925.999.8757 rnassab@comcast.net

Dr. Nassab’s Clinical Discussions:

I. Findings
The knee is the largest joint in the body, and one of the most easily injured. It is made up of the lower end of the thighbone (femur), which rotates on the upper end of the shinbone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur. The knee also contains large ligaments, which help control motion by connecting bones and by bracing the joint against abnormal types of motion. Another important structure, the meniscus, is a wedge of soft cartilage between the femur and tibia that serves to cushion the knee and helps it absorb shock during motion.

Injuries to the knee ligaments of the major ligaments found in the knee are the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) are often injured in sports. The posterior cruciate ligament (PCL) may also be injured.
• ACL injury
Changing direction rapidly, slowing down when running, and landing from a jump may cause tears in the ACL.
• MCL injury
Injuries to the MCL are usually caused by a direct blow to the outside of the knee..
• PCL injury
The PCL is often injured during a blow to the front of the knee or making a simple misstep.
• Torn cartilage
When people talk about torn knee cartilage, they are usually referring to a torn meniscus. The meniscus is a tough, rubbery cartilage that is attached to the knee’s ligaments. The meniscus acts like a shock absorber.
Today let’s talk about my female patient age 63 with pain on the anterior and medial portion of her left knee.(front and inner knee) She had constant pain and it began with stepping off of a curb. When I finally got a chance to see her, the pain was constant and with every position. My examination revealed swelling and less mobility. We took x-rays and found osteoarthritis and swelling. She had a very sharp pain with every step she took.

II. Treatment
Treatment begins with the analysis as the cause is part of the problem. It turns out she makes this particular walk on a regular basis. We decided to begin adjusting her relatively quickly. We began with her low back, as this is the nerve supply to her knee. Next we adjusted her knee and iced it following the adjustment. On this particular occasion we taped it up and sent her home for rest and icing of the knee. We also monitored her shoe type as not to make the knee Subluxation any worse.
III. Prognosis and Outcome
As luck would have it she began to respond well to our work and efforts. After 10 weeks of care on a once per week visit, her steady rehabilitation, and occasional icing of her knee, she became asymptomatic.
IV. Dr. Nassab’s Discussion
What really is exciting about this patient was her steady recovery, with the occasional lapse, and her not missing any day of work or her workout schedule. Together we revised her workout schedule to aid her healing process and not hinder it. As I told her that the body heals at its own pace no matter how much faster we want it to go. We were lucky in that an x-ray was plenty for diagnosis but, an MRI exam would be the next step if she were not to respond. Chiropractic is a common sense approach and the least invasive with the greatest result.

This is an informational discussion for you and to present and or share with your family and friends.
If you have any feedback, questions, or concerns, please email, text, or call.
Yours in health,
Richard G. Nassab, D.C.
Pleasanton, California