Dear Doctor,
I have been having right knee pain for about 3 months now. I do not remember injuring it at any time. I will be starting high school basketball and concerned what will happen when I start running. Is there something that I could do to help it? Kyle.

Answer:
Anterior knee pain is common in adolescents. There are a variety of reasons that this could occur. For example some conditions that can cause anterior knee pain are as follows: Chondromalacia Patella, Tightness of the iliotibial band, Referred pain (hip, spine). Neuroma Tendinitis, Osgood-Schlatter’s condition, Plica Fibrosis, Inflammatory conditions, Bipartite Patella, Dorsal Defect, Stress fracture, Osteochondritis dissecans, Tumors, Infection, Patella misalignment, Venous congestion, and Arthritis. There are many causes of adolescent knee pain, but the most common is misalignment. Misalignment of the patella or knee cap is much like it sounds. Every bone, muscle and tendon in the human body has a normal range of alignment. Not every abnormality hurts. For example, spinal curvatures aren’t always painful. It therefore a serious mistake for a doctor to attribute pain to the first abnormality he encounters. We see this most frequently in cases where the doctor uses an MRI report to make a diagnosis. When the kneecap is tilted or varied from acceptable range of alignment, this is a potential source of pain. This is usually accompanied by de-conditioned quadriceps muscles. A common mistake when patients hear this is that they jump on a weight machine and start to exercise to strengthen their leg muscles. One problem with this is when we exercise an inflamed joint, it usually becomes more inflamed. Another problem is that weight machines will not typically exercise the leg in the terminal extension range, which is where most of the imbalance is occurring. Individuals can delay the healing process if they put too many demands or the wrong kind of demands on the knee joint when in it’s critical state.

However, with the proper precautions and timely rehabilitation, most patients recover well when under going a controlled course of patella / knee rehabilitation. When considering rehabilitation protocols, it is crucial to make sure that there is optimal biomechanics in the joints above and below the knee. Hence, optimizing joint mobility through chiropractic adjustments in the low back, hips and ankle joints will accelerate the healing process and help prevent recurring injuries. This is another example where Chiropractic and Orthopedic care works together in fostering optimal results.