Comprehensive Knee Treatment
REHAB
Options in the Chiropractic Office
Todd G. Singleton
Knee pain is a common condition that affects millions of Americans each year. Though 20% of the population will suffer from knee pain at some point in their lives, many Americans fail to get the treatment they need to recover safely and permanently.1 Many people suffer through knee pain for years, masking their symptoms with the chronic use of painkilling drags. Others resort to premature surgeries, spending thousands of dollars on invasive procedures that fail to get to the root of the problem. As chiropractors, we have a responsibility to help our patients break free from this vicious cycle. Chiropractors aie uniquely positioned to offer healthy, holistic treatments for long-term knee-pain relief and healing.
We, as chiropractors, are trained to administer hands-on therapies, so it makes sense that when treating knee problems in our offices, we focus on treatments and modalities. However, I submit that the best course of treatment for patients suffering from knee pain would include not only physical modalities and therapies, but also a solid nutritional protocol to support healing and stabilize the body.
IN-CLINIC TREATMENTS
As a chiropractor, you have many treatment options available at your disposal. Beyond traditional chiropractic adjustments and services, you can offer therapeutic laser treatments, neuromuscular stimulation, whole-body vibration, kinesio taping, and many other modalities to patients who are suffering from knee pain. Combined with the right nutrition and lifestyle changes, most patients will experience a frill recovery and be able to return to their regular activities. Many of these treatments will save your patients thousands of dollars that they would have otherwise spent on expensive surgeries and prescription medications. Of course, you should tailor each patient’s treatment regimen to meet his or her own specific needs. In my own clinic, I have had success with several different types of treatment.
Therapeutic Laser Treatments
Laser therapy is one of the most effective nonsurgical treatment options available to chiropractors who treat knee pain. The therapeutic lasers that I use in my office aie designed to increase circulation to the tissues being treated, thereby reducing inflammation and accelerating the healing process. Each session accomplishes this by stimulating adenosine triphosphate (ATP) production in individual cells. This increase in ATP production helps the body repair damage at a cellular level, healing the cartilage and reducing pressure surrounding the knee joint. It also normalizes the sodium potassium gradient in each nerve cell, providing some immediate relief from pain. Therapeutic laser treatments are noninvasive, completely painless, and associated with no harmful side effects.
Neuromuscular Stimulation
Neuromuscular stimulation can increase blood flow to the affected area in order to accelerate healing. It relaxes muscles (preventing painful spasms), increases range of motion, and prevents atrophy in patients who are unable to engage in regular exercise. Neuromuscular stimulation can also be used to strengthen the leg muscles surrounding the knee in order to prevent or coll ect shifting of the patella. In my office, neuromuscular stimulation is my first line of treatment for patients suffering from an acute injury such as a ligament tear.
Whole-Body Vibration
Russian researchers developed whole-body vibration (WBV) when they were looking for a way to rehabilitate astronauts who had lost bone density and muscle mass in the low-gravity environment of space. WBV causes muscles to experience an involuntary contraction at the same rate that the platform is vibrating. This provides many of the same benefits of strength training to patients who aie unable to exercise on their own. Since its invention, WBV has been used to treat a myriad of health problems ranging from osteoporosis to knee pain.
Kinesio Tape
In our clinic, kinesio tape is used to facilitate the body’s natural healing process by providing support and stability to the muscles and tendons in the knee. Unlike braces or other supportive devices, kinesio tape does not restrict range of motion or interfere with daily activities. Kinesio tape alleviates pain and facilitates lymphatic drainage by microscopically lifting the skin. This increases circulation and helps to decrease inflammation in affected areas. Kinesio tape is latex-free and wearable for days at a time. It is safe for all populations, including pediatric and geriatric patients.
BACK TO BASICS: NUTRITION, SUPPLEMENTATION, AND A HEALTHY LIFESTYLE
Though knee pain can be caused by conditions that range from arthritis to chondromalacia, nutrition and lifestyle changes should always be your first line of treatment. These types of changes ai e foundational for long-term healing, and aie an effective means of preventing painful conditions from reoccurring. When you’re helping
patients transition into a healthier lifestyle, two things matter most: information and support.
