Dear Doctor Caraotta,
I have knee pain and have been going through physical therapy and it has not been helping. I was told by a co-worker who had the same experience that he went to a chiropractor and he responded very quick. What does a Chiropractor do different than a physical therapist? I also see that you practice Orthopedics and am not exactly sure of what that means. Can Chiropractic help this?

Answer:
To answer your last question first, Chiropractic Orthopedics is a specialty in which in addition to treating spinal conditions, we are trained in treating every muscle, bone and joint throughout the body. It is a non-surgical Orthopedic degree, which requires 4 additional years of training beyond Chiropractic School.

Joint manipulation to the knee as well as the spine could be very helpful in knee problems. Knee pain is often associated with weakness and inhibition of the knee extensors, that is, the muscles that cause the leg to “kick out” commonly known as the quadriceps. Traditional treatment protocols have included physical therapy/rehabilitation programs and even surgical intervention. However, the lack of full recovery has been related to strength deficits and the inability to achieve full recovery of the affected structures is often associated with nerve pressure. Recent research has suggested that the nerve pressure needs to be overcome before significant improvement in muscle strength and function can be achieved. There was a pilot study performed to establish whether quadriceps inhibition (nerve pressure to the quadriceps) in patients with anterior knee pain was affected by spinal (sacroiliac) joint manipulation. 18 subjects with chief complaints of anterior knee pain participated in this study. After following a series of correction of spinal (sacroiliac) adjustments, it was shown to decrease the nerve pressure going to the quadriceps muscles which controls the knee. It was also evidenced that patients who were treated this way, had an increase in knee extensor power. All the nerves that are supply the knee originate from the back. Often times a person may have a knee injury, because of lack of good biomechanics or spinal orientation which decreases nerve flow to the knee. As a Chiropractic Orthopedist, Identifying the problem, and working with the spine as well as the knee will usually correct the problem and help to prevent recurrences!