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RE: [RC] Knee pain helped by massage - SHEILA A WALSH

I had a deep tissue massage therapist work on my ilio-sacral muscles, as diagnosed by my chiropractor, and that helped my knee pain tremendously.  That and stretching.  Now I go to her on a regular basis and I can ride for hours on end without better living through chemistry.
> Date: Wed, 25 Mar 2009 06:36:19 -0700
> From: bweary@xxxxxxxxxxxx
> To: Ridecamp@xxxxxxxxxxxxx
> Subject: [RC] Knee pain
> Hi Cheryl--
> You have an interesting problem in your bilateral keen pain. The pes
> anserine bursa (trivia: "pes anserine" means "goose foot," referring to
> the appearance of the bursa resembling a goose's foot) is located below,
> in front and to the inside of the knee. It lies under the tendon
> attachments for the hamstring and adductor muscles. (Adductors are the
> muscles inside the thigh that keep you on the horse when he shies. :>)
> I'm not sure how your problem started, but I would stay away from any
> further injections. Steroids can be very useful, but they have a
> downside, in that they can actually impair healing, or cause tissue
> destruction if used too much. Gentle stretching of the hamstrings, foot
> and hip joint manipulation, and possibly wearing orthotics may help. The
> knee is a great compensating joint, in that problems in the hip or foot
> are often compensated for in the knee. This often sends us doctors on a wild
> goose (foot) chase, since the pain may be in the knee, but the origin of
> the problem lies somewhere else.
> The trick in diagnosing joint pain is recognizing which pain sensitive
> tissue the pain is coming from. In your knees, you would have to rule
> out pain coming from the joint capsule, the medial collateral ligament,
> the various bursae, the patellar tendon, the coronary ligaments (which
> hold the cartilage in place and are the main source of pain in torn
> cartilage) the tendons of the various adductors and the hamstring and
> the periosteum (which is the pain sensitive covering of the bone).
> I suppose an MRI might be done, of your knees, but unless you have
> significant known osteoarthritis, it probably wouldn't yield much useful
> information, if the pain is indeed coming from the bursa. I suspect your
> problem involves pain or dysfunction coming from more than one tissue.
> I would try a really good chiro who is trained in lower extremity
> diagnosis and treatment. Not easy to find. Good luck. Bruce
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[RC] Knee pain, Bruce Weary DC