Dr Neil Gardner, Contributor

Chronic knee pain creeps up on you slowly. First you feel it after the workout, then during the workout. Soon, the pain is there even when you are not exercising, when you climb stairs or sit for long periods. You may even hear a crunching or grating sound under the kneecap.

After completing the semi-finals of the 400m hurdles at the 'Don't Kneel To Knee Woenational' trials for the Sydney Olympic Games in 2000, I realised that something was wrong with my knee. I was unable to put any weight on it to walk - running was impossible. Unable to figure out what was wrong, a physician suggested that I take painkillers and rest. I failed to make the team.

Comprising three different joints, the knee joint is the largest and most complex part of the body. It is the most susceptible joint to injury because of the incredible amount of load that is placed on it when you walk, jog or play sports. The type of injury most often seen is the non-traumatic type, brought on by repetitive stresses on an incorrectly functioning joint.

'Jumped' its track

The kneecap is supposed to glide smoothly in its groove. But due to muscular imbalances, it may be pulled to the outside like a sliding door that has 'jumped' its track. This leads to bones rubbing, resulting in wear and tear over time. This deterioration causes pain and, ultimately, arthritis in the knee.

Sometimes the cause of the pain is a blow to the knee resulting in an over-straightening, a sideways shearing or an over-bending of the knee. These motions may damage the stabilising ligaments or cartilage leading to bursitis, ligament strains or meniscus tears.

Ice, anti-inflammatories, muscle relaxants, ultrasound and hot packs may help ease the pain initially, but do very little to address the real cause. Painkillers may also lead to a false sense of security; without pain you may think that all is well, while the underlying problem continues to destroy the knee. The bottom line is any injury to the knee, whether caused by overuse or trauma, may result in arthritis if it is not properly dealt with and the problem corrected.

Muscle imbalances and derangement may be corrected conservatively, if the problem is not too severe or the degeneration too advanced. If the problem is allowed to progress for too long, then corrective or replacement surgery might become necessary.

If you have persistent knee pains, speak to your chiropractor about a possible correction of the underlying cause.

Dr Neil Gardner, Diplomate, American Chiropractic Neurology Board Chiropractic Neurologist, Gardner Chiropractic and Neurology Ltd. www.gcnjamaica.com. Telephone: (876)978-1050-1/(876)622-9241/214-432-5464 (from the USA).