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One big issue with orthopedic injuries is that doctors do not like chiropractors apparently and never refer someone to a chiropractor. For example, the Mayo Clinic's informational page on knee injuries does not even list chiropractors as a solution type for knee injuries. They list acupuncture, though. That kind of shows where the average American doctor considers chiropracty: below acupuncture as a therapy.

So, the problem is that an athlete with a knee injury has basically two completely alternative approaches: go to a doctor, who will tend towards surgical approaches, or to a chiropractor. The chiropractor has the advantage that the stuff they do is not irreversible in the way that surgery is. On the other hand, an athlete that monkeys around with a chiropractor for a year, may end up putting off surgery which it may turn out is the only solution.

So, the problem is: how do you referee this? Basically you want to know, is this an injury that can be solved with chiropracty or does it need surgery? And just asking a doctor (in the USA) will probably not work because a doctor will nearly always avoid recommending chiropracty from my experience. On the other hand, the chiropractors are not able to read MRIs and say, "this requires surgery" either because they are not doctors.

Is there any kind of neutral observer that can make the right recommendation for either approach?

  • Why is a physiotherapist or an osteopath not an option for you? I totally understand not wanting to do surgery and my first port of call is always with either of these with any injury. – 234535ethr7y4w7456 May 20 at 16:09
  • How is this fitness related? You're asking for treatment recommendations for a knee injury, there isn't anything about fitness or a workout program. If you can add that information, this question may be nominated for reopening, but it would need to be worded carefully to not be personal opinion. – JohnP May 20 at 17:29
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After a knee injury, the first thing you need is an exact diagnosis, which should have a name of an already known condition, for example: "a complete tear of anterior cruciate ligament" or "a tear of the medial meniscus."

Now, whom would you trust more to get an exact diagnosis - a doctor or chiropractor?

A diagnosis can be made, for example, after an MRI or arthroscopy. It is a radiologist who usually describes the MR image first. A doctor and chiropractor should be both able to read the MR image or at least understand what a radiologist has said. On the other hand, a doctor can perform arthroscopy (as another diagnostic procedure), but chiropractors usually can't.

Not all knee injuries require surgical treatment, so it's not that a doctor will always or "usually" recommend it.

Also, "a chiropractor" can mean very different things, so you need to judge this on a personal basis.

A "neutral observation" is probably not possible. The closest to this idea would be a systematic review of studies of the effectiveness of a certain treatment for a certain knee injury.

For example, the authors of A review of systematic reviews on anterior cruciate ligament reconstruction rehabilitation have concluded:

There was moderate evidence of equal effectiveness of closed versus open kinetic chain exercise and home versus clinic based rehabilitation, on a range of short term outcomes. There was inconsistent or limited evidence for some interventions.

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I, like most doctors, believe that the chiropractic practice is a sham. (I had one shoot a flashing laser at different parts of my body to treat my heart arrhythmia, among other things.) There are probably some good chiropractors out there that can do great work and there are those that are basically homeopathy healers, but mostly fall in between. Those are not good odds to gamble imo.

My advice is to forget that route and get a second opinion from a doctor, which should be done when invasive surgery is recommended anyway. Another option is to visit a physical therapist and get their opinion. Especially a therapist who works with elderly patients since they're familiar with people who have underwent huge surgeries and see the before/after. I'd like to think that they would still recommend surgery if the injury is that severe.

I thought that I would need hip replacements and shoulder surgeries in my late 30s or early 40s. I went to a therapist and they found that some of my muscles are just atrophied to compensate my injuries and that the joints are fine. They hooked me up with some resistance bands and told me to do some specific exercises and stretches. Now that I am more active and in the gym, I find that pain is much less, suggesting that they were correct about surgery being too extreme. Though, this is all anecdotal so take my experience with a grain of salt.

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