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Hi, I'm Dr. Chalk, DC

The knee joint—undoubtedly the largest joint in the body—comprises the thigh bone (femur), the patella (kneecap), and the tibia and is supported by various ligaments and tendons. Aside from being a weight-bearing joint, it’s crucial to locomotion and is one of the most disturbed joints in the body, making it prone to injury that may result in knee pain.

Knee pain is a widespread complaint that affects people of all ages. It can result from injury to the joints, ligaments, tendons, or muscles. The management of knee joint pain is multidisciplinary, and chiropractors are at the forefront of musculoskeletal health. A recent trend in managing knee pain and its complications is using new technology like the Knee on Trac system.

The Consequence of Knee Pain and Its Management

Research on knee pain indicates that around 46.2% (32.2% in men and 58.0% in women) of the elderly population experience pain in one or both knees. US studies also indicate that 18% of adults that experienced some sort of joint pain in the last month attributed it to knee pain.

In addition, apart from the reduced quality of life knee pain imparts on its patients [spanning across depressive symptoms, increased falls, and a high BMI (body mass index)], the US spends a mouthwatering $3.4–13.2 billion in job-associated knee pain costs.

Moreover, individuals with knee pain experience up to a 5x increase in the risk of having a worsened lower extremity function. Such staggering figures necessitate continuous research on new measures to manage knee pain.

Suppose you experience sharp or severe pains in the knee, pains while squatting or walking. In that case, you may have heard that surgical intervention is the only option. However, that isn’t the case. In fact, with recent advancements in technology and the advent of innovations in medicine—such as the Knee on Trac system—your options are never exhausted.

Such technologies offer a ray of hope to those who might have grown weary about their never-ending knee discomforts. These include bone-on-bone knee pain, arthritis in the knee, joint instability, inability to bend or straighten the knee thoroughly, and many other knee pain symptoms.

What Is the Knee on Trac System?

Knee on Trac provides an innovative type of knee decompression therapy. It’s a non-invasive, non-pharmaceutical treatment procedure and an absolute game-changer for patients with everyday knee pain.

This chair-like device was developed for chiropractors a few years ago. It works by isolating the joint at a right angle, gently stretching, and tractioning the knee joint in short sessions. It’s based on the principle of mechanical traction, which is effective for increasing quality of life while decreasing patients’ pain.

Its effects are instant, and one session can have qualitative impacts on patients’ pain. Notably, it can help reduce the severe limitations imposed by pain, improving the quality of life of those suffering from it.

This new joint pain treatment method helps with most knee pain cases, including strained or sprained ligaments, tendonitis, osteoarthritis, and cartilage tears. Some of its fundamental mechanisms include the reduction of inflammation and the rehydration of the joints. These result in an improved motion and function range in short periods. Repeated sessions have far-reaching benefits and can delay or even eliminate the need for knee replacement surgery — this eliminates surgery-associated risks like delayed healing, infection risk, and discomfort.

The Knee on Trac system is proven to restore movement and ease knee pain when bending, standing, and walking. Injuries associated with aging and continuous stress—the typical starting points of knee pain—are also not spared.

This new form of treatment for sore knees tends to the root of the pain rather than providing the short-term relief most painkiller drugs offer. It gives you all-natural pain relief without going through the stress of medication intake. This makes more sense when you consider that the Knee on Trac system was invented by a chiropractor who lost his father to complications caused by painkillers. To cap it all, it’s practical, gentle, and affordable.

Chiropractors can employ the Knee on Trac System together alongside other types of treatments for sore knees. These include but are not limited to:

  • Physical therapy
  • Manual therapy
  • Platelet-rich plasma (PRP)
  • Ultrasound deep heat therapy
  • Cold laser therapy

Generally, treatment with the Knee on Trac system doesn’t hurt. However, the patient may feel soreness, similar to that induced by a workout. This is because the muscles adjust to the stretching force to provide relief to the preexisting pain.

What Conditions Does the Knee on Trac System Address?

The Knee on Trac system can provide relief from various knee pain conditions such as:

Chronic Knee Pain

This generally implies knee pain lasting longer than six months. 

Sub-Acute Muscle Strain

The Knee on Trac system is a modality that uses force to elongate soft tissue. This elongation can reduce the effects of sub-acute and chronic muscle strain. 

Chronic Muscle Strain

The Knee on Trac system is indicated for chronic muscle strain by stretching ligaments, muscles tendons, and surrounding joint structures. 


This is one of the most common chronic joint conditions. It’s a degenerative disease that occurs mainly in the knee, lower back, and hips. The disease process affects both ligament, cartilage, capsule, and synovial membrane of the knee.

