Pregnancy and Knee Pain

Dear Dr. Caraotta and Dr. Bowman:

I am pregnant and am having problems with my knees. I have difficulty climbing up stairs, and walking very long. I gained 35 pounds so far, and am in my seventh month of pregnancy. Could the weight gain have anything to do with the pain and could chiropractic help this?

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Dr. Caraotta and Dr. Bowman's Response

The knee is a dependent joint and is very sensitive to stresses that are exerted upon it. There are many individuals who gain excessive weight in pregnancy, and have minimal problems with their knees. Other individuals with little weight gain may have knee problems. What accounts for the difference? There are many factors to consider. Lets discuss a few.

1. The main supportive tissues around the knees are ligaments. Ligaments connect bone to bone, and if they are stretched due to an injury, they will remain in that state, and there will be an inherent weakness in the knee joint. If a person had a pre-existing ligamentous injury prior to becoming pregnant, she is more susceptible to becoming symptomatic with the weight gain during pregnancy.
   
2. Separating the bones are cartilage like structures called meniscus. The meniscus are very sensitive to weight that is exerted upon them. In fact, individuals who are most prone to wearing down the cartilage between their knees, and end up with knee replacements are those who have been overweight for many years. If a person is in this category, and experiences a rapid weight gain in pregnancy, they often experience knee pain.
   
3. A third classification of individuals who experience knee pain during pregnancy, are those who have poorly conditioned quadriceps or thigh muscles. The quadriceps are muscles that control the knee. If they are weak, this makes a person susceptible to knee injuries.

Since we are trained in our specialties to rehabilitate patients without the use of medication and surgery, we often get referrals from other physicians to aid pregnant patients with knee problems along with a myriad of musculoskeletal problems, including pregnancy induced carpal tunnel syndrome and upper and lower back pain.