Ask any athlete or weekend warrior how they are doing and, after some pleasantries, they may start to tell you about their knee pain. Although the knee is subject to many injuries and problems, many if not most of them have one underlying cause: misalignment of the involved joints. These may include not only the knees themselves but the feet below and hips and low back above.

The feet many times are the primary cause of knee pain that stems from faulty joint mechanics.  By age 40, 95% of us have some type of issue in the normal alignment of our feet. Gravity and every day life’s minor and not-so-minor accidents and injuries take their toll. With each step we take, aberrant forces relay stress on the knees above.

Similarly, misalignments in the pelvis and hip joints will affect the knees.  Additionally, the knees are controlled by the nerves that come down the legs from the low back.  Any compromise on those nerves, may also affect how the muscles surrounding the knees fire.

The take home lesson?  Any good practitioner will look at the entire system and not just the area of pain.  By correcting the misalignment of the knees and the surrounding joints and clearing any nerve interference from the low back, many knee complaints clear up with very conservative care.

For some reason, I have been seeing a lot of kids lately. Two things always strike me about working with kids, 1) even though their resilient young bodies often don’t feel it, they have a lot going on in terms of spinal misalignments/fixations and 2) they respond really well to treatment.

Perhaps it’s not surprising to examine a child and see the issues that can result from childhood falls, accidents and, later in childhood, backpacks. Sometimes when adults come to see me with pain, they wonder when their issues first began. I tell them that they are usually an accumulation of a lifetime of wear and tear. This starts in childhood. Fortunately or unfortunately, bad joint mechanics often don’t start to result in pain until years or perhaps decades later. By this time degenerative changes may have begun to occur in the joints. And, of course, treating things takes longer the more time a condition has been present.

For this reason, I recommend all parents bring their kids into get checked. The nice thing is that usually a mere handful of adjustments is enough to correct any spinal issues they may have had up to that point. For those kids that are complaining about pain, they almost always respond very quickly. This is truly case of “a stitch in time saves nine”.

I was working on a patient yesterday. She is in her 70s. As I was lightly stretching her neck, she told me that many of her friends her age are continually complaining about their aches and pains but she can’t get them to come in and see me. This despite the fact that coming in for care, in her case once per month, has kept her feeling quite good and active for her age. Almost gone is the chronic pain she originally had that would radiate down her arms. One friend of hers in particular seems to get on her nerves because he is always complaining about his pain. I asked her if she told him that my technique does not entail any of the cracking that sometimes intimidates people. She said she did but that he told her he didn’t want to have to go to chiropractor for the rest of his life.

I have been doing this for 15 years. The top two reasons people do not seem to want to go to a chiropractor are a fear of being “cracked” and the fear of having to keep going back the rest of their lives – either because some sort of addiction has been unleashed or because they were hit with a huge care plan in which the chiropractor wants to see them three times a week for months.

For me, the first one is easily dismissed. I should emphasize that there is absolutely nothing wrong with the traditional chiropractic adjustments that involve mobilizing the joints in such a way that a “crack” is produced. With my approach, however, I use a computerized instrument that gives a repetitive impulse to gently mobilize the joints. It accomplishes the same thing, but I like the specific control I have with my instrument and the fact that it tends to be a more gentle adjustment. It has the added benefit of not entailing the audible sound that sometimes concerns patients.

The second fear people have requires a bit more explanation on my part. I always endeavor to find out a new patient’s goals and accomplish them as quickly as possible. For some people, the goal is simply to relieve their pain. Other patients may have more active goals such as being able to get back to the gym. In any case, I will come up with a short term care plan to get them to where they want to be.

At the same time, there is a role for wellness care. Like the patient I just mentioned, many patients enjoy and benefit from coming in once a month or so for a “tune-up” to keep the joints moving and healthy. That is optional and always up to the patient.

It may be as elusive as the Loch Ness monster or Bigfoot.  But I saw it.

When I first started in practice 15 years ago, I used to do spinal screenings at the local GNC store. I would happily check the spines of interested customers and give them a consultation about what I found. Usually people who wanted to be checked had some sort of pain or symptom. But not always. I remember one young guy in his early 20s came in and asked to be checked. He didn’t have any symptoms. He was just curious about his spine.

The reality is that life takes its toll on most of us. As a chiropractor so much of what I do is to compensate for the wear and tear of life. All those childhood falls, hours with the neck craned forward on the computer or school desk and, of course, the more dramatic injuries such as car accidents do affect the spine. The body will always heal as best it can. But it can only heal with some form of scar tissue. Scar tissue by its very nature has less mobility than regular tissue. This is why, as a chiropractor, I’m very focused on finding and releasing fixations. In chiropractic speak, we call these subluxations.  When the joints in the spine stop moving properly they become more susceptible to pain and, over time, degenerative changes. That lack of motion will also affect the nerves going through that area to the vital organs of the body. If I can restore proper motion to those joints, the segments will be healthier and less painful. As a fringe benefit, a spinal joint that is moving properly results in healthier nerve flow through that area.

As I checked this guy’s spine, I expected to find some sort of fixation or muscle spasm indicating less than ideal movement or misalignment. Even though many people don’t have symptoms of neck pain or low back pain, it is very unusual to find a perfect spine. As I examined this guy’s spine, I could find absolutely nothing wrong: his legs were even, normal motion throughout the spine, no muscle spasms, perfect range of motion in the neck and the low back. As he got up I told him that I could find nothing wrong. His spine was perfect. Knowing about the connection between spinal health and nervous system health, I told him that he was probably a pretty healthy guy. He responded by saying that he had never been sick a day in his life. I shook his hand and wished him well.

I hope he is still doing well and has managed to continue to dodge the stresses and strains of life. If he hasn’t, I hope he went to see a chiropractor.

A close friend rushes to the emergency room complaining of severe chest pain which turns out to be related to the joints in his chest, not his heart. A woman suffers from excruciating pain in her shoulder which runs down her left arm that no one can diagnose or help. Another woman suffers for years from a mysterious pain in her shoulder blade without recourse – medical tests are negative. All of these have in common the same root cause: rib pain.

These are some of the most extreme examples I’ve seen in my practice. And yet, I see this issue crop up to lesser degrees on a daily basis. People come in all the time complaining of shoulder blade pain or upper back pain. Very often the pain is not in the spine or the shoulder joint but rather next to the spine were the ribs form joints with the spine. Most people don’t realize that the rib cage runs between the spine in back and the sternum (chest bone) in front. As we breathe, the rib cage expands and contracts. It also accommodates the motion of our body as it moves. This is another example of the balance that the human body has to strike between support while still allowing for mobility.

In addition to direct traumas to this area, such as auto accidents or falls, pain can also come from a forward head posture. I call this The Posture of the 21^st Century because so much of our lives now entail hours spent hunched over the computer, smart phone, desk or steering wheel. This position puts stress on the back of the spine and the ribs as the head and shoulders rotate forward.

From my point of view, these are very rewarding patients to work on.  When the exact cause of their issues hasn’t been determined and I can put my finger right on the origin of their pain, it is as if a light bulb goes on in their head. “That’s it!” they will so often exclaim.

Gently adjusting the ribs back into place tends to provide great relief. At the same time, it’s important for me to give the patient stretches and exercises they can do at home to address the forward head posture that is predisposing them to have that pain.

Interestingly, I’ve found that even if a patient comes in who does not have direct complaints of rib pain, they seem to feel better and their spines stabilize better if I address any misalignments of the ribs. So for years now, as a matter of course, I address the rib alignment of all my patients.