When ever a patient comes into the office complaining of heel pain my first question is, "Is the pain worse with the first few steps in the morning and then again when you first get up and walk after sitting a while?" These are the classic symptoms for a condition known as plantar fasciitis. The bottom of the foot is called the plantar surface of the foot. Fascia refers to a strong fibrous band of tissue, similar to a ligament. The term "itis" refers to inflammation. For instance, appendicitis is inflammation of the appendix, fasciitis is inflammation of the fascia.
The plantar fascia is a fibrous band of tissue that connects the heel to the base of all five toes. The plantar fascia acts like a spring and is responsible for maintaining the height of the arch of your foot. As you take a step, the plantar fascia permits the arch to pronate (rotate toward the floor) and flatten out a bit to allow the foot to adapt to what ever terrain it happens to be walking. At the end of the step the plantar fascia helps the foot to supinate (rotate away from the floor) and become rigid again so that a forceful push-off can be achieved.
The plantar fascia becomes inflamed if the foot pronates or rolls over too much and stretches out the plantar fascia too much. This causes inflammation where the plantar fascia is attached to the heel. The plantar fascia actually starts to pulls away from the bone and this is what causes the pain. One way that the body protects itself against this pulling away from the bone is to build up more bone in that area. The resulting build-up of bone is called a bone spur. A bone spur in-and-of-itself sounds painful but usually it is not what is causing the pain. If you have ever seen a bone spur on an x-ray it looks like a horn of bone growing out from the bottom of the heel. When you see this on an x-ray you wonder how anybody can walk with a heel spur. However many people have heel spurs on x-ray but have no heel pain. The heel pain associated with plantar fasciitis comes from the tearing away of the fascia from the bone and not the bone spur itself.
Why is the pain worse first thing in the morning or when you start walking after sitting for a while? I mentioned previously that the heel pain is due to the plantar fascia tearing away from the bone. The human body is a rapid healer. When you go to bed or even if you just sit down for a while the attachment between the bone and the plantar fascia begins to heal. However, when you get up and start walking again ...ouch! You just tore away the newly repaired attachment.
The treatment for heel pain due to plantar fasciitis is a two fold process. You have to heal the inflamed tissue where the plantar fascia attaches to the heel. As the inflamed tissue is healing it is important to also correct the problem that initially caused the plantar fasciitis and the heel pain.
The healing of the inflamed plantar fascia is accomplished by healing the inflamed tissue and correcting the cause. First of all you should start some type of anti-inflammatory medication such as Motrin® or Aleve®. Tylenol® may reduce pain but does not have anti-inflammatory properties. Applying ice to the heel will also reduce some of the inflammation. In addition some doctors prescribe what is called a dorsal night splint to heal the plantar fascia. The dorsal night splint is worn on the lower leg at night. The idea is to use the splint to hold the foot slightly flexed up toward your head as you sleep. This allows the plantar fascia to heal in a stretched out position so that the first steps in the morning do not break away the newly healed tissue.
As the plantar fascia begins healing it is essential that the problem which caused the heel pain is corrected. Most heel pain is the result of a biomechanical problem that causes excessive pronation (excessive flattening of the arch) and thus excessive stretching of the plantar fascia. The excessive pronation can be corrected with an arch support. The over the counter cushioning devices are helpful to reduce the pain, help calm things down a bit and allow the healing to start but in order to prevent the heel pain from returning you have to correct the faulty biomechanics. This usually requires a custom arch support. Custom arch supports will be made to match the exact contour of your foot. The custom arch support will limit the pronation, reduce stretch on the plantar fascia, reduce the heel pain and allow the heel to heal.
For more information please visit Heel Spurs
Showing posts with label foot pain. Show all posts
Showing posts with label foot pain. Show all posts
Sunday, September 28, 2008
Thursday, September 11, 2008
Relieve Foot Pain With Simple Exercises
Did you know that pain in the ball of the foot may be due to an inability to fully bend your ankle joint? Did you also know that the type of shoes that you wear (i.e. high heels) may be at the root of the cause of the pain? Don’t despair. There are some simple exercises that may help to relieve the pain in the ball of the foot.
