind your knee. We see this a lot in the winter, both in skiers and snowboarders. We will check the PCL for signs of strain and palpate for a baker’s cyst. However, more frequently the pain is related to the muscles on the back of the leg. The hamstring and gastrocnemius tendons cross behind the knee and this area often becomes inflamed and sore. Foam rolling your hamstrings and calves regularly can help prevent this. Getting Active Release Techniques here helps relieve the area when it is already inflamed so that you can get back on the mountain.

Patellar tracking issues develop when your lateral quad is being used more than your medial quad, and the tension pulls your patella (the kneecap) laterally. Over time this can irritate the cartilage under your patella from the constant grinding and lead to chondromalacia patella, where you feel the pain directly under your knee cap and may have swelling.

Why see a sports chiropractor for knee pain?

We look for dysfunctional patterns that are causing or contributing to the pain and address them. We are not going to just look at your knee, we are going to examine the joints above and below. Restrictions in your foot and ankle dynamics will dramatically affect the forces on the knee. If your ankle isn’t doing it’s job as a shock absorber during gait, then it is taking a toll on your knee. Hip mobility and especially stability also plays a huge role in knee pain, and we will always examine that.

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