Patients have come to expect technology in their care, and they welcome what it does well: faster service, sharper diagnostics, fewer errors. But they remain protective of something technology can’t replace, which is direct, hands-on time with a provider. In one study published in JMIR Medical Informatics, close to a quarter of patients said physicians focused on their screens were less present for the actual treatment, even as many acknowledged that the right tools, used well, can free clinicians to deliver better hands-on care.
That tension, between what technology enables and what only a clinician’s hands can do, is one Dr. Sarah Scharf has built her practice around. At Marin Joint Health, her approach to knee pain layers advanced technology, including mechanical decompression and Class 4 laser therapy, with hands-on techniques that retrain the way the body moves. She brings both sides of care to the table, sometimes literally.
The Problem With Treating Knee Pain as a Single Issue
Knee pain’s high prevalence among adults drives many to seek treatment. Around a quarter of adults report knee pain, and the impact is rising. Over the past two decades, the number of people reporting knee pain has risen by 60%.
One reason for that prevalence is the knee’s position in the kinetic chain, the connected system of joints and muscles that make up human movement. The feet, ankles, hips and spine all move in coordination with each other, and the knees, which sit in the middle of that chain, do a lot to support that movement.
But the knee has limited ability to compensate when dysfunction elsewhere in the chain impacts how load moves through the leg. Often, the knee absorbs that stress rather than passing it through.
Because of this chain, clinicians can’t treat knee pain as an isolated issue. A treatment aimed only at the joint can miss what’s actually driving the damage. “Even the best tissue-level therapy is treating the symptom of a problem that lives somewhere else,” explains Dr. Scharf.
Dr. Scharf’s approach at Marin Joint Health starts by acknowledging that reality and treating the knee with a layered approach.
Creating Space: Knee-On-Trac Decompression
Knee-On-Trac uses a patented mechanical device to gently separate the femur (thigh bone) and tibia (shinbone). Doing so creates more space in the knee joint, allowing nutrient-rich fluid to rehydrate tissue there. It also reduces compression on structures that may have been under a chronic load.
Knee-On-Trac decompression isn’t invasive, which means:
- No incisions or injections
- Patients stay clothed
- Patients are unlikely to experience downtime as a result of the treatment
At Marin Joint Health, Knee-On-Trac treatment is provided as part of a normal visit cadence when it makes sense to include it in a patient’s protocol. During treatment, patients may experience a stretching sensation; because no significant force is involved, the sensation is likely to be gentle and pain-free.
Knee-On-Trac is an early step in treating knee pain, not a one-and-done solution. If it’s not combined with other approaches, the joint may compress again, stopping effective healing.
Reaching the Tissue: Class 4 Laser Therapy
After decompression, a high-powered laser may be used to target damaged tissue in the joint. During this treatment, a laser penetrates up to 7 centimeters into the knee, where it can impact the joint capsule and surrounding structures.
The mechanism at work in Class 4 laser therapy is called photobiomodulation, which enhances circulation and tissue repair. Providers usually apply laser therapy with a handheld device, moving it over the affected area in circles continuously.
This treatment is non-invasive and doesn’t involve incisions or injections. It’s also typically painless. Patients may feel a warming sensation deep in the knee, and many report that it feels soothing.
Integrating Hands-On Care
Technology like Knee-On-Trac and laser therapy can promote the conditions required for healing, but they don’t retrain how the body moves. If the issue is further up or down the chain, such as with the ankles or hips, knee pain is likely to return.
Dr. Scharf’s protocol follows technology with hands-on care, including:
- Chiropractic adjustments to the spine, pelvis, hips, ankles and feet, as needed. Adjustments help correct misalignments that overload the knee.
- Trigenics neuro-kinetic therapy, which is a manual technique combined with resisted movement. It resets how the nervous system communicates with the muscles around the knee.
Depending on a patient’s needs, Dr. Scharf might also recommend options like corrective orthotics to support effective movement in the future.
Why the Sequence Matters
The team at Marin Joint Health treats every patient individually, combining the modalities that are likely to work in specific cases and addressing patient concerns and feedback along the way. However, generally, sequence does matter:
- When the knee is compressed, treatments like Knee-On-Trac help create the space necessary for ongoing healing.
- Lasers target existing damage to help promote repair once there’s space for it.
- Hands-on care helps retrain neuromuscular control and mechanics to help avoid future issues.
Skipping straight to retraining before addressing the immediate problems in the knee can create additional issues or cause pain during treatment. But reducing compression and promoting tissue health without correcting poor kinetic chain mechanics leaves the knee vulnerable.
Dr. Scharf has addressed the need for structured, comprehensive treatment for knee pain, saying, “Most of the patients I see have already tried medication, injections and generic physical therapy, and they’re still in pain. They don’t need another isolated treatment. They need a structured plan that addresses why the knee is overloaded in the first place.”
At Marin Joint Health, that structured plan is often built around Dr. Scharf’s 12-week knee restoration protocol, which includes the technological and hands-on approaches discussed above.