Pain-free walking requires the precise integration of numerous joints, muscles, tendons and ligaments. One of the most critical and complex joints involved this process is the ankle joint. The ankle joint is required to bend the foot downward, toward the floor, (plantar flexion), upward toward your head (dorsiflexion), rotate inward (inversion) and outward (eversion). For this discussion we are going to focus on problems caused by the limitation of ankle joint dorsiflexion during walking.
Inability to fully dorsiflex the foot results in a condition referred to as ankle equinus. It is called equinus from the term equine which refers to a horse. I am not implying that a person with ankle joint equinus has a hoof. However if you notice a horse’s hoof, the front of the foot points in a downward direction; it appears to be plantar flexed (pointed down toward the floor). The person with ankle joint equinus may appear to have a plantar flexed foot and may have a tendency to walk more on their toes.
Rarely, ankle equine is caused by a piece of bone from an old fracture blocking the proper motion of the ankle or by a congenitally short Achilles tendon that prevents full dorsiflexion of the ankle. Ankle joint equinus may also be caused by arthritis that results in deformity of the bones of the joint that interferes with the full dorsiflexion of the joint. Most commonly ankle joint equinus is caused by tight calf muscles. If the calf muscles are too tight the ankle is not able to fully dorsiflex the ankle.
Spending too much of your day in high heels can result in tight calf muscles and subsequently ankle joint equinus. The body adapts to the demands that are placed upon it. If you wear high heels the distance between the heel and knee is decreased and the calf muscles will contract in order to compensate for this shorter distance. Then when you put on your flatter shoes and try to walk the tight calf muscles interferes with the ability of the ankle joint to function as it should to provide pain-free walking.
The person with ankle equinus has a tendency to walk on the ball off the foot. They have difficulty keeping the heel on the ground as they walk and raise the heel off the ground early in the step cycle. Ankle joint equinus causes the normal biomechanics of walking to get all screwed-up. When humans have biomechanical problems that interfere with the normal biomechanics of walking they compensate. People with equinus compensate by walking on their toes. They may lift up their heel early in the step that makes them appear as if they are bouncing along as they walk. They may compensate by flattening out their arch in order to take some of the load off the front of the foot. Sometimes they turn their feet to the outside as they walk and contact the ground with the inside part of the heel. All of these compensations disrupt the normal biomechanics of walking. When the biomechanics is disrupted the joints are not loaded as they should, the muscles, tendons and ligaments are strained. Strained muscles, tendons and ligaments cause pain.
People with equinus deformity may experience pain in the ball of the foot because they tend to toe walk and overload the front of the foot. They may develop pain in the mid foot from compensating by flattening out the foot and overstretching the plantar fascia, the may develop heel pain by the tight Achilles pulling the at its insertion point on the heel.
In order to properly treat the pain associated with equinus it is first necessary to determine the cause. Obviously if the problem is due to a piece of fractured bone blocking motion at the ankle joint or a congenitally short Achilles tendon, this would require an evaluation by an orthopedist for possible surgery. However if the ankle equinus is caused by tightness of the calf muscles, which is often the case, this can usually be treated conservatively.
The goal of treatment for someone with tight calf muscles is to first reduce the strain in the calf muscles and bring the floor up to meet the heel. This is usually accomplished with a heel lift inside the shoe that is used temporarily as the calf muscles are slowly being stretched thru exercises. The patient may also require a custom orthotic to support the arch. The orthotic may incorporate what is called a metatarsal pad that fits just behind the heads of metatarsal bones (long bones of the foot) to take the load off of the ball of the foot. The long term treatment however involves stretching exercises and making sure the patient is placed into appropriate footwear. In addition your doctor may prescribe what is called a dorsal night splint which holds the foot in a dorsiflexed position as you sleep to facilitate stretching of the calf muscles. Let me describe some simple techniques that are used to stretch the two main calf muscles, the soleus (sole-ee-us) and the gastrocnemius (gas-trock-knee-me-us).
