Condition: Chronic Knee Pain for Over 30 Years
Symptoms: 52-year old female patient presents a constant, sharp, burning, shooting, and numbing pain in her knee. The pain was an 8 out of 10 on the pain scale.
Findings: Radiographs of the right knee revealed severe arthritis and swelling in the right knee as well as patella alta; an abnormal position of the knee cap. The patient has a history of repetitive stress to the knee especially when walking stairs. From examination, joint misalignment and dysfunction were found in the right knee, ankle, and foot as well as pelvis and spine. There was outward rotation of the tibia (the large bone of the leg) which is a major component to the knee joint as well as rotation at the sacrum and lumbar spine. Muscle weakness was found in the right hip flexor and popliteal muscle of the knee. This weakness of the popliteus prevented proper locking and unlocking of her knee joint while walking. The rotations at the spine and knee created torque and stress to the knee joint, not allowing proper nerve communication for the joint to move properly.
Decreased activity and strength were also found in the right cerebellum which important to fine motor movement and balance. The right portion of the cerebellum helps to control movement and coordination to the right side of the body. Decreased firing of the cerebellum as a result of joint subluxation, and decreased receptor stimulation, results in reflexogenic inhibition or weakness of muscle groups related to the knee. With this portion of her brain being less active, her knee pain and dysfunction were found to be symptoms due to the underlying root cause of decreased cerebellar activity and brain body communication, as well as dysfunction in her hips and pelvis shutting off the important muscles that move and support the knee joint.
Treatment: 12 visits of chiropractic care to the spine, pelvis, knee, ankle and foot were performed to balance and align the joints to restore nerve communication to the muscles of the knee. Specific adjustments using drop pieces were used to restore balance and alignment in the tibia, sacrum, and lumbar spine. This helps to stimulate receptors of the knee to build strength to the cerebellum. Sound wave therapy was used to the right knee to break up scar tissue and heal connective tissue swelling and inflammation.
Therapeutic taping using Rock Tape (kinesiotape) was used to help support the knee as well as promote inflammation release and decreased swelling. Neurological exercises for the cerebellum were also given by having her stand on the right leg and performing arm circles in the both clockwise and counterclockwise directions. Also, the use of headphones using hip-hop/dance music in the right ear only as well as spinning the body to the right with outstretched arms while looking at the thumbs was also performed. The purpose of this approach is to not only heal the body from injury but to promote preventative patterns so not to re-injure the body.
Conclusion: After treatment, she stated little to no discomfort with occasional aching and shooting pain in the right knee. The symptoms at her worst were rated a 3 out of 10. Improvements in range of motion and decreased swelling were also noted. There were also improvements in gait coordination, stability, and balance due to cerebellar strengthening. Bi-weekly chiropractic visits for the next three months were recommended to continue to reinforce proper neuro motor patterns and injury prevention.
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