Hip and Knee

Hip sprains and strains are common injuries sharing similar signs and symptoms. A sprain is a stretching or tearing of ligaments, the tough bands of fibrous tissue connecting bones in the joints.

Causes may include: falling, a direct blow to the muscle (a contusion), overstretching, or overuse causing muscle fibers to tear.

Pain may include pain over the injured muscle, swelling, or loss of strength and mobility in the muscle.

A.M.I.T. ® Explanation: When the hip is traumatized, muscles may become overloaded and inhibit to protect from more serious injury. Inhibited muscles do not contract in appropriate ways. From that point on, any time the muscle is loaded it “gives way” in a weak response. If it continues to be stressed, the pain will result in an effort to protect the muscle from more injury. The body will not allow motion it cannot stabilize, resulting in motion restriction for that plane of motion. Stretching the muscles to increase motion may only set up conditions for more severe injuries.

Hip Bursitis is a painful condition affecting the small fluid-filled pads, called bursae, which act as cushions along with bones, tendons, and muscles near the joints. Bursitis occurs when bursae become inflamed.

Causes of hip bursitis are repetitive motions or positions that irritate the bursae around a joint.

Pain may include: feeling achy or stiff, pain with movement or pressure, or an area appearing swollen and red.

A.M.I.T. ® Explanation: Inflammation of the bursa in the area of the hips. There are multiple bursa in the hip such as Ischial-Gulteal Bursa, Trochanteric Bursa, and Iliopsoas Bursae. The primary causes of pain are muscles attached to the hip that are injured or inhibited. Forcing injured or inhibited muscles to work may create pain and reduced motion, increasing degenerative changes.

Osteoarthrosis is the most common form of arthritis, often referred to as “wear-and-tear arthritis”.

Causes occur when the protective cartilage on the ends of the bones wears down over time.

Pain may worsen with time and can damage any joint in the body. Usually affects the joints in the hands, neck, lower back, knees, and hips.

A.M.I.T. ® Explanation: A loss of muscular support and increased inflammation leading to the breakdown of the articular cartilage of the hip, resulting in the formation of bone spurs, pain, and decreased function. One of the most common causes is long-standing muscle inhibition of the muscles supporting the hip joint. Another common cause of this condition is the consumption of soda pop, GMO foods, vegetable oil, high fructose corn syrup, and hybridized wheat.

Piriformis Syndrome is an uncommon neuromuscular disorder. The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. It stabilizes the hip joint, lifting and rotating the thigh away from the body.

Piriformis syndrome is caused when the piriformis muscle compresses the sciatic nerve.

Pain may include tingling, or numbness in the buttocks, pain extending down the leg, sciatica after sitting for long periods of time, pain walking, or running. Most cases of sciatica, are not due to piriformis syndrome.

A.M.I.T. ® Explanation: The piriformis muscle attaches to the greater trochanter (hip bone) and fans out to attach to the lateral side of the sacrum. When this muscle becomes chronically tight, it can cause pressure on the sciatic nerve, leading to symptoms associated with sciatica. In a small percentage of patients, the sciatic nerve runs through the piriformis muscle, instead of under it. Inhibition of this muscle is the most common cause of irritation, which is easily corrected using the A.M.I.T. ® method. Another common cause is sitting on a wallet for extended periods of time.

Iliotibial Band Syndrome is said to occur when the thick fascial band that extends from the outside of the pelvic bone to the outside of the tibia (iliotibial band) becomes tight and rubs against the outer portion of the femur.

Causes may include muscle tightness or weakness, poor alignment, or compensation and adaptation of connective tissue and muscles. Distance runners are most susceptible.

Pain may include swelling and stiffness of the lateral side of the hip, thigh, and knee. These areas may develop redness and warmth to the touch, weakness or instability, popping or crunching noises, inability to fully straighten the knee or any type of weight-bearing activity-causing pain.

A.M.I.T. ® Explanation: Recent research shows that friction due to the band rubbing against the knee does not cause this condition. The Iliotibial (IT) band is a thick band of tissue that runs down the side of the thigh attaching into the lateral side of the knee. It attaches to the tensor fascia lata muscle, which attaches into the anterior lateral side of the ilium to the lateral aspect of the knee. The band is anchored by the gluteus maximus muscle along the posterior margin. IT band syndrome is caused when these two muscles become inhibited and can be easily corrected using the A.M.I.T. ® method.

The Medial Collateral Ligament (MCL) supports the knee along the inner side of the leg. The MCL can be torn by a direct sideways blow to the outside of the knee or lower leg.

Causes of MCL sprains may include a severe knee twist, particularly when a fall twists the lower leg outwards, away from the upper leg.

