As you age, going up the stairs may be more challenging than in your younger years. You may have friends who have these challenges who are visiting specialists who look at the knee, tell them they are arthritic, and the injections they are giving them will offer them a few more years before you need to have your knee replaced. Drug companies are always trying to develop the next drug or procedure to grow back your knee cartilage, and without understanding why your knee is arthritic first, you may be asked to wait until they can justify replacing the joint. What if you could regenerate the cartilage; however, the knee is not in its original shape, and neither are the surrounding joints, known as your hip and your ankle and foot? Perhaps this is why treating the knee as if it is not part of a mechanism has failed with many meniscus surgeries and rehab regimens to the knee. Looking at an X-ray as a history of malfunction rather than just an arthritic joint which needs shots and eventual replacement often fails to alter the course especially if the knee pain is actually a hip problem, which is common. If you run, you may have been warned that running will make your knee worse. The good news is, running produces lubricants and other substances around the knee which reduce inflammation and are nutritionally good for the knee. The MRI after the X-ray is often used to green light a procedure that works on the symptom. The MRI is, in my opinion, the most overused test to get a joint surgery approved. Knee replacement surgeries are traumatic, risk-laden, and often reduce pain and then lead to other joint surgeries, as the problem in your adaptations in walking has not been solved. I have personally witnessed this in my 40 years of being a certified chiropractic sports physician. The current research suggests that there is more to a bad knee than the knee itself. To understand the knee, we must look at the patient and how they walk, hit the ground, and if they developed compensations compromising the knee years later. Clues include ankle pain, knee pain, hip pain, lower back pain, shoulder pain, and plantar fasciitis. A recent paper reinforces this idea. Impact of Running on the Risk and Progression of Knee Osteoarthritis: A Review of Current Evidence It is important to ask yourself: why me? There is a better way forward. Traditional thought on the knee has fed the joint replacement machine for years now, yet nobody can argue that improving how you walk protects or damages the knee, hip, back and other joints. Prevention is safer, prevents unnecessary suffering and pain, and improves how you move and function in your daily activities. Move and walk better, age better and enjoy activity even into your 80’s. Knee and gait problems causing bad hips and knees years later begin when we are young, usually around the time of puberty with growth spurts and secondary changes related to our sex. Girls are more prone to knee injuries to the anterior cruciate ligament during sports by planting and twisting of the knee with the foot planted. Exercises of the core muscles reduce the risk significantly. Athletic trainers know this because a better, more functional core and fascial system reduces the stress on the knee as well as ground impact. We as a society can improve knees with more squatting, better core control, and looking below and above the knee when we are young, to avoid the inevitable injuries as we age with those same bad movement adaptations. Here is why your sports chiropractor is where you should begin your journey. Sports chiropractors, like us, look at patients from the feet up, evaluate function, posture, and balance. These movements during an exam are often in addition to standard orthopedic and neurologic tests. Knee pain can be identified by the knee, but to understand the cause, we must look at the person with the pain and resolve or improve those forces acting on the knee. An X-ray or MRI can tell us the current condition, and it can also tell us about pathology, but it may not help us understand why your knee hurts if it is a foot, hip, or even a back issue. A thorough history and exam are far more helpful in diagnosing a knee properly as we look at how you walk. If the knee pain started with activity rather than a direct lateral hit in football, there is more to diagnosing the knee than looking at just your knee and then using imaging to confirm. The foot can determine how the knee functions, and the hip will be affected by the ankle and foot. These forces will affect the knee. This is why evaluating knee pain requires a thorough history that is holistic. It is also likely you may have a history of foot pain, hip pain, back pain, and other manifestations of poor gait habits, which ultimately can be solved by a sports chiropractor. Sometimes, these problems can be markedly improved with a foot orthotic to balance the hips and improve how you move. Chiropractors use methods such as manipulation of the spine and extremities combined with myofascial release or other soft tissue treatments to improve how you move. Finally, appropriate exercises can further improve how you move and function. Sports chiropractors have additional orthopedic, neurological and extremity training to diagnose problems on and off the field. Keep it simple. Think chiropractic first.