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Knee pain may occur due to a variety of causes. Sporting injuries or other accidents account for the majority of acute knee pain. A sports or trauma orthopaedist best manages serious injuries or accidents. Chronic, less severe knee pain may be associated with localised arthritis or biomechanical abnormality within the lower extremity.
Podiatrists treat knee pain that is caused by abnormalities in foot posture. An altered foot posture and, therefore, a modified walking pattern can cause strain on specific knee structures, leading to pain.
Foot posture is often overlooked as a cause of knee pain. Many clients are referred to us by surrounding Physiotherapists. If you suspect that you have a knee problem that is caused by the posture of your foot during standing, walking or running, you should arrange a podiatry appointment as soon as possible to allow you to continue with your everyday activities without pain.
If you have knee pain, it is not advisable to ignore the pain as you may be causing more damage to the joint. Having your knee and lower gait examined by a physiotherapist and a podiatrist is the first thing you should do when your experience pain in your knee.
If a misalignment within the posture of your foot is the cause of your knee pain, it is unlikely that the pain will be resolved without treatment. Long term knee pain will make walking, running and other sports a lot more difficult and will typically only worsen over time.
Our primary focus is managing knee pain that is caused or at least aggravated by some form of biomechanical abnormality. A variety of muscular and/or skeletal conditions within the lower leg, ankle or foot can lead to excessive pronation (flattening) of the foot. This, in turn, causes an abnormal amount of internal rotation of the leg that creates torque on the knee joint. As a result, there is increased wear and tear on the cartilage behind the kneecap. This is typically assessed during a complete biomechanical examination.
Knee pain induced by biomechanical abnormality is commonly increased when first getting up after a prolonged time sitting as well as going up or down stairs and hills. This is because the back of the knee cap is under increased compression pressure when the quadriceps (front thigh muscles) contract and the knee undergo alternate flexion and extension.
Decreasing local inflammation - If our initial clinical examination of your knee reveals the presence of localised inflammation, we will advise appropriate measures for reducing this. This may involve a specific oral anti-inflammatory medication regimen, the application of intermittent direct icing or a course of ultrasound treatments. A flexible knee brace may also be recommended to provide added support to the knee, depending on the nature of the symptoms.
Biomechanical assessment - Once the inflammation has subsided, it is essential to determine the exact nature of the biomechanical abnormality that is causing the knee pain. The range of motion of the forefoot, midfoot, rearfoot, ankles, knees and hips are measured. Limb lengths are measured to check for significant length differences. Muscular weaknesses and/or tightness are noted as well. This one-hour examination includes digital video gait analysis on a treadmill.
Custom-made orthotics - Custom-made orthotics must be based on the findings of a complete biomechanical assessment. Then, a plaster of Paris cast impression of your feet (held in their neutral functional position) is taken and sent to a laboratory that specialises in fabricating custom-made orthotic devices.
If your knee pain still has not settled with ultrasound therapy, orthotic therapy and muscle strengthening exercises. Radial Shock Wave Therapy may be a form of treatment suitable for your condition.
We are one of a few practices in the country that have this type of treatment. Please ask our podiatrists about this if you think it may be of benefit to you.
A series of strengthening and stretching exercises will be prescribed to help prevent the recurrence of knee pain. Return to normal exercise activities depends on the ability to perform preliminary exercises without discomfort. Then, the return should be "phased in" with only limited amounts at first and gradually increasing as symptoms permit
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