Treating knee pain from the ground up with orthotics
Abnormal alignment of the foot and lower leg is a common cause of knee pain as well as repetitive movement and excessive pressure. This can cause inflammation in the knee joint.
Evidence suggests that foot orthotics can help relieve painful knee symptoms and help prevent injuries and degeneration of the knee joint. The key factor is how orthotics control the abnormal movements of the foot which in turn affects internal rotation of the bones of the lower leg.
Causes of knee pain:
- Trauma injuries (Ligament, tendon tears and ruptures)
- Degenerative diseases (Age and overuse injuries / Arthritis)
- Alignment / mal-tracking of the muscles and tendons into the knee joint)
- Growth spurts in adolescents (Osgood schlatter disease)
- Tight calf muscles
As podiatrists we generally deal with the alignment problems which most often are caused from poor foot biomechanics or foot alignment. This problem can be experienced by any age group but more commonly 12 to 16 year olds and 50+ year olds.
As stated above not all knee pain should be attributed to abnormal biomechanics. Ruling out other pathologies or potential causes of knee pain is essential for successful orthotic treatment.
Medical literature was silent for many years about the mechanical origins of knee pain, despite podiatrists successfully treating patients that have knee pain with orthotics for over 20 years.
From the clinical knowledge gained in my 15 years as a podiatrist, I can definitely and confidently confirm that knee pain responds to orthotic treatment
A lot of medical literature considered that knee pain was the result of osteoarthritis and was thought to have no etiology except ligamentous damage resulting in unstable knee joints.
Literature today reflects a more complete understanding of the pathomechanics of mechanically induced knee pain and the role of foot orthotics in treatment. If knee alignment issues are left untreated it is more likely that osteoarthritic changes will occur at the knee joint due to the stresses of everyday walking will put on this joint.
Foot problems that commonly contribute to knee pain and degeneration of the knee joint:
The podiatrists at the Kew Foot Clinic are highly skilled and trained in dealing with patients of all ages and problems of the feet and knees.
Orthotics are commonly used in getting the foot to function in an improved aligned position and in turn will put the muscles and tendons of the knee in a better tracking position. This will take the stress of the knees and pain generally settles.
We are dedicated and passionate about helping patients with their pain but even more passionate about preventing pain and damage to the feet and knees, keeping you as active as possible.
It is of great importance to get your child’s feet checked even before they complain of knee pain as we can improve the foot and lower limb function to prevent knee pain.
Improved foot function = Improved performance = Less likelihood of pain and degeneration
Definitions and common names for syndromes of the feet and knees:
Pronated feet:
This is where the foot rolls inwards, the arch collapses.
This causes excessive internal rotation of the lower leg at the same time that the upper leg is rotating in the opposite direction due to forces produced during walking and running.
The knee area is the area that absorbs these twisting forces and can become stressed and injured. Pronated feet can also cause a “knock-knee” position, which results in various muscles exerting their pull in incorrect directions.
High arched feet:
A high arched foot or excessively “supinated foot” does not allow the knee to absorb shock adequately. The knee therefore takes too much force and is subjected to stress and injury.
Patellofemoral syndrome (Chrondromalacia patella):
With pronated feet the knees move into the ‘knock-kneed’ position. This causes the patellar tendon (which connects the muscles of the thigh to the lower leg via the knee cap/patella which acts as a pulley) to pull in the wrong direction. The patella thus runs over areas in the knee that it is not supposed to, and eventually this will result in injury and pain. The pain is often felt with bent-knee activity, like squatting and walking upstairs.
Iliotibial band syndrome:
This is the muscle that runs down the outside of the thigh, and which crosses the knee, is the iliotibial band. With excessive pronation, this muscle shortens over time and is therefore subject to pain and injury. Pain is felt on the outer edge of the knee joint.
Osgood schlatter disease:
This condition commonly affects teenagers, and is an inflammation of the growth plate of the tibia (lower leg bone), which is situated just below the kneecap.
If you are knee pain, call Kew Foot Clinic on 03 9853 6877 to make an appointment for the appropriate treatment.