To stretch the gastrocnemius muscle you stand facing the wall with your feet about 12 inches from the wall. Step back about 6 inches with one leg. Then while keeping your rear knee straight, your forward knee slightly bent, your back straight and both heels on the floor, lean into the wall. When you feel the muscle start to stretch hold the position for 10 seconds. Do this stretch ten times in a row for each foot and repeat 3 times per day.
To stretch the soleus muscle stand facing the wall as described above for stretching the gastrocnemius with one foot further back. However this time squat down as if in a seated position while keeping your hands on the wall for balance. When you start to feel the muscle stretch as you lean toward the wall, hold the position for 10 seconds. Do this stretch ten times in a row for each foot and repeat 3 times per day.
These stretching exercises together with a temporary heel lift and possibly a dorsal night splint will reduce the pain in the ball of the foot as our biomechanics improve. If however these measures do not improve your symptoms you may want to consider a custom foot orthotic.
For more information please visit Archatomics
Pain-free walking requires the precise integration of numerous joints, muscles, tendons and ligaments. One of the most critical and complex joints involved this process is the ankle joint. The ankle joint is required to bend the foot downward, toward the floor, (plantar flexion), upward toward your head (dorsiflexion), rotate inward (inversion) and outward (eversion). For this discussion we are going to focus on problems caused by the limitation of ankle joint dorsiflexion during walking.
Inability to fully dorsiflex the foot results in a condition referred to as ankle equinus. It is called equinus from the term equine which refers to a horse. I am not implying that a person with ankle joint equinus has a hoof. However if you notice a horse’s hoof, the front of the foot points in a downward direction; it appears to be plantar flexed (pointed down toward the floor). The person with ankle joint equinus may appear to have a plantar flexed foot and may have a tendency to walk more on their toes.
Rarely, ankle equine is caused by a piece of bone from an old fracture blocking the proper motion of the ankle or by a congenitally short Achilles tendon that prevents full dorsiflexion of the ankle. Ankle joint equinus may also be caused by arthritis that results in deformity of the bones of the joint that interferes with the full dorsiflexion of the joint. Most commonly ankle joint equinus is caused by tight calf muscles. If the calf muscles are too tight the ankle is not able to fully dorsiflex the ankle.
Spending too much of your day in high heels can result in tight calf muscles and subsequently ankle joint equinus. The body adapts to the demands that are placed upon it. If you wear high heels the distance between the heel and knee is decreased and the calf muscles will contract in order to compensate for this shorter distance. Then when you put on your flatter shoes and try to walk the tight calf muscles interferes with the ability of the ankle joint to function as it should to provide pain-free walking.
The person with ankle equinus has a tendency to walk on the ball off the foot. They have difficulty keeping the heel on the ground as they walk and raise the heel off the ground early in the step cycle. Ankle joint equinus causes the normal biomechanics of walking to get all screwed-up. When humans have biomechanical problems that interfere with the normal biomechanics of walking they compensate. People with equinus compensate by walking on their toes. They may lift up their heel early in the step that makes them appear as if they are bouncing along as they walk. They may compensate by flattening out their arch in order to take some of the load off the front of the foot. Sometimes they turn their feet to the outside as they walk and contact the ground with the inside part of the heel. All of these compensations disrupt the normal biomechanics of walking. When the biomechanics is disrupted the joints are not loaded as they should, the muscles, tendons and ligaments are strained. Strained muscles, tendons and ligaments cause pain.
People with equinus deformity may experience pain in the ball of the foot because they tend to toe walk and overload the front of the foot. They may develop pain in the mid foot from compensating by flattening out the foot and overstretching the plantar fascia, the may develop heel pain by the tight Achilles pulling the at its insertion point on the heel.
In order to properly treat the pain associated with equinus it is first necessary to determine the cause. Obviously if the problem is due to a piece of fractured bone blocking motion at the ankle joint or a congenitally short Achilles tendon, this would require an evaluation by an orthopedist for possible surgery. However if the ankle equinus is caused by tightness of the calf muscles, which is often the case, this can usually be treated conservatively.
