Knee Pain

Knee joint disease

Knee pain is one of the most common orthopedic complaints. More than 15 million people seek treatment for their knee pain ever year. It has been estimated that more than 100 million people suffer from chronic knee pain. That means 1/3 of all Americans currently have a knee pain complaint. What do we know? The older you are the more likely it is that you will develop knee pain and there are no long-term cures. Maybe we can find that knee pain is a symptom of an underlying cause.

Types of knee pain

Every chronic disease process of our body begins at a starting point. Babies are not born with arthritic knees. This is a condition that slowly develops over many years and decades. The first clues that something is wrong shows up around high school, especially with student-athletes. The ones who have been playing soccer or other running sports will start complaining of knee pain. The typical symptoms do not occur during running, rather they show up the morning after.

Younger individuals will develop ligament and tendon damage.

They will be forced to end their sports activity due to the pain. Others will continue, regardless of the pain, until they “blow-out” their knee with a ligament or tendon rupture. They require surgery to repair the damaged tissues, and if “lucky”, they will return to their sport only to have the same ligament or tendon become ruptured again.

The years of walking on a knee with ligament and tendon damage create further instability within the knee.

The excessive knee motion will strain the ligaments which trigger strain-sensors within the ligaments causing the muscles of the thigh to contract in an attempt to stabilize the knee joint. But the knee still has its instability and the ligaments and tendons will continue to get over-stretched leading to a negative cycle of tissue disease.

Eventually, usually by 30 to 40 years of age, the strong thick cartilage of the knee joint develops a mild inflammation due to the repetitive motion of the thigh bone on the top of the leg bone.

The combination of persistent excessive motion on a knee joint that is unbalanced leads to the formation of osteoarthritis. This is the “wear-and-tear” destruction of cartilage within the knee. This damage will not show up on an x-ray until there is significant damage.

The story of knee joint disease. 21 years old, 50 years old, over 50 years old

What causes knee joint tissue disease?

There are many different causes that can lead to knee pain.

You can do your own online search to discover those. The most common form of knee pain that is going to be discussed here has to do with an imbalance of forces acting on the knee. This is a mechanical issue first that develops into a chain reaction of tissue deformation. The signs are all there to recognize why knee pain developed and why it progressively gets worse but the medical attention is focused on symptom relief, rather than first cause orthopedics – to discover and fix the underlying cause.

When a person has developed knee pain, there was probably a point at which someone recognized their feet were somewhat misaligned, like a flexible flatfoot.

They could have even been taken to a doctor to examine their feet but the parents were convinced by the doctor that “it is just a normal variant” and no treatment is necessary. Given that advice, the parents signed up their child to a soccer camp. The child is running all day long on a faulty foot structure. Maybe the child has growing pains or developed pain to the back of the heel but those went away – so the child kept running becoming a promising soccer player.

The child then developed pain below the kneecap bone.

This is caused by excessive pulling from the strong tendon that connects the kneecap to the leg bone. This is usually the first, but not last, sign that there is a mechanical issue within the knee. With time, the inflammation of the leg subsides, and the child is back to playing soccer. A few years go by until the next big injury, anterior cruciate ligament (ACL) partially or completely ruptures. Then surgery is needed to repair the ligament. This is usually the career-ending injury for most, but there are few lucky ones who get back on their feet and hit the soccer field again. That is until the next injury and at that point, it is game over.

Life after soccer is ok but the knee joint has been injured and will never be the same.

The bigger issue is that the underlying cause, the mechanical imbalance within the knee, is still present and still causing tissue destruction within the knee. Fast forward a few more years and the knee joint is starting to really cause pain. Physical therapy didn’t work, injections helped a little at first, but not anymore. The next treatment option is arthroscopic surgery. There was a long-recovery and there seemed to be some improvement.

Another 10 years go by and little by little that knee pain slowly came back.

X-rays now show the cartilage is being worn away. There is still some cartilage left and the surgeon says to just wait it out as long as possible but it is just a matter of time until a knee replacement will be the only option. In the meantime, just live with knee pain and do your best. This leads to a decreased activity level, weight gain, and then other health issues set in.

Finally, the time has arrived that the knee damage is so severe that a knee replacement can be justified. It is performed but there was a warning that there is a good chance that sometime in the future it will have to be replaced. That’s right, somehow the knee implant can wear out and also cause pain. It’s not the end of the story.

A misaligned ankle bone can lead to a misaligned knee joint

Let’s go back to this example and rethink the beginning point – the appearance of a “not so normal” foot alignment.

The foundation of the body stands on our feet.

The “foundation” joint is the area where the joint surface of the ankle bone rests on the matching joint surface of the heel bone. There should only be a slight amount of motion between the two bones. There is a very common orthopedic disease where the ankle bone loses its normal stability on the heel bone. There is a partial dislocation of the ankle bone on the heel bone. When the ankle bone falls down, forward, and inward, instantly the foundation joint is out-of-alignment. This will cause an increase of forces acting on the leg bone resting on top of the ankle bone.

The body of the ankle bone should be “locked” into the ankle bone. There are many ligaments that attempt to keep that ankle bone motion limited to the normal amount. If they are successful, then the excessive force from the partial dislocation of the ankle bone will have to be compensated for at the next level – the knee joint. This means there will be an excessive amount of twisting within the knee. In addition to the twist is an altered joint surface.

