Do You Have Knee Pain We Can Help With?

Knee problems can be categorized as one of several things and we diagnose and potentially treat all of them. At Integrative Sports Medicine, we specialize in addressing knee pain and injuries to get your back in the game. Visit our knee pain specialist, Dr. Brad Abrahamson, to verify a diagnosis and determine the correct course of treatment.

In all cases the hierarchy of importance of knee treatment is

  • Joint stability.  We can tell on physical exam

  • Good movement patterns.  Don’t worry, we do the biomechanics evaluation

  • Joint health on the inside of the joint.  We think about the biochemistry happening

  • Treating the symptoms

Knee pain can be broken down into these categories:

Child and Adolescent Knee Pain

Knee pain in children and adolescents is generally tricky for parents.  It can be hard to know when to call for help. Youth knee pain also represents a major factor in the return to sports when it happens during a sporting season.  What could it be? Is it worth a doctor visit? A visit is always safe, and sometimes it is better to be safe than sorry. Still, we understand as parents that we don’t always over-react and that we are busy.  Here are some “red flags” that should definitely trigger a call to ISM and a visit:

  1. The pain is always in one knee and not the other.  

  2. There is a history of fracture or trauma and you are not sure the legs are the same length.  

  3. The pain is worsening from week to week, or there are color changes to the overlying skin or the child will not bear weight on the leg.

  4. One knee seems to be bigger, or more swollen than the other.

  5. There is pain shooting down past the knee.

Knee pain in youth patients can be related to:

  1. Benign growth pain at the growth plate

  2. Growth plate injuries

  3. Contusions (deep bruising from a direct blow).

  4. Fractures.  A break in the bone can be far from obvious.

  5. Common injuries such as Osgood-Schlatters and Sinding Larsen Johansson syndrome.

  6. Tendon overuse.

  7. Tumors

  8. And a basket of less common knee problems in youth.  Really it is our job to make the diagnosis. Often because of our experience, we can tell at the first visit, and it is also common that we need to follow knee pain over time so that it declares itself as being one thing.  As always, an accurate diagnosis is key, and we are dedicated to making that with and for you.

These are problems that should also be taken seriously and may need some of the treatment offerings that we provide at ISM.  Normally, adults in our culture let their joints deteriorate instead of getting seen proactively to stop the progression of problems.  There is a definite tendency to under-react to seemingly minor problems in weight-bearing joints especially the knee. We highly recommend not under-reacting.  With ISM as part of your care team, you may be able to stave-off surgery and salvage a knee that is worse than it seems.

  1. Arthritis, often osteoarthritis – This is the prime example of a problem that is too often left too long before you call for an appointment.  Modern biologic treatments such as stem cell and PRP (platelet rich plasma) as well as multiple old-standard treatments can help stop the progression of some kinds of arthritis.  If stem cells are the right thing to do, ISM offers bone marrow aspirate, filtered and concentrated at the highest levels available anywhere.  You need to know all of the underlying cause, and so do we, in order to effectively stop the progressive damage.  Putting off seeing an ISM specialist is like ignoring a warning light on your car dashboard that turns out to be a timing chain going bad.  You can only ignore it for a short time and then you are in for big problems, maybe even knee replacement. If you proactively get care, you may not need catastrophic measures.  We would like to replace the sick care model of healthcare here with a true health care focus on salvaging a knee in trouble. Doing so would save you, and society, lots of time, hassle and money in the long term.

  2. Meniscal tears –  These can be diagnosed by physical exam.  It does not make sense to treat these surgically if there is moderate or severe arthritis, and we can help you sort this out.

  3. Ligament tears –  Physical exam and/or in-office diagnostic ultrasound at ISM can tell you if you may need bracing, activity modification, physical therapy, biologic treatments and activity modification.  And don’t worry. If the best option really is surgery, we will be honest about that and let you know and refer you to the best surgeons available.

These are usually tendon problems related to the patellar tendon, quadriceps tendons or hamstring tendons.  Fortunately, these are often the easiest to treat in a clinic such as ISM that has many non-operative treatment options including PRP (platelet rich plasma).  Not all of these problems need the PRP boost of growth factor. Many knee problems in adults are related to overuse, under-recovery or adverse movement patterns.  At ISM we can spot these problems and have special tools such as diagnostic ultrasound to see the soft tissues and use of an on-site gym. We can also use Functional Medicine and other natural techniques to get the tissues to heal.  

The hip, femur or tibia and all the overlying soft tissue structures can seem like a pain in the knee because they share the same nerves.  This diagnosis may take time, but we are dedicated to your care throughout the process of making a clinical diagnosis and treatment plan.

Dr. Abrahamson Examining a Patient’s Knee