The goal of treatment for someone with tight calf muscles is to first reduce the strain in the calf muscles and bring the floor up to meet the heel. This is usually accomplished with a heel lift inside the shoe that is used temporarily as the calf muscles are slowly being stretched thru exercises. The patient may also require a custom orthotic to support the arch. The orthotic may incorporate what is called a metatarsal pad that fits just behind the heads of metatarsal bones (long bones of the foot) to take the load off of the ball of the foot. The long term treatment however involves stretching exercises and making sure the patient is placed into appropriate footwear. In addition your doctor may prescribe what is called a dorsal night splint which holds the foot in a dorsiflexed position as you sleep to facilitate stretching of the calf muscles. Let me describe some simple techniques that are used to stretch the two main calf muscles, the soleus (sole-ee-us) and the gastrocnemius (gas-trock-knee-me-us).
To stretch the gastrocnemius muscle you stand facing the wall with your feet about 12 inches from the wall. Step back about 6 inches with one leg. Then while keeping your rear knee straight, your forward knee slightly bent, your back straight and both heels on the floor, lean into the wall. When you feel the muscle start to stretch hold the position for 10 seconds. Do this stretch ten times in a row for each foot and repeat 3 times per day.
To stretch the soleus muscle stand facing the wall as described above for stretching the gastrocnemius with one foot further back. However this time squat down as if in a seated position while keeping your hands on the wall for balance. When you start to feel the muscle stretch as you lean toward the wall, hold the position for 10 seconds. Do this stretch ten times in a row for each foot and repeat 3 times per day.
These stretching exercises together with a temporary heel lift and possibly a dorsal night splint will reduce the pain in the ball of the foot as our biomechanics improve. If however these measures do not improve your symptoms you may want to consider a custom foot orthotic.
For more information please visit Archatomics
Thursday, May 1, 2008
Preventing Tennis Injury
The advance of technology in tennis rackets have led to an increase in the number of injuries. The ball is hit with much more power and at greater a speed which means that the response time of the players has to be all that much faster. Tennis players are required to start, stop, change direction and contort their bodies in unnatural ways constantly throughout the game. This combined with the increased power in which the ball is hit leads the tennis player more prone to injury. Tennis players also spend a lot of time with their body weight concentrated on the ball of their foot. In addition, it is difficult to get the tennis player to stop playing when injured so it is all that much more critical to avoid injury in the first place.
The most common injuries of the tennis player are subungual hematomas, (broken blood vessels under the toe nails), ankle sprains, plantar fasciitis, foot and calf cramps, Achilles tendonitis, muscle strains.
Proper foot orthotics can play a significant role in preventing some of these injuries. In particular the foot orthotic should be able to provide shock absorption and arch support to prevent excessive pronation and strain on the plantar fascia. The orthotics should distribute the body weight evenly across the foot the prevent the pain in injury associated with overloading the forefoot. The shoes must fit properly (and accommodate the orthotic) to prevent excessive motion in the shoe which may lead to toenail injury. In addition some players may benefit from orthotics which promote mobility of the great toe.
Today there are orthotics that are specially designed to prevent tennis injuries and keep the tennis player on the court.
For More Information Visit www.DocDavies.com
The most common injuries of the tennis player are subungual hematomas, (broken blood vessels under the toe nails), ankle sprains, plantar fasciitis, foot and calf cramps, Achilles tendonitis, muscle strains.
Proper foot orthotics can play a significant role in preventing some of these injuries. In particular the foot orthotic should be able to provide shock absorption and arch support to prevent excessive pronation and strain on the plantar fascia. The orthotics should distribute the body weight evenly across the foot the prevent the pain in injury associated with overloading the forefoot. The shoes must fit properly (and accommodate the orthotic) to prevent excessive motion in the shoe which may lead to toenail injury. In addition some players may benefit from orthotics which promote mobility of the great toe.
Today there are orthotics that are specially designed to prevent tennis injuries and keep the tennis player on the court.
