To understand knee pain, you have to remember that your knees are affected by the alignment and function of your feet, hip and pelvis.
Traumatic pain starts after a direct hit to the knee.
Non-traumatic pain creeps up slowly, it doesn't come on its own and is almost always accompanied by flat feet, a sore back or both. If you have any of these problems, please read on.
Our bodies are designed to meet all the challenges of different terrains and uneven surfaces.
In the modern world, we don't have the luxury of walking daily on grass, sand and other natural soft surfaces. We have changed our foundations to flat and hard tarmac and concrete. When the ground's surface is too hard, our feet have to compensate by collapsing at the arch.
This changes the way the joints are aligned, causes excessive loading and wear and tear, therefore ankle, knee and hip pain.
We see many patients with knee problems who have had all sorts of treatment and surgeries and are still unaware that they have flat feet (over-pronated feet or both). This also affects their pelvis and lower back, because it rotates your hip inwards and twists your pelvis forwards, putting your lower spine at a disadvantage. Therefore we need to correct the problem at its source – the feet. When alignment is corrected the knee will heal, because it will wear less and move according to its design.
We use ICB heat mouldable arch supporting insoles (orthotics). Our patients have great results using these which we need to get fitted in the clinic. They are also much cheaper than "bespoke" and "hand-made" options, but deliver same results.
If knee pain is caused by a trauma, such as ligament rupture or direct impact, the knee will heal better when the alignment of the knee joint is correct. This is insured by a correct foot arch, supported by orthotics. Muscle strength around the knee is important too, muscles keep joints aligned and provide smooth movement when you walk or run. Exercise your knees for stability.
Your spine and especially your lower back is important for your knees too, because nerves which manage and repair the structures around the knee, exit from your spine. If these nerves are under pressure because your back is stiff and sore, they can not perform well. That is why we want your spine to move like a well-oiled machine.
Other symptoms that are often caused by flat feet and can be helped with orthotics include:
- Bunions and Corns,
- Heel Spurs,
- Weak Ankles,
- Tired, Aching Legs,
- Knee Pain,
- Lower Back Pain,
- Neck Pain,
- Poor Posture.
If you have any of these symptoms, ask your chiropractor to assess your feet, knees and back to see if there is a problem which can be corrected with arch supporting insoles and chiropractic care.
As I described in the "Balance" section, the quality of movement and amount of "wear and tear" largely depends on the quality of muscle control around the joint. It is as important for the knee as it is everywhere else including the joints in your spine.
With a sedentary life style and incorrect training, our knees often weaken and are not balanced correctly by pairs of oposing muscles. Re-training these muscles is easy - it can take as much as 10-15 minutes a day, but training consistently will achieve very good results helping reduce the pain and gaining stability. We have had great success in retraining knees using twist steppers and I show some of them on this page .
When using the twist steppers, remember to maintain good upright posture. Shallow fast stepping will make it safe and effective. If you slouch when using them this will train your spine towards slouching. If you step deep and slow, you could injure your knees and back if you lose balance. Good luck!
Pronation Self Check
I'm often asked to help with self-assesment of pronation. This easier than you think. If you draw a line following a protruding edge of shin bone on the front of your shin, this vertical line should intersect the point between your big toe and the second toe. This is when you have a good foot arch. If this vertical line falls more towards the inside of the foot - you have foot excessive pronation. In other words: if you draw three dots, one on the shin bone, second in the middle of the ankle and third in the gap between big toe and the second toe, these three dots have to be on one vertical line! See the picture below.
P.S. Your foot may be not over-pronating but simply be flat, in terms of the effects of flat feet on your health, there is almost no difference, however different type of correction may be required, depending on the extent of the problem. Always seek professional help and educate yourself, so you know what to expect and what to ask for. Good luck!
Pictures courtesy of Foothealthclinic
lf assessment of above with pictures)ortaheel from physiosupplies