Knee sufferers often show joint tenderness, stiffness, joint enlargement, crepitus, deformity, muscle weakness, limitation of joint motion, impaired proprioception, and disability. When the Knee on Trac system is applied, it takes care of pain, re-hydrates joints, and relieves pressure that comes with bone-on-bone destruction. 

ACL Injuries

Anterior Cruciate Ligament (ACL) tear can worsen to cause permanent knee damage. However, it can’t be treated in the acute phase because the Knee on Trac may exacerbate the injury. Instead, in the chronic stage, patients with ACL can benefit from the pain-relieving symptoms that the Knee on Trac system offers.

Meniscus Tear (Medial and Lateral Collateral Tear)

The medial meniscus can be found within the inner side of the knee joint, while the lateral meniscus is located outside of the knee. Just like ACL injuries, meniscus tears can’t be treated in the acute phase. All tears vary in size and severity and are caused by any activity that forcefully twists or rotates the knee and makes squatting, kneeling, or lifting anything heavy extremely difficult.

Chiropody uses the Knee on Trac system, soft tissue work, and corrective exercise to treat chronic meniscus tear. This involves carrying out soft tissue work to the areas around the injury. These can include FAKTR (Functional and Kinetic Treatment with Rehab), Active Release Technique® (ART®), and dry needling.

Failed Surgery or Post-Surgical Rehab

Generally, surgery results in trauma. In most cases, the dissection and resection of the muscles during surgery will cause pain, necessitating rehab following surgery, if successful. Repeated sessions on the Knee on Trac system will help relieve pain, increase range of motion and return the patient to be as functionally fit as possible.

The primary knee pain symptoms that the Knee on Trac system caters to include the following:

  • Swelling
  • Sudden, intense pain at the knee
  • Stiffness
  • Bruising
  • Tenderness
  • Redness
  • Warmth 
  • Difficulty bending or fully straightening of the knee
  • Difficulty walking
  • Instability
  • Popping sound at the time of injury
  • Weakness

What Is the Science Behind the Knee on Trac System?

The Knee on Trac system was created based on the principle of traction therapy. This principle has been widely used in treating musculoskeletal pain, especially in the cervical and lumbar segments of the spine.

The Knee on Trac system is a form of automated mechanical knee traction. It uses a distracting or decompressive force to stimulate joint repair and relieve pain by altering joint surfaces interface. The force applied is kept long enough to help to decrease mechanical pressure or loading on the joint structure. This is why the process is called knee decompression therapy. 

The proposed sub mechanisms on which the knee Trac system operates include the following; 

  • Interrupting the pain-spasm cycle
  • Gating out pain transmissions
  • Reducing pressure on pain-sensitive structures 

While in a sitting position, traction allows for more accurate positioning to the correct angle of pull, which the Knee on Trac System is built on. The physiological effects of the Knee on the Trac system are that it stretches muscles and ligaments and tightens posterior ligaments by exerting a centripetal force.

When considering mechanical traction, several crucial factors come into play. The most common ones include but are not limited to:

  • traction equipment,
  • body position,
  • the force used,
  • traction pattern (constant, intermittent, or sustained traction), and
  • duration of traction.

The effects of intermittent traction include increased lymphatic and vascular flow (via a vacuum aspiration effect), which helps to minimize edema and stasis. It also stimulates proprioceptive reflexes and helps tone muscles, reducing fatigue and restoring elasticity and resiliency.

Radiographs showed increased joint space width and decreased subchondral sclerosis. The improvement in functional outcomes after applying mechanical traction may be due to the relief of abnormal pressure on nociceptive receptor systems. A detailed description can be given based on the direction of its primary force, whether distraction (axial force together with off-axis forces such as flexion or lateral bending) or axial (superoinferior axis of the spine).

Some studies indicate that mechanical traction decreases pain significantly than a typical ultrasound and exercise. This is excellent news, as knee pain causes a lot of suffering and affects literally every step you take. In this context, getting some pain relief is of utmost importance.

It’s essential to, however, get diagnostic images before using the Knee on Trac system. Therapeutic traction is not a new concept in managing musculoskeletal conditions, and it’s backed up with tons of research proving its efficacy. Mechanical traction devices often comprise a cable, a harness or device secured to the patient’s body, and an electric motor. It was found to be more effective than exercising alone or exercising in addition to using over-door traction.

Calculation of traction weight is done using patients’ body weight. The resistance is nearly equivalent to 50% of the body segment weight. The force can be constant, sustained, or irregular. Constant traction makes use of a low force over extended periods, up to 40 hours. However, constant traction is typically not well tolerated and is not often used.

Sustained traction poses difficulty in operation and uses a much larger force for a shorter period (typically 30–60 minutes).