The kneecap, patella, in front of the knee joint is an accessory bone to help the muscles of the thigh keep the leg straight, extended, during standing, walking, and running.

When the ankle bone partially dislocates, the angle between the leg and thigh bone will become altered. This creates excessive motion of the knee cap. If the person is very active, the tendon attachment into the leg will have excessive pulling on the bone. That creates a tissue reaction at the insertion of the tissue called Osgood Schlatter’s disease.

There will be an excessive twisting within the knee joint because of the unstable ankle bone position.

There are very strong tissues within the knee that are designed to bring stability and also to monitor knee joint position. If there is an excessive motion within the knee, the ligament strain is detected, and a signal is sent to the spine to cause the supporting muscles to contract to bring additional stability to the knee joint. Eventually, those secondary supportive tissues get tired of working so hard and they become pain – hamstring tightness, iliotibial band cramping/tendonitis.

The underlying deforming force of knee pain, ankle bone instability, if left untreated, will continue to exert its damaging effects on the knee.

Every step taken on a partially dislocating ankle bone is a step closer to that critical threshold when the supporting ligaments just get stretched out and partially, or completely rupture. Even after that ligament is repaired, the ankle bone instability is still present and that is why that reparative surgery is not as successful as we’d like it to be.

The top joint surface on the leg bone will become angled because of the partial dislocation of the ankle bone and the thigh bone will rub against the joint surface of the leg bone abnormally. These forces are repeated with every step. The average person will have taken 90 million steps by the time they are 50 years of age. If that person was an athlete, like a soccer player or runner, that step count will be significantly greater. Imagine the abnormal pressures subjected to the cartilage within the knee joint 90 million times. It’s no wonder why the cartilage wears away. It also makes sense why the disease gets worse and worse as one ages because the deforming forces are acting on the knee thousands of times per day, day after day, year after year.

Why is knee pain a “bad” thing?

Knee pain is not a life-threatening condition but it will severely affect the quality of life and can have a negative effect on one’s physical and mental health in general. Pain in general is a bad thing; living with chronic pain takes it to a whole other level. The psychological impact of knowing and anticipating a massive knee replacement surgery is waiting for you at some point down the road will be a source of anxiety for sure. Chronic pain is known to cause depression.

Another important issue is that the more active someone is with knee pain, the more pain they experience. So, it is quickly discovered that less activity equals less pain. Decreased activity levels lead to decreased metabolism. That means there is going to be some weight gain because the calories from the food you eat are not being burned off but rather are being stored as fat. The more weight you gain leads to diabetes, high blood pressure, and heart disease. One of the recommendations for those who have these metabolic-related diseases is to go out and walk, get some exercise, but it is useless. The exercise is simply not worth the pain that is rewarded after that 20-minute walk.

There are other extremely important factors that are at a global level; the burden of paying for knee joint disease. This is one of the most expensive healthcare costs. There are costs in lost work due to doctor’s appointments and then there are personal expenses to pay for the medications, braces, physical therapy, doctor consultations and treatments, and finally surgical fees. The insurance companies are the ones who have to pay for the lion-share of those costs, but it all circles back to the employers and the beneficiaries of healthcare treatments.

Every year the number of people suffering from knee pain increases and the costs of treating knee pain are skyrocketing. It really makes no sense why these numbers are getting out of control with the modern advances in stem-cell therapy and robotic surgery. The reasons why they are out of control and why there is no long-term knee care fix is because the underlying cause of knee pain is still present – make sense?

What is the best form of knee pain treatment?

When warning signs of pain develop in the knee, the first place that should be examined is not the knee. Of course, it has to be examined and it depends on the pain to the knee, should be the foot – specifically the stability or instability of the ankle bone. This is tested when the person is sitting, standing, and walking.

It is well known that the partial displacement of the ankle bone leads to a prolonged period of pronation. This is a motion of the ankle bone compared to the other bones of the foot. It is a complex motion that weakens the joints of the foot to adapt to an uneven ground surface. When the ankle bone partially dislocates on the heel bone, this will lead to a longer than normal amount of weakening within the foot. This is commonly known as over-pronation or hyperpronation.

The link between over-pronation and knee joint disease is well established but little to no attention is ever directed to fixing/reducing the underlying cause which is the missing link in the treatment of knee disease. All of the attention is misdirected to where the pain is located, not the source of the excessive forces that are acting on the tissues.

HyProCure offers a real solution to fixing the underlying cause of knee pain. Instantly, after the insertion of HyProCure, a reduction of force and a realignment of the knee can occur. It is the only form of treatment that has been scientifically proven to reduce the forces acting on the inner knee, the most common location of knee disease. It makes perfect sense as a treatment for knee pain at the root-cause.

Misaligned knee - partially dislocated ankle bone, Aligned knee - realigned ankle bone

What happens if you don’t fix the underlying cause of knee pain?

If the underlying cause of knee joint disease is ignored, the knee disease will continue to get progressively worse. Just do an online search to read testimonials of patients who suffer from chronic pain to their knees. The disease will get to a point of no-return where so much damage has occurred that even the insertion of HyProCure won’t be able to reverse the decades of damage that have been inflicted on the knee. Prevention and early intervention of any disease is the key to success. HyProCure offers the most effective form of treatment and prevention of knee joint disease.

knee joint surgery types

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