The knee is the largest joint in the body. It is the articulation between the femur and the tibia, between our thigh and our leg. It is basically a hinge that needs to provide great strength to support the body weight in a large range of motions. The knee is subject to very large stresses during movement. The main disorders of the knee are;
- Muscular Referral Pain; Several muscles can refer pain into the knee.
- Ligamental Injuries; The knee ligaments can be torn (usually only partially) especially by trauma to a flexed weight-bearing leg.
- Meniscus Lesions
- Overuse including; Patello-femoral syndrome, patellar tendonitis, Illiotibial band friction, Hamstring tendonitis, Per arsine Bursitis, Gastrocnemiums tendonitis
Muscular Referral Pain
There are several muscles that can actually refer pain into the knee including;
- Rectus femoris
- Vastus lateralis
- Adductor longus
- Lateral Hamstring – Biceps femoris
Acupuncture can be used in the trigger points of these muscle groups. By needling these trigger points it relaxes and loosens painful “knots” that develop in muscles and fascia, the layer of tissue that surrounds muscles. Acupuncture works by deactivating these painful trigger points, unknotting sore spots and helping relax the unnatural tension that can develop in the muscle fibers as a result of injury.
The collateral ligaments are the most commonly injured. The collateral ligaments (Medial and Lateral) basically run on either side of the knee, they control the sideways motion of your knee and brace it against unusual movement. the spreads of this area are graded;
- A mild sprain producing tenderness, some pain and no swelling
- A moderate sprain producing more pain and tenderness, possibly some swelling
- A rupture fo the fibres producing swelling, pain and tenderness
Grade 3 or a complete tore needs surgical repair, Acupuncture can only treat mild (grade 1/2) or chronic cases. Acupuncture helps increase circulation to the injured area, and that helps healing in a couple of ways. When blood flow is increased, all the toxins and fluids that build up as a result of inflammation can be removed more quickly. That means swelling will decrease more rapidly, reducing the painful friction that occurs when swollen tissues rub against each other. Improved circulation also promotes healing by supplying the injured area with an increased supply of oxygen- and nutrient-rich blood, speeding up the tissue repair process.
These are produced from repeated small trauma to the soft tissue around the knee from friction, traction and impact of repetitive rhythmic activity. Athletes, runners, and dancers are especially prone, although an intense burst of any unusual activity can be enough to trigger an episode. Apart from overuse there is often faulty biomechanics present that throws an excessive load into the affected tissue. Common overuse syndromes include;
- Patello-Femoral Syndrome
- Patella Tendonitis
- Illiotibial Band Friction Syndrome
- Hamstring Tendonitis
- Gasttrocnemium Tendonitis
Acupuncture works well in many cases. However it is important to address the faulty mechanics with Chiropractic care or Exercises.
Osteoarthritis as described above is a degenerative process beginning in the articular cartridge of a joint. The irritation caused by the degeneration eventually leads to inflammation. Degenerative changes appear long before the start of symptoms such as pain or swelling. Osteoarthritis manifests in middle age, and not ‘just a normal ageing process’. In osteoarthritis of the knee we see;
- Pain on walking and after prolonged activity
- Stiffness after inactivity
- Decreased range of motion – esp. Flexion
- Symptoms are worse in cold weather
- Often a wasting of the quadriceps muscles
- Previous trauma to the knee
Acupuncture has been found to be effective for the management of knee pain and debility associated with osteoarthritis (2). Acupuncture aims to increase circulation, ease pain and inflammation, but also to reduce further degeneration. People who have Acupuncture show a decreased pain level and better freer movement of the knee.