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spinal conditions, knee pain and disability is one of the
most common ailments of the musculoskeletal system. Problems
with the knee can be classified into three categories:
- Poor
mechanics or overuse of the knee joint
- Traumatic
injury from events such as sports and falls
- Problems
due to arthritic changes in the joint.
Patella
Femoral Syndrome (Knee Cap Pain):
Poor
mechanics of the knee joint and the associated stress upon
the soft tissues of the knee is by far the most common cause
of non-traumatic pain. The most common part of the knee
affected by this is the patella or knee-cap. Often the patella
does not move smoothly or does not move sufficiently on
the femur during bending of the knee causing abnormal stresses
upon the tendons cartilage and ligaments. This condition
is often called chondromalacia patella or CMP though a better
term is patella femoral syndrome. The problem usually originates
when there are imbalances in the quadriceps muscles of the
thigh which attach to and move the patella.
Repetitive
Knee Strain - Overuse Injury:
Imbalances
in other muscle groups that attach to the knee can also
lead to pain and dysfunction. As an example, the muscles
on the inside of the thigh when strained and tight can cause
pain on the medial or inside side of the knee.
Lower
back problems especially in the sacroiliac joints, are one
of the main reasons for imbalances in the muscles associated
with knee movement and subsequent knee problems. Foot problems
that cause gait abnormalities such as pronation are another
cause of mechanical knee pain.
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 correct any subluxations of the sacroiliac joints and
foot problems. In certain cases, a brace is used to help
with the alignment of the patella or to stabilize the joint.
Dr. Cady is ideally trained to provide the proper diagnosis
and management of these problems.
Trauma:
Traumatic
injuries often occur during sports that involve running
and jumping, such as football and basketball, and with activities
such as skiing. When the knee is stretched or twisted beyond
the strength of the ligaments that hold the joint together,
tearing of these tissues can occur causing a sprain. The
muscles that move the knee can also be torn during injury
causing a strain or pull of the muscle. As with a sprain,
a muscle strain can vary from a minor injury that requires
little care to a severe injury requiring surgery.
The
knee also contains two special "cartilages" -
the menisci - between the tibia and the femur that provide
for smooth movement and cushioning. These cartilages can
also be torn during trauma and often require surgical repair
or removal if damaged severely. Traumatic knee injuries
can cause severe pain and swelling and require immediate
evaluation and attention. In most cases Dr. Cady can manage
these conditions, though there are some injuries that do
need the expertise of an orthopedic surgeon. In any case,
it is important to stabilize the injured joint and ice if
possible until you can get the injury evaluated. If poor
mechanics or traumatic injuries are not corrected at an
early age, the tissues of the knee joint especially the
cartilage will eventually begin to wear out. As a result
the bones rub upon one another and changes such as bone
spurs can occur. This painful condition is known as degenerative
joint disease or osteoarthritis and is often progressive
with age.
Treatment:
Dr.
Cady will carefully evaluate the motion of your knees, ankle,
foot, and lower back in order to determine the best treatment
for your specific problem. Correcting the motion in the
knee will improve the circulation, thereby reducing the
inflammation and pain the knee. Physical therapy modalities
such as ultrasound, electrical muscle stimulation, ice and
heat can be used to speed up the healing time. As you improve,
specific stretches and exercises can be implemented to help
stabilize your knee.
There
is some evidence that nutritional substances such as Glucosamine
and Chondroitin can be helpful in the long term management.
People can often help themselves by keeping their weight
down, doing exercises especially in the pool, and wearing
cushioned shoes or insoles.
Call
us at 408-739-2273 to make an appointment
today.
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