Tag Archives: Joint Pain

Causes of Knee Pain in Kids

11 May

Knee pain accounts for at least one-third of musculoskeletal complaints in the pediatric
population seen in healthcare clinics, including chiropractic offices. This is especially common
in active children during the growth spurts of early adolescence. Let’s review some of the most
common causes of knee pain in kids and teens and how they are typically managed.
Patellofemoral pain syndrome, or kneecap pain, is the most common cause of knee pain
in children and adolescents. Pain typically arises from behind the patella and worsens with
activities involving knee flexion, such as climbing stairs, squatting, or prolonged sitting. On
examination, pain may be reproduced with a single-leg squat, often with inward knee collapse.
Treatment includes both weight-bearing and non-weight-bearing exercises targeting the posterior
hip and quadriceps. Manual therapy and movement retraining may be used to restore normal
joint mechanics. Treatment may include a foot orthotic if excessive ankle pronation is
contributing to pain.
Osgood-Schlatter disease (OSD) is inflammation of the growth plate at the tibial tubercle
just below the kneecap, often producing a prominent bump that can irritate the patellar tendon
during running, jumping, squatting, and kneeling. Treatment typically includes patient education,
activity modification, exercise therapy, and use of an infrapatellar strap. Sinding-LarsenJohansson syndrome is similar to OSD but involves the bottom of the patella rather than the
tibial tubercle. Management follows a similar approach.
Patellar tendinopathy, or jumper’s knee, results from cumulative microtears due to
repetitive jumping, landing, and sprinting. Management includes reducing high-load activities
(while avoiding complete rest), gradually reloading the tendon as symptoms improve, and
performing strengthening and flexibility exercises for the quadriceps and hamstrings. Manual
therapy and biomechanical corrections may also help improve loading patterns.

In cases such as juvenile idiopathic arthritis, chiropractors may work in coordination with
the child’s medical physician or rheumatologist to provide supportive care—such as gentle
manual therapy and soft tissue techniques—to improve mobility and reduce muscle tension.
The good news is these conditions generally respond well to conservative management,
helping most children return to their normal activities without the need for invasive treatment.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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Hip Pain Characteristics That Can Inform Diagnosis

9 Apr

The hip is a ball-and-socket joint in which the femoral head meets the pelvis, supported by
several layers of cartilage and other soft tissues that allow for a wide range of motion. While this
design provides mobility, it also creates multiple opportunities for instability and irritation that can
result in what is generally referred to as hip pain. However, there are many potential causes of hip
pain, and the specific characteristics of a patient’s symptoms can help guide the healthcare
provider—such as a doctor of chiropractic—on what to evaluate during the physical examination.
Anterior (front) hip pain may suggest osteoarthritis, particularly in middle-aged and older
individuals with gradual symptom onset and pain that increases after prolonged sitting or walking. In
contrast, younger and more athletic adults who present with groin pain that worsens during hip
flexion and rotation may have femoroacetabular impingement or a labral tear. Sport collisions or
other forms of trauma can also result in hip flexor muscle strains that produce pain in the front of the
hip.
Lateral (side) hip pain is often associated with greater trochanteric pain syndrome, especially
in middle-aged women who report discomfort when lying on the affected side. In many cases, there
is no clear inciting injury, and the area may be painful or tender when touched or palpated.
Posterior (back) hip pain is less commonly due to a primary hip joint condition and is more
often referred from another structure. Potential sources include the lumbar spine, sacroiliac joint
dysfunction, deep gluteal syndrome (also known as piriformis syndrome), or strain or tendinopathy at
the proximal hamstring attachment.
Certain red-flag conditions require urgent referral to an emergency department or specialist.
These include femoral neck fracture—typically in older adults with osteoporosis or after a fall or
trauma—often presenting with inability to bear weight and a shortened, externally rotated leg; septic
arthritis, which may involve fever, severe joint pain with movement, and elevated inflammatory
markers on blood or joint fluid testing; and avascular necrosis, in which interruption of blood supply
to the femoral head causes bone tissue death, potentially leading to joint collapse, chronic pain, and
limited mobility (often requiring MRI for diagnosis).
The good news is that many causes of hip pain, aside from these red-flag conditions, respond
well to conservative chiropractic care. Treatment is often multimodal and may include a combination
of manual therapies such as manipulation, mobilization, and soft-tissue techniques; therapeutic
exercises and stretching; temporary activity modification followed by gradual return to normal
activities; physiotherapy modalities to support healing; and nutritional recommendations aimed at
reducing inflammation. If dysfunction in an adjacent area, such as the low back or knee, is
contributing to the hip condition, these regions may also need to be addressed to achieve the best
outcome

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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What Is Tennis Leg?  