As for intermittent traction, it employs large forces that can be raised or lowered during each treatment sequence, as well as modifiable pull durations. This cycle is done repeatedly for 15–25 minutes, with the traction phase having a duration of 5–60 seconds and the rest phase sitting at 5–15 seconds.

Are There Any Contra-Indications When Using the Knee on Trac System?

Yes, there are. The following are some absolute contraindications to using the Knee on Trac system: 

Severe Osteoporosis or Osteopenia

This is a medical condition characterized by loss of bone density. Bones become fragile and brittle and are usually a result of hormonal changes or vitamin D and calcium deficiency. The Knee on Trac system is contraindicated because the structural integrity of the joint is compromised. Treating a patient with such a condition may result in fracture.

Uncontrolled Hypertension or Severe Vascular Compromise

This is another crucial contraindication of the Knee on Trac system since traction causes an increase in blood pressure and heart rate following an increase in lymphatic and vascular flow, especially in the elderly.


This is a disorder caused by the inflammation of the bone marrow. It has a high tendency to progress and spread. It begins as a bacteria infection and can cause tremendous damage. Traction is contraindicated in most inflammatory and infective conditions to prevent their spread and worsening.


This happens when the ligament and joint capsule supporting the joint are too lax. Patients with hypermobility in the knee joint are a relative contraindication to the Knee on Trac system since joint laxity makes it challenging to know the appropriate distracting force to be applied to the knee joint. 

Recent Fracture

The Knee on Trac system is contraindicated to prevent the recurrence of more extensive fractures. It can be employed only when the existing fracture has been appropriately reduced and healed.

Knee Bone Cancer

The knee on the Trac system is contraindicated to prevent metastasis.

Rheumatoid Arthritis

This is a systemic autoimmune disease characterized by inflammatory arthritis and extra-articular involvement. The Knee on Trac system is contraindicated because the cause of knee pain is systematic and inflammatory. Employing this non-invasive therapy may cause ligamentous laxity and joint instability.

As a rule of thumb, all inflammatory, infective conditions of the bone and joints are contraindicated to traction therapy of all types, including the Knee on Trac system. Other contraindications include blood clots and knee replacements that are less than 12 months old.

Other Safety Precautions to Note When Using the Knee on Trac System

In acute conditions, chiropractors have to be careful and ensure the following:

  • That there is no significant joint laxity
  • That the joint is not locked or can go into a locking position

Detailed medical history and a physical exam are carried out before using the Knee on Trac system. The common diagnostic tests include:

  • X-rays: This uses small amounts of electromagnetic radiation to visualize internal structures, especially the bones.
  • Magnetic Resonance Imaging (MRI) Scan: This uses radio waves and strong magnetic fields to generate detailed images of the body tissues and organs.
  • Computed Tomography (CT) Scan: This combines a range of X-ray images taken at various body angles to create elaborate cross-sectional images of the body’s soft tissues, bones, and blood vessels.

Where there are no contraindications, traction can be employed to facilitate treatment of any state that can benefit from the physiological effects of traction.

The chiropractor’s job is to establish whether the experimental traction provides some sort of relief to the patient after each session. This makes it easy to modify the treatment technique, eliminate discomfort and sometimes discontinue traction if there’s no improvement.

How Does the Knee on Trac System Help Those With Knee Conditions?

The physiological effects of the Knee on Trac system on the body range from decreased inflammation to a more rapid recuperation period. The following section goes into deeper details on how these effects manifest.

It Promotes Joint Rehydration

The Knee on Trac is a computerized system that uses a motor to sense the knee’s pressure. It isolates the lower part of the leg allowing the knee to decompress.

This movement creates space between the joints, allowing for adequate knee lubrication, where the synovial fluid acts as a lubricant. This lubrication/hydration relieves the preexisting pain and makes movement more fluid.  

It Increases Range of Motion

Since knee pain inhibits full joint motion, eliminating it via the use of the Knee on Trac system allows for a more extensive range of knee joint motion as well as increased joint function.

It Speeds up the Healing Process

The rehydration and increased synovial fluid production promote more rapid recovery from knee pain.

It Decreases Inflammation

A proposed mechanism of pain relief offered by the Knee on Trac system is that it promotes local vasodilatation, which increases blood flow to the affected area washing away inflammatory and nociceptive metabolites. The pain gate control mechanism may also reduce pain.

It Separates the Ligament and Joints and Relaxes Muscle Spasm

Due to the intermittent traction provided by the Knee on Trac system, the ligaments of knee joints get relaxed, and slight lengthening/strengthening also occurs. This relaxation of structure reduces the friction between knee joint structures, which helps reduce pain and increase the walking distance as well as the range of movement of the knee joint.

