Knee pain can have a variety of sources, organic or mechanical. The organic sources are things like osteoarthritis, DJD, or a disease process. The most common cause of knee pain that I see are mechanical stresses due to aberrant joint mechanics. As a result, it is important to understand the mechanics of the knee. The knee is part of the lower extremity’s kinetic chain. Because all the joints of the lower extremity work together, any joint that is not doing what it is supposed to will cause deleterious mechanical effects above and below the affected joint. The joints above and below the problem joint will compensate by locking up, or becoming hyper-mobile.
Knee pain can come from many points in the lower kinetic chain. A pair of orthotics can often align the joints of the leg removing the mechanical distortion. Proper knee function can reduce or eliminate knee pain hence an orthotic can often provide an effective solution.
How pronation and supination can affect knee pain.
The tibial plateau interacts with the femoral condyles and allows rotation of the tibia and femur in relation to the forefoot. What does that mean?
As we go through the mechanism of our normal gait, we pronate and supinate. This is part of the shock absorption system of the lower extremity. Some people refer to the idea “I over pronate” or “I over supinate.” Sadly, most people who speak in these terms got the idea from a shoe salesman who may or may not truly understand what this means. The salesman gets this idea from observing the person’s static alignment and then makes a diagnosis of a dynamic process. Because they often have no medical training, this is VERY…. not so good. The way we can help knee pain is by placing the patient into their shoes in sub-talar neutral.
Sub-talar neutral is the center point, if you will, of the pronation supination process. Therefore, this will provide maximum mechanical motion. Thereby allowing normal pronation and supination to take place. Placing the patient in sub-talar neutral can relieve or eliminate knee pain in patients with this type of mechanical problem. Please feel free to call to schedule a complimentary consultation to see if a pair of custom orthotics might be the answer for you.