| There are several painful conditions of the | | | | (such as running or bicycling) can lead to |
| knee that may be caused by problems with your | | | | inflammation where the iliotibial band |
| feet. The knee joint is one of the most | | | | inserts into the outer knee. There are |
| complex joints in the body. It is a hinge | | | | several different foot problems that can |
| joint, a sliding joint and a rotating joint | | | | cause this inflammation. If the person is |
| all at the same time. The proper and | | | | flat-footed (over-pronatnor) this causes the |
| pain-free functioning of the knee requires | | | | tibia (lower leg bone) to excessively |
| near perfect alignment of the bones, | | | | internally rotate. This increases the |
| ligaments and tendons that make up the knee | | | | stretch on the iliotibial band and causes |
| joint. Pain in the knee is usually an early | | | | inflammation. On the other hand if someone |
| warning sign that something is wrong with the | | | | has a high-arched foot, the foot is in a |
| alignment. It is important to address these | | | | supinated position (see normal foot motion) |
| problems early to avoid serious, long term | | | | and this too can cause excessive stretch on |
| problems such as severe arthritis. | | | | the iliotibial band and inflammation. These |
| | | | two very different types of foot problems |
| The improper alignment that causes knee pain | | | | result in the same painful condition |
| is often the result of improper alignment of | | | | (iliotibial band syndrome). However the two |
| the joints of the foot and ankle. Let me | | | | problems require very different treatments. |
| give some examples. | | | | In order to correct the problem it is |
| | | | essential to determine what exactly is |
| Pain on the inside part of the knee may be | | | | causing the problem. |
| caused by bursitis at the location where | | | | |
| three of the tendons from the thigh muscles | | | | Knee arthritis can be caused or exacerbated |
| (sartorius, gracilis and semitendinosus) come | | | | by problems with the foot. Someone that has |
| together and insert into the upper/inner part | | | | arthritis pain on the part of knee closest to |
| of the tibia (bone of the lower leg). This | | | | the midline (medial compartment) may have a |
| condition is known as Pes Anserine bursitis. | | | | supinated foot that contributes to a |
| Pes Anserine is Latin for "goose foot". I | | | | bow-legged type of stance. Someone with pain |
| suppose it is called goose foot because these | | | | in the lateral compartment (the outer part of |
| three tendons coming together look somewhat | | | | the knee furthest from the midline) may be |
| like a goose's foot. The pain is caused by | | | | flat-footed, a hyper-pronator, which leads to |
| inflammation of the bursa beneath these three | | | | a knock-kneed type of stance. Through the |
| tendons. A bursa is a fluid-filled sac that | | | | proper use of a foot orthotic I believe that |
| is found where tendons and ligaments rub | | | | we can, over time, reduce the load on the |
| against bone. The bursa is designed to | | | | painful knee compartment, reduce the pain and |
| prevent the bone from irritating and damaging | | | | at least slow down the degeneration of the |
| these tendons and ligaments as the rub back | | | | cartilage. |
| and forth over the bone. When these bursa | | | | |
| become inflamed this is known as bursitis. | | | | Pain in the center of the knee is often cause |
| Pes anserine bursitis is inflammation of the | | | | by chondromalacia patella, also known as |
| bursa beneath the three tendons that form the | | | | retropatellar (behind the kneecap) pain |
| goose foot. Pes Anserine bursitis can be | | | | syndrome. This is often seen in someone with |
| caused by excessive pronation of the foot. | | | | excessive pronation (flat-feet). As the knee |
| The excessive pronation (see article on | | | | straightens and bends the kneecap is supposed |
| normal foot motion) causes excessive | | | | to ride smoothly in a cartilage-lined groove |
| stretching of these tendons which over time | | | | on the lower end of the femur (thigh bone). |
| results in inflammation. The treatment and | | | | Someone that is a hyper-pronator has |
| prevention of this condition involves an arch | | | | excessive internal rotation of the tibia. |
| support to prevent excessive foot pronation. | | | | This excessive internal rotation changes the |
| | | | angle that the kneecap rides up and down in |
| Pain on the outside of the knee is sometimes | | | | this groove (known as the Q angle or |
| caused by a condition known as iliotibial | | | | Quadriceps angle). Over time this leads to |
| band syndrome. The iliotibial band runs from | | | | irritation behind the kneecap and the |
| the pelvis down the outside of the leg and | | | | retropatellar pain syndrome. An arch support |
| attaches to the outside part of the knee. | | | | or orthotic can be very helpful in treating |
| Problems with the foot together with overuse | | | | this condition. |