For More Information Visit www.DocDavies.com
Saturday, November 10, 2007
Pain in the Ball of the Foot
If you have pain in the ball of your foot you are not alone. Pain in the ball of the foot is a common complaint. When someone is referring to the ball of the foot they are usually referring to the location of the metatarsal heads. The long bones of the foot are called metatarsals. The metatarsal heads are the knobby ends of the metatarsals that form a joint with the toes. Thus the ball of the foot is the area where the toes form a joint with the long bones of the foot, the metatarsals.
Pain in the ball of the foot can come from a problem with the nerves as seen in conditions such as neuropathy or a neuroma, which will be discussed shortly. Often, pain in the ball of the foot can is the result of one or more of the metatarsals taking more than their share of the load. Metatarsalgia is a general term which simply means pain in the metatarsal bones. For this discussion I am going to be talking specifically about pain in the metatarsal heads.
There are several reasons why one or more of the metatarsal heads can become overloaded.
• Some people gradually lose the fat pad that cushions the area under the metatarsal heads as they age. If there is less cushion the bones feel more of the load and this causes pain.
• Some people were born with a deformity known as Morton’s toe in which the first metatarsal bone (long bone of the big toe) is short. As a result the second metatarsal or second toe is longer than the big toe. This causes most of the body weight to be put onto the second metatarsal head. This overloads this bone and causes pain.
• Some people with high arches have pain in the ball of the foot. In the person with the high arch we often see that they load the foot primarily at the heel and then again in the ball of the foot. The mid-foot does not take its share of the load. This again overloads the metatarsal heads at the ball of the foot.
• Another painful condition felt in the ball of the foot is Morton’s neuroma. This is usually felt between the 3rd and 4th toes. One quick way to tell if you may have this condition is to grab your foot around the metatarsal heads and squeeze your whole foot. If you have a neuroma this squeezing will causes pain at the site of the Morton’ Neuroma.
Although the cause of pain in the ball of the foot is varied, the treatment, at least the initial treatment, is the usually the same. We try to reduce load and if necessary movement of the metatarsal heads. This is accomplished by adding a metatarsal pad to an orthotic or arch support. The metatarsal pad fits in the ball of the foot just behind the metatarsal heads. This allows more of the weight to be taken up by the long shafts of the metatarsals and less on the metatarsal heads. The metatarsal pads can be added to a custom arch support. They can also be purchased over-the-counter from a pharmacy or specialty shoe store. The correct placement of the metatarsal pad is critical so follow directions or ask your physician or podiatrist for help.
For more information please visit Archatomics
Pain in the ball of the foot can come from a problem with the nerves as seen in conditions such as neuropathy or a neuroma, which will be discussed shortly. Often, pain in the ball of the foot can is the result of one or more of the metatarsals taking more than their share of the load. Metatarsalgia is a general term which simply means pain in the metatarsal bones. For this discussion I am going to be talking specifically about pain in the metatarsal heads.
There are several reasons why one or more of the metatarsal heads can become overloaded.
• Some people gradually lose the fat pad that cushions the area under the metatarsal heads as they age. If there is less cushion the bones feel more of the load and this causes pain.
• Some people were born with a deformity known as Morton’s toe in which the first metatarsal bone (long bone of the big toe) is short. As a result the second metatarsal or second toe is longer than the big toe. This causes most of the body weight to be put onto the second metatarsal head. This overloads this bone and causes pain.
• Some people with high arches have pain in the ball of the foot. In the person with the high arch we often see that they load the foot primarily at the heel and then again in the ball of the foot. The mid-foot does not take its share of the load. This again overloads the metatarsal heads at the ball of the foot.
• Another painful condition felt in the ball of the foot is Morton’s neuroma. This is usually felt between the 3rd and 4th toes. One quick way to tell if you may have this condition is to grab your foot around the metatarsal heads and squeeze your whole foot. If you have a neuroma this squeezing will causes pain at the site of the Morton’ Neuroma.
