Knee and hip pain are related!
To understand knee pain, you have to remember that your knees are affected by the alignment and function of your feet, hip and pelvis.
Trauma or accident
Traumatic pain starts after a direct trauma to the knee.
Slow onset/non-traumatic knee pain
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.
Original design versus modern world
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 is not helped by narrow and uncomfortable shoes.
This causes uneven and excessive loading and wear and tear, therefore ankle, knee and hip pain.
How to unload the feet to help the knees?
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 hips inwards and twists your pelvis forwards, putting your lower spine at a disadvantage. Therefore we need to correct the problem at its source – at the feet. When alignment is corrected the knee will heal, because it will wear less and move according to its design.
Benefits of arch-supporting insoles, orthotics and Barefoot shoes
We use ICB heat mouldable arch supporting insoles (orthotics). Our patients have great results using these. These insoles need to be fitted at the clinic. They are much cheaper than “bespoke” and “hand-made” options, but deliver same results.
We also recommend and we do wear ourselves popular Vivo Barefoot shoes. These are essentially a great version of minimalistic footwear which has been shown to strengthen the foot and ankle by 60% after wearing them for a couple of moths. Your chiropractor will advice you about best choice of footwear and insoles for you. Often people benefit more from shoes like Vivo Barefoot, others need more traditional shoes, just need to choose the wider version with a thicker sole and use insoles to support the arch. There is a great evidence that Vivo Barefoot are a great choice for children of all ages and they have different designs, some suitable for wearing in school.
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.
Fix the spine and spinal nerves!
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 and correct choice of footwear 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 your spine to see if there is a problem which can be corrected with arch supporting insoles and chiropractic care.
Minimise unnecessary impact!
As 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 opposing 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 simple exercises we recommend to our patients.
Pronation Self Check
I’m often asked to help with self-assessment of pronation. This is 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 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.
Soft and bouncy shoes will help to minimise the impact to feet, knees, hips and back!
P.S. Your feet 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 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