When it comes to common patient complaints, knee pain tends to top the list. According to a 2006 National Health Interview Survey, approximately 30 percent of adults experienced some form of joint pain in the previous 30 days, and knee pain was a leading complaint.

There are many causes of knee pain, including trauma, infection, poor diet and repetitive strain/stress/overuse. When infection, or other presentation that needs a more critical care approach is ruled out however, it’s important to look at the patient’s overall biomechanics in order to determine which part of the body is causing the knee pain. Just because the pain is in the knee, doesn’t mean that the knee is the source of the problem.

In order to determine the underlying issue, it’s important to consider the body’s kinetic chains. The kinetic chain refers to the idea that the human body is connected from top to bottom – a series of joints and muscles working together in perfect harmony. Like an orchestra, however, when one part of that chain is disrupted, the harmony is broken. More often than not, when pain is experienced at one point in the body – the knee, in this case – it’s the result of a “broken link” somewhere else in the kinetic chain. That’s why it’s critical to look up and down the kinetic chain when treating the knee to determine where the breakdown is — as opposed to just taking the “one-size fits all” approach of prescribing anti-inflammatory medication, exercises or suggesting the patient “work through” the pain.

For example, if one is experiencing pain on the inside of the knee, it may be due to a deep buttock muscle group, known as the external hip rotators, being overly tightened and not allowing the thigh bone (femur) to rotate properly, which places stress on the knee. Or, hyper-pronation of the foot can lead to an internal twisting of the lower leg bone (tibia), causing significant stress on the medial meniscus of the knee joint and the iliotibial band on the lateral side of the knee. The point is that the knee is just one more link in the kinetic chain and is only as strong and healthy as the joints above and below it. This is why just treating the area of pain (the knee) may prove frustrating and, in a number of situations, futile.

So, what do you do for your knee? First, take responsibility for the things you have control over and:

1. Assess the pain and recount what the possible mechanism of injury is to rule out need for meds or other crisis care (think gout, infection or torn ligaments).
2. Have a chiropractic examination to determine restrictions around the knee, as well as along the kinetic chains involved, including up to the pelvis and spine. The surrounding fascia should be examined as well. Also, determine if there are any weak or inhibited muscles involved.
3. Fix the restrictions to diminish or resolve the pain, increase the range of motion and then engage (via electric stimulation or exercise if possible) any weak muscles to strengthen.

As you get back to your regular activities, go slowly and “test the waters” so that you can perform the movements you desire dialed back several notches (think slow-moving Tai Chi versus all out Tai Kwan Do). As we reach that “onset of maturity” phase of our lives, it makes good sense to warm up with very slow golf or tennis swings or even sweeping and vacuuming motions to prepare your body for impending increased demands. So, slow down before going all out, stretch and hydrate well, and remember your kinetic chain…it’s only as strong as your weakest link.