Although the cause of pain in the ball of the foot is varied, the treatment, at least the initial treatment, is the usually the same. We try to reduce load and if necessary movement of the metatarsal heads. This is accomplished by adding a metatarsal pad to an orthotic or arch support. The metatarsal pad fits in the ball of the foot just behind the metatarsal heads. This allows more of the weight to be taken up by the long shafts of the metatarsals and less on the metatarsal heads. The metatarsal pads can be added to a custom arch support. They can also be purchased over-the-counter from a pharmacy or specialty shoe store. The correct placement of the metatarsal pad is critical so follow directions or ask your physician or podiatrist for help.
For more information please visit Archatomics
Saturday, November 3, 2007
Knee pain? Maybe It Your Feet
There are several painful conditions of the knee that may be caused by problems with your feet. The knee joint is one of the most complex joints in the body. It is a hinge joint, a sliding joint and a rotating joint all at the same time. The proper and pain-free functioning of the knee requires near perfect alignment of the bones, ligaments and tendons that make up the knee joint. Pain in the knee is usually an early warning sign that something is wrong with the alignment. It is important to address these problems early to avoid serious, long term problems such as severe arthritis.
The improper alignment that causes knee pain is often the result of improper alignment of the joints of the foot and ankle. Let me give some examples.
Pain on the inside part of the knee may be caused by bursitis at the location where three of the tendons from the thigh muscles (sartorius, gracilis and semitendinosus) come together and insert into the upper/inner part of the tibia (bone of the lower leg). This condition is known as Pes Anserine bursitis. Pes Anserine is Latin for “goose foot”. I suppose it is called goose foot because these three tendons coming together look somewhat like a goose’s foot. The pain is caused by inflammation of the bursa beneath these three tendons. A bursa is a fluid-filled sac that is found where tendons and ligaments rub against bone. The bursa is designed to prevent the bone from irritating and damaging these tendons and ligaments as the rub back and forth over the bone. When these bursa become inflamed this is known as bursitis. Pes anserine bursitis is inflammation of the bursa beneath the three tendons that form the goose foot. Pes Anserine bursitis can be caused by excessive pronation of the foot. The excessive pronation (see article on normal foot motion) causes excessive stretching of these tendons which over time results in inflammation. The treatment and prevention of this condition involves an arch support to prevent excessive foot pronation.
Pain on the outside of the knee is sometimes caused by a condition known as iliotibial band syndrome. The iliotibial band runs from the pelvis down the outside of the leg and attaches to the outside part of the knee. Problems with the foot together with overuse (such as running or bicycling) can lead to inflammation where the iliotibial band inserts into the outer knee. There are several different foot problems that can cause this inflammation. If the person is flat-footed (over-pronatnor) this causes the tibia (lower leg bone) to excessively internally rotate. This increases the stretch on the iliotibial band and causes inflammation. On the other hand if someone has a high-arched foot, the foot is in a supinated position (see normal foot motion) and this too can cause excessive stretch on the iliotibial band and inflammation. These two very different types of foot problems result in the same painful condition (iliotibial band syndrome). However the two problems require very different treatments. In order to correct the problem it is essential to determine what exactly is causing the problem.
Knee arthritis can be caused or exacerbated by problems with the foot. Someone that has arthritis pain on the part of knee closest to the midline (medial compartment) may have a supinated foot that contributes to a bow-legged type of stance. Someone with pain in the lateral compartment (the outer part of the knee furthest from the midline) may be flat-footed, a hyper-pronator, which leads to a knock-kneed type of stance. Through the proper use of a foot orthotic I believe that we can, over time, reduce the load on the painful knee compartment, reduce the pain and at least slow down the degeneration of the cartilage.
Pain in the center of the knee is often cause by chondromalacia patella, also known as retropatellar (behind the kneecap) pain syndrome. This is often seen in someone with excessive pronation (flat-feet). As the knee straightens and bends the kneecap is supposed to ride smoothly in a cartilage-lined groove on the lower end of the femur (thigh bone). Someone that is a hyper-pronator has excessive internal rotation of the tibia. This excessive internal rotation changes the angle that the kneecap rides up and down in this groove (known as the Q angle or Quadriceps angle). Over time this leads to irritation behind the kneecap and the retropatellar pain syndrome. An arch support or orthotic can be very helpful in treating this condition.