15 Oct

The term tennis elbow is widely known because it’s a common malady associated with tennis (and more recently, pickleball), primarily due to the use of a back-hand stroke. For those who play racquet sports, there’s another common orthopedic condition that includes the word tennis: tennis leg. 

The condition is characterized by a popping noise in the calf during a movement associated with the leg pushing off during a jump, sprint, or sudden change of direction followed by a sharp, burning sensation that makes it difficult to bear weight on the leg. Though it may not initially be observed, tennis leg can lead to superficial bruising, swelling, limitations in knee and ankle range of motion, and increased calf pain at the end-range of ankle dorsiflexion (bringing the toes toward the nose) and with manual palpation. It’s important to note that like tennis elbow, tennis leg is not just a sport-related injury but can also occur in non-athletes.

If you hadn’t heard the term before, you may be surprised to discover it was first clinically described way back in 1883! The condition was initially attributed to rupture of the plantaris muscle tendon in the calf region of the lower leg.  However, more recent studies using ultrasound and MRI have shown that in nearly all cases, tennis leg is the result of injury to the gastrocnemius and/or soleus muscles in the calf. In one study, researchers evaluated MRIs of 58 patients with tennis leg and observed that edema or disruption of the medial head of the gastrocnemius at the muscle-tendon junction in 55 cases (90.2%); fluid collection between the medial head of the gastrocnemius and soleus in 44 cases (72.1%); injury to the soleus muscle (which is deeper to the gastrocnemius) in 22 (36.1%) of the cases; and plantaris muscle disruption in 7 cases (11.5%). In rare cases, tennis leg may be due to deep venous thrombosis posing as a muscle injury, which may require prompt medical attention.

Treatment generally follows the PRICE (Protect, Rest, Ice, Compress, Elevate) protocol and may include the use of a boot, modalities to reduce inflammation and promote healing (like laser or pulsed magnetic field), passive range of ankle/knee motion within pain boundaries, and manual therapies to address any musculoskeletal disorders in adjacent parts of the body that may have preceded and contributed to the injury. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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How Older Individuals Can Manage Hip Pain  

15 Sep

Hip pain is a condition that becomes more common with age. It’s reported that 1 in 7 seniors experience significant hip pain on most days, particularly with simple movements such as sitting and standing. In addition to being painful, these individuals are also likely to report a diminished ability to carry out their regular activities. As such, it’s not unusual for a hip pain sufferer to schedule a visit with a doctor of chiropractic to see if a conservative course of care can benefit them without the need for medications, injections, or surgical intervention.

When a patient first presents for chiropractic care for hip pain, they will be asked to complete paperwork to describe both their past medical history and their current hip pain. This may also include questionnaires using diagrams and scales to assess pain and disability. The information provided will be useful to rule out red flags (fracture, infection, malignancy, and/or acute nerve injury) that may necessitate referral to a specialist or emergency services. The data will also provide insights as to the potential cause/s of the patient’s hip pain. 

The possible causes for hip pain are myriad. In addition to trauma, arthritis, congenital defects, and other issues that can affect the soft tissues and bones that comprise the hip joint, the pain experienced as “hip pain” may actually be referred pain from the low back or buttocks. Or the patient might not even have hip pain but may be mistaking pain from nearby locations as hip pain. There may even be indication that the underlying cause is not musculoskeletal in nature and part of a larger issue that may need to be co-managed with the patient’s medical physician. 