To provide your patients with adequate information, sit down and talk with them in your one-on-one consultations, provide them with reading materials (books, brochures, pamphlets, etc.), or invite them to regular wellness classes hosted in your office. To provide them with adequate support, you must hold them accountable for the decisions that they make outside of your office. Ask your patients to fill out a food diary and report back to you each week. In your one-on-one consultations, you can talk to them about how they’re doing and encourage them to keep going strong. This type of feedback is invaluable.
Nutritional Programs
Though in-clinic treatments matter a great deal, permanent healing requires a healthy, nutrient-rich diet. Many people with chronic pain consume a poor diet comprised of foods that make inflammation worse, rather than better. Many patients also carry around excess weight that puts unnecessary strain on the knees. As a chiropractor, you have the opportunity to teach your patients to distinguish between foods that will help and those that will hinder their progress. When it comes to knee pain, advise your patients to eat nutrient-rich foods, such as salmon, dark leafy greens, brightly colored vegetables, and fresh fruit. Recommend cold-pressed olive oil and coconut oil over refined vegetable oils, as well as unrefined natural sweeteners (e.g., pure maple syrup, raw honey, and stevia) over sugar.
Supplementation
When it comes to supplementation, your goal is to reduce inflammation and accelerate healing. If a healthy diet could accomplish this all on its own, supplementation would be unnecessary. Unfortunately, contemporary fanning methods have rendered our produce less nutritious and created a need for supplements that fill the nutritional gaps in our modem diet. For my patients, I always recommend high-quality salmon oil and vitamin D for their powerful anti-inflammatory and painreducing properties.2’ 3 I also recommend joint-supporting supplements, such as MSM, glucosamine, and chondroitin. I always advise my patients to choose MSM and glucosamine supplements that come in a sulfate form.
■ "Don’t underestimate the scope of what you can accomplish with the right tools at your disposal. J Ï
Lifestyle Coaching
Many lifestyle changes will accelerate the healing process and render your in-clinic treatments more effective. Getting enough sleep, for example, is crucial to the healing process. Patients who are recovering from illness or injury may require
more than the standard seven to nine hours of sleep each night. Advise your patients to listen to their bodies and ensure that they are getting adequate rest. This may seem like a small task, but the results can be profound. You may also recommend home exercises to help reduce pain and inflammation more quickly than you would regularly accomplish in your office. Don’t let your patients waste away in front of the TV! Physical activity is more important now than ever.
As a chiropractor, you are uniquely trained to step in and offer effective knee-pain relief services that aren’t available elsewhere. The combined effects of these treatments—proper nutrition, a healthy lifestyle, supplementation, and in-clinic services—are profound. Many patients make a full recovery within a matter of weeks. Given many of my patients’ original prognoses, these changes are remarkable and worth sharing with others in the chiropractic community. Don’t underestimate the scope of what you can accomplish with the right tools at your disposal.
References:
1. Institute of Medicine of the National Academies Report. (2011). Relieving pain in America: A blueprint for transforming prevention, care, education, and research. Washington D.C.: The National Academies Press.
2. Simopoulos, A. P. (2002). The importance of the ratio of omega-6 omega-3 essential fatty acids. Journal of Biomedicine & Pharmacotherapy, 56
3. Kragstrup, T. W. (2011). Vitamin D supplementation for patients with chronic pain. Scandinavian Journal of Primary Health Care, 29(1): 4-5.
Todd Singleton, D.C., is an author, speaker, and consultant who has been a practicing doctor for more than 20 years. He ran the largest MD/DC/PT clinics in Utah before switching to an all-cash, nutrition model in 2006. He runs a very successful practice in Salt Lake City, Utah. For additional information, contact him at 801-903-7141 or [email protected], or visit www.DoctorsGoldMine.com.
