Hip and Knee Pain ... when are your Hips and Knees not to blame?

Do you have knee pain? Have you tried pain killers, exercise even physiotherapy to no avail? Is it possible to have knee pain but not have a problem with your knees? Your knees along with your hips are the largest joints in the body. They are responsible for supporting your weight as you walk, stand, run and jump. It is possible for there to be a link between your feet and how they function and your knee or hip pain. First we need to know a little about the knee joint. Knee Pain – in a nutshell The knee is made to bend in one direction – forwards and backwards. If the joints in your foot move too much or not enough; or if you have “flat feet” these changes can affect how you stand, walk and run. When the foot “collapses" or "overpronates” the effect is an inward rotation at the knee… remember the knee is only designed to move forwards or backwards; not rotate. Rotation at the knee is like calling an Australian a Kiwi … you generally only do it once. Essentially this rotation - caused by the foot remember - puts additional stress through the knee which results in pain. Pain at the front of the knee or under the knee cap – known in medical speak as “Anterior knee pain” is caused by the pressure of your foot contacting the ground and compressing the knee cap against your thigh bone. This can indeed be caused by weak muscles or malalignment of your knee cap, it can also be caused by alterations in foot mechanics. If your foot does too much of one thing and not enough of another this can cause greater pressure through the back of the knee cap or cause too much pressure through one particular point of the knee cap the result … you guessed it - PAIN

Your knee pain might not be caused by your Knees! Ok so you don’t have knee pain but you get pain in or around your hip – this has the coming from the hip right? Wrong! Whilst this is the logical explanation it is not true in all situations. Have you ever been told you have hip Bursitis ? this is typically characterised by pain on the outside of the hip. Bursitis is an irritation of the cushions that decrease the friction around muscles and aid movement. As in knee pain issues with the feet can equally cause inward rotation of the hip, with similar painful results. This excessive inward rotation and altered distribution of weight bearing can cause Arthritis of the hip… think about it - in a day how much time do spend standing, let alone walking, running? … lots right? So imagine all this additional force going through the wrong place, not so surprising your hips and knees hurt. I now have 2 questions for you… 1. If your knee or hip pain hasn’t gone away has anyone ever looked at your feet? I thought not. 2. What would you say if I told you we could help to ease your pain ? Sound good? Here goes – exercise is hugely important and cannot be ignored, also manual therapy to help mobilise stiff painful joints of the foot and ankle is also a must – your foot and ankle have likely been functioning poorly for a long time so good hands on physiotherapy to mobilise these stiff joints is equally important. BUT and this is a BIG BUT all the physio and exercise is not going to solve the root cause of the issue, sure it will help for a bit but the likelihood is that you are going to need either corrective footwear or an insole to help correct the mechanics of the foot and prevent the nasty inward rotation we talked about. Now insoles or orthotics; like so many things in this world are not created equal. There is too much to discuss on this subject here. Keep an eye on your inbox for my next post about orthotics. Essentially if you suffer from hip or knee pain you will want to read this … I promise. Until next time remember, nothing is impossible. The word itself says ”I’m possible”. Dave Out