Chiropractic, a profession that assesses, prevents, and treats bodily joints while focusing on their relationship with the central and peripheral nervous system, seeks to preserve the body's ability to organize itself and improve its functioning through corrective maneuvers, advice, and posture evaluation. Additionally, it plays an important role in observing the body across different age groups. The same holds true for the knees, and alterations should be noted along with the body's development throughout growth.
In the context of knees, the main conditions involve varus deformities (bow-legged, with knees apart and ankles together) and valgus deformities (knock knees). These alignment changes undergo shifts as a normal process of lower limb development. Newborns usually exhibit varus knees, which tend to straighten out by around a year and a half due to upright posture and locomotion. Between two and three years of age, knees transition to valgus, reaching their maximum angulation at around four years old. Gradually, they spontaneously correct between seven and ten years old, assuming their permanent conformation in adolescence.
Although hereditary factors play a role, valgus deformity is more common in women as a normal condition. However, it can become a deformity due to sequelae from fractures, osteoarticular infections, nutritional rickets, muscular imbalances, and endocrine anomalies. In the case of varus knees, vitamin D deficiency, osteochondritis, dyschondroplasia, and epiphyseal injury can cause uneven weight bearing towards the medial side of the knee (more pressure on the 'inner' side of the knee), resulting in excessive stress that can lead to osteoarthritis and tension in the fibular collateral ligament.
Prevention and treatment of biomechanical issues and extremity pain represent 10% of complaints in chiropractic clinics. If a child continues to have varus or valgus knee alignment beyond the physiological period, it's important for them to undergo a chiropractic evaluation. The chiropractor will aim to maintain the joint's freedom from fixation to prevent knee malformation. The musculoskeletal system should be seen as a unified system by the chiropractor, so when examining the knee joint, they should also consider the hip, pelvis, ankle, and foot joints, as dysfunction in any region can impact another. Consequently, misalignment (subluxation) in an extremity can lead to a vertebral subluxation, both in children and adults.
Referências Bibliográficas.
DALPRÁ, Criscieli. Prevalência de joelhos varo e valgo em adolescentes de 13 a 16 anos. Prevalência de joelhos varo e valgo em adolescentes de 13 a 16 anos. 2011, 40p. Monografia - Universidade Feevale, Novo Hamburgo.
OSHIRO, Valéria Akemi; FERREIRA, Palmira Gabriele; DA COSTA, Roberto Fernandes. Alterações posturais em escolares: uma revisão da literatura postural deviations in schoolchildren: a literature review. Revista de Atenção à Saúde (antiga Rev. Bras. Ciên. Saúde), v. 5, n. 13, 2010.