How To Treat Knee Pain
Hello, my name is Dr. Troy Giles. I am a doctor of Chiropractic and a Natural Internist. Today I wanted to talk to you about knee pain. So many people suffer from knee pain, going up and down the stairs, walking, and so forth, that the knee really is a basic hinged joint. It is just a hinge. It is like moving your finger. You can only go one way. Where your shoulder is 360…full range, where your knee can just go up and down. That’s it. So really, the knee is fairly basic. You have two ligaments that cross inside of the knee that keep the femur from sliding forward on top of the tibia. So there is a ligament that crosses this way and then there is another one that keeps the tibia from coming underneath the femur. So there is a cross right here called the cruciate ligament. You have got some collateral ligaments that are on the side, on each side of the knee, to keep it from going to this side or to this side. I am actually turning my hip and then bending that way, but that is what happens when a football player is getting hit from the side and it blows the knee. If it hits from the side the inside ligament goes, there’s the medial collateral ligament. If he gets hit from this side then it is going to be the lateral or outside ligament. But, it is a basic hinge. You have two cartilage bowls called meniscus and these meniscus are like little bowls that allow movement with inside that joint capsule. What I find as I have been checking out patients for 21 years of practice, that generally knee pain is associated with the ankle. The ankle being dropped inside or we call it pronating, where the ankle is dropping forward. So this is a neutral position. This would be pronating. This would be supinating. So going into a supinated or a pronated position, what happens to the knee is it’s forced to the inside and so you have a tendency to put more pressure on the outside meniscus versus the inside meniscus. So I noticed that once we clear and get an orthotic into that shoe, we actually put a…an orthotic looks like this. It is very easy to form. We form it with the patient standing right down on the hot blinks. The blinks are very thin. They are maybe 1/16 of an inch, maybe not even that much, thick. We heat them up to 200 degrees and then the patient steps down on top of it while I support the arch and flex the big toe. Flexing the big toe makes it so that the joint right here is in neutral. We call it a talus, a sub-talor neutral position. If you think about it, that is going to stop that ankle from dropping over as you walk. Because what we don’t want to do is, we usually come into a heel strike, then we go into mid-stance, and then toe off. Those are the three positions of contacting the floor…heel strike, mid-stance, toe off. But, if you are pronating, you will heel strike, only using on the outside, you come over, and then you come to the inside and then go into your pronated state and then off your toe. So that pronated state here is what causes a lot of torsion, a lot of side-to-side motion in the knee. That has a tendency to wear down the cartilage joint…the cartilage or the meniscus. So we have to have knee surgeries done all the time, or we have hip issues as well. By you pronating your ankle, puts the knee internally and it also internally rotates and drops the hip. So, by putting the orthotic in the shoe, makes the ankle come to the outside, makes the knee externally rotate and makes the hip raise and lift. That is so important. I can’t tell you how important this is. From there, it affects scoliosis, Here again, we have shown this picture before on some of our videos, how this curvature is happening on this particular patient because she is low on the right side. She is low by 10 mm or 1 cm. 7.4 from the femur head to the bottom of the x-ray. This is 6.4 from the top to the bottom of the x-ray. This is in the standing position, so which causes the sacrum to drop and now you have got a curve, all starting with pronating of the foot, but the knee is that center area. So, if it is dropping inward, it is not going straight through the hinge and it is going to start to wear abnormally. So that is going to be a big thing for the knee. Adjusting of the knee is very important. When the patient lays down on the table here, we prop the table up slightly. The patient is laying face down. I contact the knee and then the table drops. I am just going to drop it with my knee. So I pushed down on the knee and that gaps the knee joint over the top of my hand. So I pushed down on the buttock as I gap the knee joint. That helps to open and stretch and strengthen, not strengthen, but move, so you are getting appropriate motion into the knee. But, what I wanted to show you as well today is how to do climbing up and down stairs so that you cannot have pain. As you are going up a stair, lets say I am on the flat area right here. I should have some stairs, but I don’t have. Well, lets just look right here. I think this will be okay. As you are approaching the first step, if you will go up on to your toe, with the foot that is going to stay on the floor, you go up on your toe, and then you are going to put your foot on the next step, landing on your heel, and then rock forward and then go up on your toe. So what you are literally doing is, you are doing heel-to-toe as you walk on the step that you have just stepped upon. Okay? So I am going to up on to the first step with the foot that is staying on the floor. Go up on your toe, raise up, put your heel down, on the stair tread. Land on your heel. Then go over to your toe. Go up on your toe, lift up, put your next heel down. So you are literally doing heel-to-toe, all the way up. If you will do that, what you are doing is basically elongating, or you are raising your body up so that there is not quite so much of a boom, boom, boom up the stairs. So you want to raise your toe up. Go up to the next one. Put your heel down. Step, go on your toe, up, heel, mid-stanced toe, up. I know that is kind of like “holy flip, I never thought it would be so hard to go up the stairs”, but that idea will help you raise up and take less space by that process. Going down the stairs is the same way. As you go down and land on your toe first, then come down on to your heel, land on your toe, come down on your heel, toe, heel, toe, heel. So it is basically backwards of going up the stairs. Again, you are using more of your muscles in order to go up and down the stairs, rather than so much jarring to your knee and to your hip. Try that for your knee pain and see what happens there. If you have questions about pronating, ankles pronating, and so forth, feel free to call the office here on the number you are seeing below, or contact us on the internet site here familywellnesscenter.info. We will be able to answer any questions you might have. Even fly in to Salt Lake here, Salt Lake City, Utah and we can do some orthotics for you, very inexpensively. A lot of the orthotics I have seen around are from 400 – 600 dollars a set. We do our for 100. So it is very inexpensive and makes the difference. We also could take an x-ray of your hips and see if one hip is shorter than the other, put a lift on the bottom of the orthotic. So if the orthotic, remember the patient over here, this one is short by 1 cm. So we would want to put a lift on the bottom of this orthotic that will raise it up, just a little piece of plastic that actually sticks on the bottom and that will raise that side up. Let me show you what that looks like. I am so animated about this concept, because I have seen so many people over these 21 years of practice get well by doing this. So this is what this looks like. It is just a piece of sticky tape. One side is sticky and that goes just on the bottom of the side that is low. Of course, we trim it off so that it fits and so forth. But, that is going to raise that low leg up. Now, most people aren’t anatomically short, they are actually pronating, their ankle is pronating and dropping over, which makes that drop. But, some people do have bones that are less length discrepancy. So, I hope that has been beneficial for you. Take care of your knees before you have to have them surgeried. If you have knee pain, determine why. If you have any pain anywhere in your body, why is that there? Don’t just take a pain med. Don’t just take Aleve or whatever. Fine. Take it until you get over the pain, but find out why, what’s happening here doc? Well, you just needed to have surgeries on your knees, you need a knee replacement. Great. Talk to me about your children before you get so old that it has degenerated. Okay. Okay. I am going on. Have a great day.