Answers to Questions about Chiropractic:
Should a Chiropractor Massage
My Back to Treat Knee Strain?

Samuel Homola, D.C.

Question

I am 29, a life-long runner and former all-state cross-country champion. I have run 4-6 miles a day most of my life. This fall, I decided to train for the L.A. Marathon. By December, I was suffering from IT-band syndrome, a common distance-runner injury. I began to experience knee pain after running about two miles. When the injury did not heal with rest, my general practitioner referred me to a specialist who diagnosed tendonitis. Since the physical therapist she wanted me to see would not accept my insurance, my doctor recommended a chiropractor who treats sports injuries.

The chiropractor suggested that I had probably injured myself because I am "too limber." Besides massaging the scar tissue in my sore knee, he said he would "tighten me up" with a special exercise and weight program. In general, he focused on my back, asking me a lot about back pain. I kept telling him that I didn‚t have any back pain. He insisted that I had a childhood hip and ankle injury that made my butt muscle and my left leg weak, causing my knee problem. He spent time massaging my knee and hip, which seemed to help. Then things began to get weird.

He started telling me about the "special" exercise program he was going to put me on, telling me how it was going to "change my life" and lower my body fat. During my 3rd week of visits, he seemed to forget about my injured knee. He spent most of the time massaging my lower back to get rid of "plaque." I kept telling him that I did not have any back pain. He explained that we all have plaque building up in our body (just like on our teeth) and that without visiting a chiropractor this "dangerous" plaque is just sitting there, making us tight. (He said earlier that I was too limber.)

During my 4th week, things finally came to a head. He massaged my upper thigh again and then hooked me up to his trusty old electrodes, telling me that my next training session was going to change my life. While I am doing my crunches, he tells me that tightness in my upper back is causing my knee problem. He tells me that I will be able to run again only if I follow his exercise plan and that if I don‚t I may be able to run again for only a few more years. But first I would have to have a "before" picture taken (wearing my bra) and have my body fat tested. The results revealed that my fat percentage was a very low 13%. Normal for women my age is around 17-22%. He told me that I have 16 pounds of fat on my body (I am 5' 6" and weigh 124) and that he wants to convert as much of this fat as possible to muscle, requiring continued visits to his office. I knew then, beyond a shadow of a doubt, that he was a complete fraud and that I had been had.

I am outraged that someone as irresponsible as this is treating a minor injury with unnecessary or harmful treatment methods. At least 75% of the time I spent in his office was spent on my back, arms, and other areas that were not injured. Clearly, his motive was not to help me but to figure out a way to keep me coming to his office as long as possible. I am sending a copy of this letter to the general practitioner who referred me to this chiropractor.

Answer

In view of the fact that you are a former long-distance runner who is still running four to six miles a day, the treatment this chiropractor recommended for a simple knee strain certainly does not seem appropriate. When treatment drifts to parts of the body that have no symptoms, you have a right to be suspicious. The warning that you may not be able to run again without a "special" treatment plan is reason for further suspicion.

I do not know of any way that massaging "plaque" out of your back, arms, and legs and reducing your body fat to a level below normal could relieve a knee strain. When scare tactics are used to encourage continuing a long-range treatment program that involves treating areas where there are no symptoms, it's time to go elsewhere. A good orthopedist or a physical therapist should be able to offer self-help tips that will speed recovery from your knee strain. In the meantime, kudos to you for having the common sense to withdraw from inappropriate treatment.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This page was posted on February 25, 2005.