Once a chiropractor has reviewed the information provided by the patient, they will conduct a physical examination of the hip joint that may include analysis of gait or walking, sitting, and standing; ability to stand on one leg; range of motion (ROM) from seated and recumbent positions; leg length variance; muscle length checks; and neurovascular assessments in the lower limbs. This may also involve evaluation of the feet, ankles, knees, and lower back, as musculoskeletal disorders in these areas can place added stress on the affected hip during movement and would need to be treated to provide a satisfactory outcome for the patient.

While the specifics of treatment will vary from patient to patient, as well as the chiropractor’s training and clinical experience, care may involve a multimodal approach that includes manual therapies, exercise training, nutrition recommendations, and physiotherapy modalities aimed at restoring normal movement to the hip and other joints that could play a role in the patient’s chief complaint. As with many conditions, the longer it persists, the more time it can take to achieve a complete recovery, if at all. If you’re currently experiencing hip pain, call your doctor of chiropractic sooner rather than later. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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Can Hip Osteoarthritis Be Prevented?

20 Jun

Hyaline cartilage is the slick, translucent tissue that lines joint surfaces and allows for the smooth movement of joints in the body, including the hip. If the structure or health of this cartilage is compromised, it can gradually wear away, leading to joint pain, stiffness, and disability. Eventually, the hip osteoarthritis patient may have no choice but to accept a dramatically reduced lifestyle or undergo total hip arthroplasty. Is it possible to prevent osteoarthritis of the hip or at least slow its progression?

Unfortunately, the answer isn’t a firm yes or no. There appears to be a genetic component to osteoarthritis risk, so you may be destined for the condition. However, it does appear that if you manage to avoid major trauma to the hip and stay physically active and otherwise live a healthy lifestyle, then it may be possible to significantly reduce the risk for developing the condition and requiring surgical intervention. 

Between 2014 and 2017, researchers in Germany conducted a study in which nearly 24,000 patients with either hip or knee osteoarthritis received usual care or participated in a structured program focused on guidelines-recommended therapies and patient empowerment, including lifestyle changes and exercise interventions. Patients in the experimental group were 33.6% less likely to be hospitalized or undergo joint replacements related to their knee/hip. 

 Chiropractic care offers a unique opportunity for patients as the initial history typically includes a comprehensive review of systems including all aspects of health, both past and present. This approach often extends care well past the primary presenting complaint (hip pain, in this case) to include patient education regarding diet/nutrition, stress management, sleep quality enhancement, and more. Additionally, a doctor of chiropractic will assess related areas of the body to identify problems that can affect normal movement patterns (the foot, ankle, knee, pelvis, low back) as addressing these issues may be critical to help the patient achieve a satisfactory outcome.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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Preventing Shoulder Injuries in Athletes

25 May

Shoulder injuries are common in athletes, especially those requiring overhead repetitive movements at high velocity and extreme range of motion. For example, shoulder injuries account for 19% of injuries to baseball players and nearly 40% of injuries to swimmers. Because a shoulder injury can sideline an athlete and even prematurely end their season, a current trend in sports medicine is to find ways to prevent shoulder injuries in the first place.

A systematic review conducted in 2022 looked at 25 studies conducted between 1970 and 2018 to uncover common risk factors for shoulder injuries among athletes from a variety of sports including volleyball, handball, basketball, swimming, water polo, badminton, baseball, and tennis. In the final analysis of the review, the authors concluded that prevention programs should focus on strengthening the rotator cuff muscles and maximizing shoulder range of motion. 

In fact, another literature review found that a pre-season range of motion evaluation may help identify athletes at risk for a shoulder injury during the coming season. The review included 15 studies involving a total of 3,313 collegiate or Olympic athletes from sports with overhead shoulder movements such as baseball and swimming. The results indicated that the risk for shoulder injury was greatest for swimmers whose external shoulder rotation range of motion fell outside of the 94-degree to 99-degree range. For baseball players, especially pitchers, an external shoulder range of motion difference between the throwing and non-throwing arm below five degrees was associated with a two-fold greater risk for shoulder and/or elbow injury. 

As the saying goes, prevention is the best medicine. So if you participate in sports that include overhead movements, schedule an appointment with your doctor of chiropractic before the season starts so they can evaluate you to uncover any current conditions that may lead to issues during competition as well as instruct you on ways to augment your pre-season training regimen to maximize the function of your shoulder, including its external range of motion.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

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