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Knee Pain : a confusing diagnosis ….

We often see patients in our clinics who suffer with knee pain due to ‘arthritis’. This can be a rather confusing and misleading diagnosis, as it literally means inflammation of the joint and it is by no means always the case that the knee structures are inflamed..  arthritis of the knee is rather too unspecific and therefore not particularly helpful when attempting treatment.

The knee joint is a highly complex structure.  It is particularly vulnerable to damage, as it not only takes the full weight of your body, but also any extra force when you run or jump.

 Sporty people are at higher risk of damaging their knees, especially with activities that involve turning or twisting, such as skiing, netball or football.

You are also more likely to experience knee pain as you get older or if you are overweight due to the additional strain placed on the joint.

A better diagnosis for knee pain.

 Patients who complain of “knee pains” are assessed for joint line tenderness to determine where the damage has occurred.

This allows us to have a more accurate diagnosis:

Central joint line;    symptoms affecting this area generally involves a tendinitis of the patella ligament.

These conditions are likely to appear for example, in people with severe pronation (inward roll of the foot).

Lateral joint line;    e.g.  iliotibial band bursitis, lateral meniscus small tear. These conditions are linked with people who demonstrate significant pronation or poor shock absorption.

Muscle imbalances may also be present in some knee complaints. For example, in “knee syndrome”, the knee cap (patella) is misplaced and the cartilage, tendons, ligaments and muscles can become strained and inflamed.

In patient reporting knee pains, we would always recommend a bio-mechanical assessment.

The majority of chronic knee injuries are mechanical induced problems caused by abnormal foot placement.

A biomechanical assessment will include an examination of the foot and leg, as any misalignment can cause excess stress to be placed on the muscles, ligaments, tendons.

By understanding the foot biomechanics involved in knee pain, we can really help our patients to recover.

Treatment options include the prescription of over the counter /off -the-shelf insoles or functional/custom orthoses. These are clinically proven to provide a significant relief of symptoms associated with chronic problems. The insoles correct foot placement, which in turn reduces the stress on the knee joint.

We will, where appropriate, refer patients on to other health-care professionals, (GPs, physiotherapists, osteopaths, sports therapists) to have their symptoms treated. All this as part of a “holistic” treatment.

At Randell’s Footcare we have a fantastic podiatry bio-mechanics team who strongly believe that prevention is the best way to keep our bodies and feet in great condition.

At the first sign of pain or discomfort you should visit your podiatrist.

If left untreated, knee pains can easily become chronic and disabling, affecting the ability to carry out sports and activities, as well as influencing our normal daily lives.

Iván Maestre

Podiatrist at Randell’s Footcare

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