It’s easy to focus on the knee when it hurts, but is the pain truly arising from the knee? There are many studies that link knee pain to problems with the lower back, hips, ankles, and feet. This month, let’s focus on the role the foot and ankle play in preserving knee health!
Because we are all bipeds—we walk on two legs—EVERYTHING from the ground up affects the rest of the body. The first “link” of this “kinetic chain” is our feet and the last link in the head. If any of the links are altered lower down in the kinetic chain, it will affect the links that follow—usually in a negative way!
For example, a flat foot and/or pronated ankle (where the foot and ankle roll inward) can create a “knocked knee” effect. The next time you’re in the mall or grocery store, look at people from behind and watch how many roll their ankle(s) inwards when they walk. This is especially noticeable among those wearing shorts and flip-flops. It’s estimated that 80% of us are over-pronating by the age of 30, and many of us are born with congenital flat feet, so this behavior is not uncommon in kids.
There are many tissues in the knee that can generate pain. In the over-pronation scenario, the medial, or inside the compartment, of the knee is overloaded by opening up excessively while the lateral, or outer compartment, over-compressed or jams together. We often find medial and/or lateral compartment pain in the over-pronated ankle/knocked-knee side.
The front of the knee houses the knee cap that glides in a groove, and the knocked-knee results in overloading on the outside of the knee cap/groove creating a condition called lateral patellofemoral pressure syndrome and/or chondromalacia patella.
When you present for a chiropractic evaluation, your doctor will pay great attention to your gait or walking rhythm and look for over-pronation vs. supination (an outward shift of the ankle), the degree the knee “knocks” inwards (genu valgum) vs. outwards (genu varum or “bow-legged”), respectively. You can correct the pronation effect and unload the compartment that is literally getting “beat up” (hopefully BEFORE arthritis occurs) by placing a medial (or lateral) heel wedge into a foot orthotic.
The next topic is exercise! It is SO important to keep the muscles around the knee stretched and strong! There is ONE particular muscle (vastus medialis oblique or VMO) that connects our upper/inner knee cap to the medial/inside leg. It is the ONLY muscle that counteracts the outward pull by the other quadriceps muscles that attach to the kneecap. Your doctor of chiropractic can show you how to specifically exercise and isolate the VMO, if necessary.
You may wonder, what is wrong with my knee?
Pain in the knee or pain on the knee is a problem that needs attention. Kneecap pain can be particularly annoying.
Do I have a muscle strain in the knee or neuropathic pain?
You may be worried about a torn meniscus or a Baker’s cyst or kneecap pain.
Pain in the knee or pain on the knee is concerning for sure. Some who may be concerned about neuropathy may be concerned if this is neuropathic pain. Many who have been diagnosed with neuropathy have been on high-dosage chemicals and wonder why their knee pain remains persistent. Pickleball, golf, and tennis are common sports to cause knee pain. Some try strong chemicals to no avail. Some have tried applying chemical gel to the affected area with temporary relief at best.
As a last resort, some type in pain management to find relief. Hopefully, you won’t have a torn meniscus but if you do it doesn’t mean surgery is your only option. Obviously, most want to avoid a knee replacement. Sometimes it can be a patellar tendon irritation easily resolved with conservative non-surgical treatment. Persistent or worsening pain intensity and/or frequency necessitate a visit to see a professional before it becomes a surgical case.
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