We all know that balance is important to health. Activity needs to be balanced with rest. Concern needs to be balanced with not caring. In the area of the musculo-skeletal system the left side of the joint needs to be in balance with the right side of the joint. Both musculature and connective tissue can become more tired on one side of the joint, causing malfunction, irritation, inflammation, and pain. The knee is a perfect example of a joint that is highly susceptible to imbalances of musculature. The quadriceps muscle is a group of 4 muscles that work to extend the knee. Often, the medial or the lateral muscle in this group can become hypertensive resulting in misalignment, and wear and tear on the knee itself. Over time, this can worsen, causing the individual to seek help from a professional. In our office, we assess the knee orthopedically for stability of the ligaments and the integrity of associated structures such as the menisci. If findings in this area are unremarkable we next check the muscles of the quad group, and often find one side hypertensive, tender, and reactive. Treatment in this area with trigger point therapy relieves the muscle spasm returning the knee to balance. A chiropractic adjustment of the knee joint reinforces proper alignment. The patient is instructed in appropriate exercises and stretch in for the muscle groups of the knee. A holistic appraisal of the individual general lifestyle can detect any contributing factors to general health issues. An assessment of the arches of the foot may reveal the need for orthotic support. A majority of knee pain patients respond favorably to this very simple and straightforward approach.