By Dr. Virginia Nsitem

A common knee complaint is pain either climbing up or going down stairs, or both. In addition, patients often complain of hearing cracking noises in their knees when they move. One of the first questions they ask is if they have arthritis and may eventually need a knee replacement. Before jumping to conclusions, I start by asking questions about their pain, completing a physical examination, and explaining the findings. It is important to review the parts of the knee with the patient, so they have a better understanding of their diagnosis and treatment goals.

How does the knee joint work?

The knee joint is important for activities such as standing, bending, climbing, kneeling, sitting, walking, running, and jumping. The knee joint needs to be flexible but also strong enough to provide stability. The main bones at the knee are the femur (thigh bone), patella (kneecap), tibia (shin bone), and fibula (small lower leg bone). The knee joint connects the thigh with the shin bone. The kneecap sits on top of the knee joint. The ligaments that run on the inside, outside, front, and behind the knee work to provide stability to the joint. The cartilage of the knee is called the meniscus and covers the ends of the bones. There is a meniscus on the inside of the knee (medial) and one on the outside of the knee (lateral), and they help the joint glide smoothly during movement, balance the weight at the knee, stabilize the knee, and act as “shock absorbers”. There is also cartilage at the back of the kneecap that helps the knee cap glide easily over the bones. There are fluid-filled sacs (bursa) that prevent the tendons from rubbing against the bone. The two main muscles that attach to the knee are the quadriceps (front thigh muscles) that straighten or extend the leg and provide stability, and the hamstrings (back thigh muscles) that bend or flex the leg at the knee. There are nerves and blood vessels around the knee joint. The knee joint is surrounded by a capsule that bathes the joint with lubricating fluid that is rich in nutrients.

Pain Going Up and Down Stairs

A breakdown of the cartilage around the knee joint can lead to friction at the joint, stiffness, and decreased flexibility. A loss of cartilage can cause pain when bending the knee, climbing steps, and descending stairs. Osteoarthritis (wear and tear) and chondromalacia patella (runner’s knee) are conditions that lead to a breakdown of cartilage at the knee and knee cap. Symptoms may also include pain with standing, and popping or cracking noises with knee movements.  Ligament injuries can also make it difficult for you to climb up and descend stairs. These injuries are often caused by a sport injury or trauma/accident.

Recovering from Knee Pain

Chiropractors specialize in diagnosing, treating, and rehabilitating injuries of the muscles, joints and nerves.  The first step to relieving your knee pain is understanding the cause of the problem. Your rehabilitation program may vary, depending on your diagnosis and the severity of the injury.

1. Chiropractic techniques: Manual therapies are used to improve tightness of the muscles and ligaments and restore proper movement of the knee joint. Therapeutic Laser therapy is a useful device that works to reduce inflammation and pain and allow the patient to start the exercise portion of the rehabilitation. Cold therapy (ice) can be helpful in the initial stages of inflammation to reduce the pain and swelling.
2. Specific Rehab Program: Every injury requires a specific type of rehabilitation. If you are working towards returning to a sport or resuming specific tasks at work or at home, you may require an individualized program that allows you to reach your goal and prevent re-injury.
3. Activity modification: You may need to avoid certain activities and exercises until your injury heals. In addition, activities such as swimming, biking, and walking can be incorporated into your rehab program. If you choose to exercise at the gym, you should avoid the stair climber, as this type of exercise can aggravate your knee pain.
4. Massage therapy and Acupuncture: Studies have shown that these techniques are helpful for providing a pain-relieving effect throughout the body, an anti-inflammatory effect, and a general sense of improved well-being.

Dr. Virginia Nsitem is a chiropractor specializing in laser therapy for muscle, joint, and nerve injuries, and is a Fellow of the Royal College of Chiropractic Sports Sciences in Canada. She may be reached at (905) 275-4993, or by email at totalhealth@bellnet.ca

Stop the Pain … Before the Pain Stops You!