“Oh by the way, my knee has been bothering me.”
That is one of the most common phrases heard in our office, particularly as seasonal changes also change our physical activities. With it being the holiday season (EAT! EAT! EAT!) most patients associate unknown knee pain with an increase in body weight. However, A recent study posted by the National Institute of Health confirmed that increased obesity accounted for only a small percentage of the increasing prevalence of knee pain. The overall cause of the pain in this study was “unknown.”
There are numerous causes of knee pain, some more insidious than others, many of which don’t actually originate with the knee. If you’re experiencing knee pain, it is important that you receive a proper examination to check for the cause of the pain. That being said, here are a few of the more common and less insidious causes of knee pains that I encounter regularly.
The knee joint itself if composed of cartilage on the ends of the thigh bone (Femur) and the shin bone (Tibia). The Patella protects the front of the knee joint and underneath the kneecap two C-shaped pieces of cartilage called the medial and lateral menisci act as shock absorbers between the femur and tibia. All together the knee is designed to absorb shock and provide a smooth, gliding surface for joint movement. Tendons connect the knee bones to the leg muscles that move the knee joint. Ligaments join the knee bones and provide stability to the knee.
Pelvic imbalance earns top honors as the most popular reason for knee pain. When there is imbalance in the pelvis; whether due to joint dysfunction, muscle tightness, or a combination of both, it will cause a rotation of the pelvis. When the pelvis rotates it causes one leg to pull up and become shorter than the other. This leads to unequal weight distribution, and as confirmed through MRI studies, will cause joint damage and leads to osteoarthritis. To check for pelvic imbalance, simply remove your shoes, lie flat on your back, and have somebody check to see if the bony bumps on the inside of your ankles match up. If they aren’t equal, then nor is your weight distribution.
To correct these imbalances you must have your chiropractor address any joint dysfunction as well as any tightness found in the psoas or piriformis muscles. It is also important to target these muscles as part of a regular, gentle stretching routine. Be patient when stretching, these muscles must be retrained over time and with consistency. Overstretching is always a concern as this will cause a muscle to contract and tighten instead of loosen and lengthen. Start your stretches slowly and ease into it, supporting yourself however necessary.
Perhaps your knees don’t hurt, but just feel stiff. Old injuries and dysfunction in your ankle joints also lead to knee stiffness. When the ankle joint is injured and left untreated, it will not allow the full range of motion necessary to promote proper biomechanics. When there are abnormal biomechanics of the knee, a small muscle behind the knee called the popliteus muscle will spasm in a compensatory effort to limit the forces into the joint, creating loss of motion and subsequently lead to chronic stiffness and osteoarthritis.
If you suffer from chronic right knee pain, your gallbladder (or lack therof) may be the source. Our organs don’t sense pain very well, in fact only 10% of our nerves can sense pain. When there is a problem with an organ, people often experience what is known as “referred pain.” A classic example is a heart attack and its association with pain in the arm. Another referred pain is gallbladder pain referring to the right knee or right shoulder blade. The gallbladder is responsible for storing and releasing substances that allow us to easily digest fats in our meals. When somebody eats food with a high enough fat content to overwork the gallbladder, referred pain can occur. Individuals without a gallbladder generally have a lower threshold for fatty foods because they lack the storage and secretion of these substances. There are a number organic, food-based, non-prescription supplements that will promote healthy fat digestion and eliminate referred pain.
Another common cause is due to spinal nerve irritation. When somebody damages their lumbar spine with daily, chronic stresses of sitting or heavy lifting it can lead to joint dysfunction and irritation. If these dysfunctions are not addressed, these stresses will compound daily on a more inflamed joint. Just like your ankle swells when injured, so do our spinal joints. Our spinal nerves exit between the bones of our spine, intimately close to our joints. In fact, the joints in the spine provide the exits portals for the nerves of the spinal cord. These nerves originate in the brain, travel to all parts of the body, and modulate every process of your body. These nerves are responsible for relaying signals and information about everything in our body to and from our brain.
When left unresolved, joint dysfunction will cause enough inflammation to irritate these sensitive tissues leading to a disruption in muscle coordination. When the muscles don’t coordinate congruent biomechanical movements on the knee joint, the knee will suffer serious damage. Often times, there are other signs of spinal nerve irritation such as: favoring a certain side when sitting/standing/walking, numbness/tingling/weakness in hands or feet, unresolved diarrhea or constipation, leg spasms or dull cramps, or even restless legs. Resolving the joint dysfunction will remove the roadblock and allow your body to begin healing the nerve and the joint to normal.
This article covers some common types of knee pain; however there are more rare, yet sinister, causes of knee pain. If you experience knee pain it is strongly recommended you seek the diagnosis of a qualified healthcare professional. If you have questions about the treatments discussed or would like to know more about knee pain, please feel free to email me,, Dr. Brack at email@example.com and put “Knee Pain” in the subject line.