The term “jumper’s knee” was first coined in 1973 to describe an injury to the tendon that attaches the lower (most common) to the prominence (tibial tuberosity) on the proximal shin bone (tibia) or the upper pole of the kneecap or “patella” to the quadriceps femoris muscle.

Jumper’s knee is one of the more common tendinopathies that affect up to 20% of all adult athletes in sports with frequent jumping, typically among adolescent basketball and volleyball players. Individuals who are obese or who are bow-legged or knock-kneed or whose lower limbs are unequal in length have a higher risk for jumper’s knee. Poor jumping technique can also increase the risk for this condition as can cause overtraining, especially on hard surfaces.

The disease process for jumper’s knee can be divided into four stages: 1) pain only after activity without disability; 2) pain during and after without disability; 3) prolonged pain during and after which affects function; 4) complete tendon tear that requires surgical repair.

Treatment for jumper’s knee can include: 1) reducing jumping activity;  2) icing the knee for 15-30 minutes, four to six times a day, especially after the activity; 3) a thorough exam of the hip, knee, ankle, and foot to assess joint function; 4) stretching the hamstrings, calf, quadriceps, hip flexors, gluteal (buttocks), iliotibial band, and tissues around the knee cap; 5) strengthening exercises focused on specific parts of the quadriceps (vastus medialis oblique especially) and other leg muscles; 6) ultrasound and other therapies that may help speed recovery; and 7) taping to help patellar tracking.

Doctors of chiropractic are trained to evaluate and treat the whole person and frequently treat athletic injuries. A successful treatment outcome for jumper’s knee requires both local knee care and the management of the entire lower “kinetic chain” which includes the foot, ankle, knee, hip, and pelvis.

Low back pain (LBP) affects about 80% of adults at some point in their life, and its impact on work, recreation, and overall quality of life can be devastating if it transitions into chronic LBP (low back pain that persists for more than three months).

So, is there really a simple remedy for chronic LBP (cLBP)? Since back pain is often multifactorial in its causation, the simple answer is “probably not”. BUT, a 2017 study reports that simply taking vitamin D can offer significant benefits for the cLBP patient.

In the study, researchers provided participants (68 patients with a history of cLBP and low vitamin D levels) with an oral dose of 60,000 IU of vitamin D3 every week for eight weeks. The research team measured pain intensity and disability using common outcome assessments at baseline and at two, three, and six months post treatment. They also collected blood samples to measure vitamin D serum levels.

The data show that not only did the patients’ vitamin D levels improve from 12.8 ng/mL (+/- 5.73) at baseline to 36.07 (+/- 12.51) at eight months with 45 (66%) of the patients attaining a normal level of >29 ng/mL, but the participants also report significant improvements in pain and disability throughout the course of the study.

The authors conclude that vitamin D supplements can improve pain and function in cLBP patients with vitamin D deficiency. Hence, this is a VERY SIMPLE remedy!

It is well known that vitamin D deficiency is a very common problem, with up to 75% of teens and adults having suboptimal levels. Past research has demonstrated vitamin D deficiency may be a risk factor for many disorders including cancer, heart disease, diabetes, and depression. It appears that we can now add cLBP to the long list of conditions that vitamin D supplementation may benefit.

Chiropractic services frequently include nutritional counseling, diet management, and other wellness-related services in the quest of optimizing patient health, well-being, and quality of life.

According to a World Health Report, migraines are the nineteenth most common patient complaint worldwide with an 18% of women and 6% of men in the United States experiencing at least one migraine headache episode each year.

There is evidence that patients with migraines have an energy deficit disorder associated with their glucose intake. As such, adopting a strict ketogenic diet (in which ketones are the primary source of energy for the body in place of glucose) does appear to benefit patients with migraines.

A 2017 study set out to determine if it was the absence of glucose or the increase in ketone bodies that made the difference for patients. In the study, researchers provided four female migraine patients with a specially designed ten-gram beverage containing a specific type of ketone called B-hydroxybutyrate or bHB twice a day for four weeks.

After one month, their migraine frequency rate dropped 50% to eight days/month on average without any serious side effects.  The patients also lost weight, presumably due to consuming less glucose in their diet. An additional benefit of higher levels of ketones in the body is that they have an anti-inflammatory effect.

A larger double-blind, randomized, placebo-controlled trial is now underway with a group of 90 patients that will last three months The goal of the study is to determine if this nutritional supplement is capable of reducing migraine headaches without the significant side effects and associated disabilities that are currently associated with many migraine medications.