A.M.I.T. ® Explanation: When the vastus medialis muscle group has become inhibited the knee loses medial stability. As the vastus medialis muscle group continues to activate, it tends to put the knee in a valgus or “knocked knee” position. This places more stress on the MCL and makes it susceptible to rupture with later knee trauma. If any of these muscles have been inhibited through prior injuries, people will be susceptible to tearing these ligaments. It may also lead to the kneecap tracking improperly, which is why having an A.M.I.T. ® evaluation before having a surgical release is recommended.

The Lateral Collateral Ligament (LCL) supports the outer side of the knee. It is the least likely knee ligament to be sprained.

Causes of LCL sprains are due to a blow to the inside of the knee.

A.M.I.T. ® Explanation: When the vastus lateralis muscle group has become inhibited the knee loses lateral stability. As the vastus medialis muscle group continues to activate it tends to put the knee in a varus or “bull legged” position. This places more stress on the LCL and makes it susceptible to rupture with medial knee trauma. When force is applied from the lateral side of the knee it overloads the gracilis, Sartorius, semimembranosus, and semimembranosus muscles. This leads to medial instability of the knee, even after the ligaments have healed.

A meniscus tear is one of the most common knee injuries. Each knee has two menisci C-shaped pieces of cartilage, which act as a cushion between the shinbone and the thighbone.

Causes may include any activity requiring someone to forcefully twist or rotate the knee, especially when putting the pressure of full weight on it.

Pain may include: a popping sensation, swelling or stiffness, pain when twisting or rotating the knee, difficulty straightening the knee fully, or experiencing what feels like a block to the movement of the knee, as if the knee were locked in place.

A.M.I.T. ® Explanation: Defect of one or both of the fibrocartilage circular menisci of the knee that properly position and support the knee, causing a small painful click inside the knee and joint line tenderness. Surgical repair is the only option to treat a torn meniscus. Conservative care only increases the likelihood of more severe tearing in the future.

Chondromalacia Patella is a term indicating damage to the cartilage under the kneecap, also referred to as Patellofemoral Pain Syndrome. It is characterized by softening of the cartilage surfaces.

Causes may include overuse or repetitive stress on the knee joint, poor control of the muscles, when muscles around the hip and knee don’t function optimally to maintain proper tracking of the kneecap, or trauma to kneecaps, such as a dislocation or fracture.

Pain may include a dull and aching pain in the front of the knee, pain walking up or downstairs, pain kneeling or squatting, or pain sitting with a bent knee for long periods of time.

A.M.I.T. ® Explanation: When muscles supporting the knee joint become inhibited from the accumulation of injuries, they no longer support the joint. The stress of weight-bearing is increased on the cartilage and other connective tissues. This creates a chronic inflammatory and degenerative process. If there is the addition of long-standing nutritional deficiencies related to cartilage repair, the cartilage surfaces begin to soften and degenerative processes are increased. Frequent consumption of soda pop can increase joint degeneration as well.

Jumper’s Knee (patellar tendinitis) is an injury affecting the tendon connecting the kneecap (patella) to the shinbone (tibia). The patellar tendon helps the muscles extend the knee to kick a ball, run uphill, and jump up in the air.

Causes may include: overuse, repeated stress on the patellar tendon creating tiny tears in the tendon. When tears become numerous they cause pain from inflammation and a weakening of the tendon structure. This is most commonly seen in athletes whose sports involve frequent jumping, such as basketball and volleyball. This condition is the primary reason athletes retire from the sport.

Pain may include: pain in the section of the patellar tendon between the kneecap and the area where the tendon attaches to the shinbone, progressive pain in the area, pain when climbing up and downstairs, pain present as beginning a physical activity, or pain after an intense workout.

A.M.I.T. ® Explanation: This condition is caused by muscular imbalances of the quadriceps complex, gluteus maximus muscle group, and the gastrocnemius muscles. Historically, the quadriceps have been made up of four muscles: vastus medialis, vastus lateralis, vastus intermedius, and rectus femoris. We’ve discovered these muscles are actually divided into thirteen muscles: vastus medialis, upper, middle, lower, and oblique divisions, as is the vastus lateralis. The vastus intermedius is divided into two divisions, the medial and lateral divisions. The rectus femoris is divided into the straight head and reflected head. The last muscle is the small articularis genu. Each of these muscles has its own precise action. When these muscles become inhibited due to injury or overuse, their tendonous attachments become inflamed during the first six weeks following injury. After six weeks have lapsed, degenerative processes begin. The pain centers in the tendon/bone attachment, called the enthesis, generating intense pain to unload the muscle and protect it from tearing. Due to the muscle’s inability to stabilize the kneecap, it does not tract properly and the condylar surface becomes inflamed and more prone to degenerative changes.