It Regulates the Stimulation of Small and Large Diameter Afferents

Small diameter afferent fibers are nociceptive fibers and are usually blocked by large diameter fibers inhibiting the transmission of painful stimuli in the central nervous system. The Knee on Trac system causes stimulation of large diameter afferent fibers, which carry non-nociceptive stimuli.

Type II Mechanoreceptor Stimulation

Mechanoreceptors detect changes in mechanical pressure or distortion. They are stimulated when a distraction force is applied, transmitting information on vibration and pressure to the central nervous system.

What Are the Advantages of the Knee on Trac Therapy?

This non-invasive mode of treatment presents certain advantages, including but not limited to the following. For one, it’s an alternative to knee surgery. It also saves time and is a relatively cheaper means of managing knee pain. However, that’s not all — the following sections further illuminate why you might want to opt for the Knee on Trac therapy.

It Eliminates the Trauma of Surgery

Since the Knee on Trac system is non-surgical, it prevents the complications associated with orthopedic surgery, including but not limited to the following:

  • bleeding,
  • infections,
  • blood coagulation,
  • nerve damage,
  • lack of full range of motion,
  • reaction to anesthesia,
  • development of arthritis,
  • scar formation, and
  • re-injury of the joint or soft tissue.

It Extends the Knee Lifespan

Most joint replacements have an average lifespan of 20 years. In most cases, patients live longer than that, necessitating a replacement surgery.

Suppose you plan on having knee surgery. In that case, the Knee on Trac system can help manage the pain in the meantime, pending when you eventually decide to undergo a surgical procedure, further boosting the knee lifespan.

It’s Easy to Receive

All patients basically have to do is sit in a chair while the decompression takes place, under the supervision of the chiropractor.

It Can Be Paired With Other Treatment Procedures

Most chiropractors couple Knee on Trac therapy with therapeutic exercise, especially for post-surgical rehabilitation. Other treatments that can be successfully paired with this system include:

  • The use of hot packs
  • Ultrasound
  • Short wave diathermy (SWD)
  • Electrical stimulation
  • Low-level laser therapy

What Is the Recommended Frequency of Visits to Produce the Best Outcomes?

Each patient is unique, and so is management. The chiropractor has to know that what works for one patient might not work for another. Assessment and following decisions on the type of traction to be utilized, the force/weight of distraction, and the treatment duration should vary from patient to patient.

The treatment session begins with the patient seated comfortably, and the leg extended. The leg is secured with a strap on the upper thigh and an inflatable cuff that goes over the knee that secures it in place. The chiropractor programs the Knee on Trac equipment informs the patient or client on what sensation to feel, starting with a gentle separation of the articular surfaces.

Chiropractors recommend 24 sessions, scheduled gradually. It starts with three sessions per week, then two, and finally one session per week, by the end of the treatment. The therapy session can last for approximately 10 minutes per knee, depending on the patient’s condition. In some cases, the chiropractor may use the pre-set time of about 5–6 minute treatment times.

The first therapeutic session begins with less distracting force or weight and is adjusted relative to the patient’s tolerance level. The frequency of the therapy sessions will depend on the severity of the treatment, patient cooperation, and set treatment goals. The cuff bladder should be adjusted to remove extra air so that the cuff fits the knee well.

The therapist’s goal in each session is to reduce symptoms and not worsen them. Hence, the therapist may not put the knee in full extension while using the Knee on Trac system due to patients’ low tolerance. However, it’s better to start the traction sessions and extend the knee to the full position. Range of motion can be measured in each session alongside a pain rating using any available scale to measure progress.

Summary and Overall Conclusion

Chronic knee pain doesn’t have to hinder your day-to-day activities. The majority of knee pain can now be treated by licensed chiropractors using the Knee on Trac system. Hence, if you suffer from knee pain but fear surgery or are not inclined to use medication, you should visit a chiropractor today.

The Knee on Trac system is a safe, non-invasive, and wonderfully effective way for patients to resolve knee pain and enhance knee function. Certain knee conditions where this system has found use include ACL injuries, osteoarthritis, and meniscus tear. However, it’s contraindicated in osteomyelitis, osteoporosis, and fracture.

This system is founded based on the principle of traction. Traction helps reduce or relieve the constant pressure endured by specific skeletal parts and groups of muscle, be it from disease, injury, or routine activities.

The overall goal of chiropractic care using the Knee on Trac system is to restore optimal knee health and function over a short period. Patients will be reviewed on pain while sitting, standing, walking, sitting, and sleeping to ensure each session has the desired effect.

For best results, chiropractors recommended a 24-session visit that begins with three sessions a week and gradually tapered to two sessions a week, and finally one session a week based on improvements. Each session lasts approximately 10 minutes.

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