Chiropractic care often includes nutritional counseling as an important part of caring for the whole person. In fact, there is research supported evidence that spinal manipulation alone has a very positive benefit for migraine headache patients as noted in the 2010 and 2014 UK studies regarding the effectiveness of manual therapies. Based on the outcome of this large-scale study, the use of ketone-based supplementation for migraines may become a new standard.

At some point in time, most of us have had a “Charlie horse” or muscle cramp. In fact, 50% of adults over the age of 50 suffer from night cramps. Doctors of chiropractic are often asked by their patients, “Where do these come from? Why am I having these? What can I do to get rid of them?”

The most common type of muscle cramp is caused by exercise, hence the label “exercise-associated muscle cramps” (EAMC). Though EAMCs are common in both recreational and professional athletes, the actual cause remains unclear. Therefore, treatment is often based on anecdotal studies rather than sound scientific evidence.

With that said, a thorough analysis of previous studies published between 1955 and 2008 concluded that the two most widely discussed theories for the cause of EAMC are 1) dehydration and the resulting electrolyte imbalance/depletion and 2) neuromuscular causes. The authors of the analysis concluded that the actual cause is “…likely due to several factors coalescing to cause EAMC.” In other words, it’s sort of like “a perfect storm”, as several causes interact to result in the cramp, which is why treatment and prevention strategies for EAMC can vary considerably.

The recommended care for acute EAMC is to apply a steady, moderate static stretch to the muscle followed by gathering a proper history to determine if any predisposing conditions exist that can trigger EAMC. Prevention should focus on fluid and electrolyte balance (replacement) and/or neuromuscular training.

Specific physical problems that can increase the rate and/or intensity of muscle cramps include conditions affecting the endocrine system (hormonal imbalance), the metabolic system (loss of fluids and electrolytes), and/or the neurological system (such as nerve injury or damage). Common areas for muscle cramping include the calf, front of the thigh (quadriceps), and back of the thigh (hamstrings).

A thorough history and physical examination may include a nutritional assessment, which can lead to treatment strategies tailored for each unique, individual patient. Additionally, it’s a good idea to review what medications a patient is taking as they may play a role in the development of cramps. For example, diuretics commonly prescribed for high blood pressure and other heart-related conditions may lead to potassium depletion.

Some helpful natural remedies for those with persistent muscle cramping may include a mineral/electrolyte replacement such as calcium, potassium, and/or magnesium. Anti-inflammatory nutritional care such as ginger and turmeric and/or muscle relaxing approaches such as valerian root can also be helpful. Other anti-cramping natural substances include Cassia oil and capsaicin. Riboflavin has been used preventatively with success as well.

 

There are two types of muscles that help facilitate motion in our hips and lower extremities: tonic and phasic.

Tonic (postural) muscles are always working or contracting to keep us upright. Therefore, these muscles tend to be tight and short. When we sleep, they contract or shorten and are taut upon waking and need to be stretched on a regular basis.  Examples of tonic muscles include the hamstrings and the iliopsoas or hip flexors muscles. Here are two great stretches for these muscles:

Iliopsoas stretch: 1) Stand and take a step forward with the left leg into a front straddled position.  2) Rotate the left side of the pelvis forward so that it becomes square with the right side of the pelvis. 3) Perform a posterior pelvic tilt by flattening the curve in the low back while rocking the pelvis forward to create a strong stretch in the left groin/front of the hip. 4) Lean backwards to the right to further increase the left groin/hip stretch.  Hold for five to ten seconds and repeat this on the opposite side. Practice these stretches multiple times a day.

Hamstrings stretch: 1) Lie on your back and place the left leg on a door jam with the right leg flat on the floor extending through the opening of the doorway.  2) Push the left leg into the door jam and hold for three to five seconds and then scoot closer to the door jam to stretch the hamstring.  Hold for one to two minutes and repeat this on the opposite side, multiple times a day.

Phasic muscles, on the other hand, only work when needed and tend to be weak. These require strengthening, not stretching. Examples of phasic muscles include the abdominal and buttock muscles. Here are two great strengthening exercises for these muscles:

Abdominal strengthening: 1) Lying on the floor, place your hands behind your low back. Bend one knee/leg while keeping the other straight. 2) Lift your breast bone toward the ceiling one to two inches (2.54 to 5.08 cm) and hold for ten seconds. Repeat multiple times until the abdominal muscles are fatigued.

Buttocks strengthening: 1) Squeeze your buttocks together multiple times a day when sitting or standing. 2) Lie on your back with your knees bent and your feet flat on the floor. Raise your buttocks so it lines up with your trunk while pushing your heels into the floor. Hold for ten seconds and repeat five to ten times.

Depending on the nature of your hip pain, your doctor of chiropractic may recommend further exercises that you can perform at home as part of your treatment plan.