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