(EMAILWIRE.COM, June 24, 2020 ) I teach anatomy and adjusting technique classes at a chiropractic
college. I've been in private practice for more than 32 years. I'm appalled
by the lack of rational care provided for knee injuries. In my
clinical experience I find that in the majority of patients I encounter
with knee pain as a symptom or complaint, the tibia is not properly
aligned with the femur. This includes people under long term care
with orthopedists, physical therapists, chiropractors, patients who've
had knee replacements, and most of my chiropractic students who
were under care.

Range of motion of the knee is a common evaluation process. With
most of the patients who come to me with knee injuries, the knee
demonstrates a range of motion that is within normal limits. This can
give the impression that there is nothing really wrong with the knee
itself. So many physicians and chiropractors have their patients focus
on muscle strengthening, activity, and stretching. The intervention
becomes exercise and more exercise.
However, exercise on displaced joints only leads to more irritation
and inflammation, muscle guarding and pain. Over time, this leads to
arthritis. Osteoarthritis of the knee is caused by a chronically subluxated
or displaced tibia. Drugs become a lot of people's main interventions.
But there is no pharmacological remedy for the displaced tibia
and unfortunately, there is no exercise that will put the tibia back in
place. However, there are a lot of exercises and stretches that can make
the displacement of the tibia worse. So, I will spend some time talking
about what not to do with your injured knee.

A common problem for a lot of patients is that very few doctors will
palpate (touch to assess) the affected joint. Evaluation of knee problems
requires direct palpation of the joints and bones. ‘Knee pain’, is a
diagnostic term for a lot of providers. However, knee pain is a symptom,
not a diagnosis. A ‘diagnosis’ of knee pain usually gets you a
prescription for drugs and exercise. However, the misaligned tibia will
not be put back in place with a pill or exercise. So the question I have
is this - Is this rational care?