Chronic Hip and Knee Pain -- Improve Strength and Function
• The femur bone is the longest bone that makes up a portion of the hip and knee joints
• The hip consists of a ball and socket joint complex
• The knee is the largest joint in the body with two corresponding condyles
The Hip
• Pelvic socket called the acetabulum receives the head of the femur
• Subluxates primarily in internal rotation (90+%), sometimes in external rotation
• Primarily a weight bearing joint
Signs of Femur Subluxations
• Limp during gait, and often toe-out or toe-in during gait
• Dull ache
• Muscle fatigue (Trendlenberg sign; cant stand on one leg)
• Limited range of motion (Internal Rotation is 35 degrees, and External Rotation is 80 degrees)
• Tenderness around Greater Trochanter
• Orthopedic tests (Fabre's, Anvil, Adduction tests can be positive)
• Muscle test of TFL (tensor fascia lata) can be weak
The Knee
• Most traumatized joint in the body
• Condyles of femur and tibia while fibula makes up lateral knee
• Knee cap (patella) glides up/down the femoral groove
Signs of Knee Subluxation
• Limp in gait
• Dull ache in joint
• Difficulty sitting long or climbing stairs
• Tenderness at joint line
• Orthopedics (Valgus/Varus, Drawer, McMurry's, Bounce Home, Clark 's tests can be positive)
• Muscle testing of popliteus; weakness indicates movement of the tibia posteriorly.
Hip Rehabilitation
• 3-way series “up to the sky” motions (on your back, side, and face down lift straight leg to the sky)
• “Rule of Threes”: 3 minutes, 3 times/day
Knee Rehabilitation
• Terminal knee extension with foot externally rotated (toe-out), and than slowly lower
• Wall squats
• Lunges
• Hamstring and Quadriceps stretches
• Rule of Threes (3 minutes or 3 times/day)
Neurology of a joint
• Hilton's Law: Innervation of adjacent muscles and joint capsules related.
• Pre: Pre-test the joint with muscle testing. If weak or painful, and adjustment is warranted.
• Post: Post-test the joint, improvement of strength by 50% or >, and reduction in pain by 50%.
CCEP
• Certified Chiropractic Extremity Practitioner
• Dr. McRoberts has extensive training in extremities.