In conclusion I have discussed a few of the common causes of knee pain that can be relieved or at least improved through the use of a simple foot orthotic. The key to treatment however is knowing what is causing the problem in the first place. The techniques we use for diagnosing the problem will be discussed in an upcoming article.
For More Information Visit www.Archatomics.com
The improper alignment that causes knee pain is often the result of improper alignment of the joints of the foot and ankle. Let me give some examples.
Pain on the inside part of the knee may be caused by bursitis at the location where three of the tendons from the thigh muscles (sartorius, gracilis and semitendinosus) come together and insert into the upper/inner part of the tibia (bone of the lower leg). This condition is known as Pes Anserine bursitis. Pes Anserine is Latin for “goose foot”. I suppose it is called goose foot because these three tendons coming together look somewhat like a goose’s foot. The pain is caused by inflammation of the bursa beneath these three tendons. A bursa is a fluid-filled sac that is found where tendons and ligaments rub against bone. The bursa is designed to prevent the bone from irritating and damaging these tendons and ligaments as the rub back and forth over the bone. When these bursa become inflamed this is known as bursitis. Pes anserine bursitis is inflammation of the bursa beneath the three tendons that form the goose foot. Pes Anserine bursitis can be caused by excessive pronation of the foot. The excessive pronation (see article on normal foot motion) causes excessive stretching of these tendons which over time results in inflammation. The treatment and prevention of this condition involves an arch support to prevent excessive foot pronation.
Pain on the outside of the knee is sometimes caused by a condition known as iliotibial band syndrome. The iliotibial band runs from the pelvis down the outside of the leg and attaches to the outside part of the knee. Problems with the foot together with overuse (such as running or bicycling) can lead to inflammation where the iliotibial band inserts into the outer knee. There are several different foot problems that can cause this inflammation. If the person is flat-footed (over-pronatnor) this causes the tibia (lower leg bone) to excessively internally rotate. This increases the stretch on the iliotibial band and causes inflammation. On the other hand if someone has a high-arched foot, the foot is in a supinated position (see normal foot motion) and this too can cause excessive stretch on the iliotibial band and inflammation. These two very different types of foot problems result in the same painful condition (iliotibial band syndrome). However the two problems require very different treatments. In order to correct the problem it is essential to determine what exactly is causing the problem.
Knee arthritis can be caused or exacerbated by problems with the foot. Someone that has arthritis pain on the part of knee closest to the midline (medial compartment) may have a supinated foot that contributes to a bow-legged type of stance. Someone with pain in the lateral compartment (the outer part of the knee furthest from the midline) may be flat-footed, a hyper-pronator, which leads to a knock-kneed type of stance. Through the proper use of a foot orthotic I believe that we can, over time, reduce the load on the painful knee compartment, reduce the pain and at least slow down the degeneration of the cartilage.
Pain in the center of the knee is often cause by chondromalacia patella, also known as retropatellar (behind the kneecap) pain syndrome. This is often seen in someone with excessive pronation (flat-feet). As the knee straightens and bends the kneecap is supposed to ride smoothly in a cartilage-lined groove on the lower end of the femur (thigh bone). Someone that is a hyper-pronator has excessive internal rotation of the tibia. This excessive internal rotation changes the angle that the kneecap rides up and down in this groove (known as the Q angle or Quadriceps angle). Over time this leads to irritation behind the kneecap and the retropatellar pain syndrome. An arch support or orthotic can be very helpful in treating this condition.
In conclusion I have discussed a few of the common causes of knee pain that can be relieved or at least improved through the use of a simple foot orthotic. The key to treatment however is knowing what is causing the problem in the first place. The techniques we use for diagnosing the problem will be discussed in an upcoming article.
For More Information Visit www.Archatomics.com
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