Podiatrist Ian Sadler talks to The Sports Injury Clinic about knee pain and why pain occurs. For more information on anterior knee pain or inner knee pain visit:
So, one of the common running injuries is patellar pain or kneecap pain. Your kneecap translates all the power that’s generated by your quadrucep muscles down through it a single tendon that attaches into here.
Ok, so there’s a lot of load going through that muscle and its job is to translate that so that the pull doesn’t then rip the bone off your tibia and it makes it all go in a single direction. A nice line.
So, it’s v-shaped behind it. It runs in a grove in the femur, so it needs to run up and down that groove to work smoothly.
So a common cause of knee pain is to have increased wear on the actual groove behind so it’s not running smoothly in that groove. That maybe because that muscle pull isn’t even, it may be that the rotations going through your leg aren’t even or it may be that they’re twisting between the two from what your feet are doing to what your hip’s doing and rotating through there.
Other forms of knee pain, you can have the actual muscles come down they don’t all just descend into there they send other bits of themsleves around the actual knee cap to give it a joint capsule itself they can become inflamed as well.
But, again, essentially, as your leg needs to remain stable in that position and in that position the kneecap has to run smoothly up and down so if it gets pulled out of position it starts to wear. So, effectively it’s an imbalance between the damage that’s occurring, so the wearing and your repair mechanisms. What we need to do is work out why that’s happening.
So, for it to be pulled in or out of rotation, so if it’s coming from a foot cause, so, if the foot is pronating too late into the step or too much it will rotate the tibia inwards.
After about mid stance you’re in the middle of your step, your femur starts being rotated out by the hip.
So, you end up getting a rotation like that occurring. That obviously pulls the kneecap in that direction and out of line, so changing the dynamics of the way that your foot is working will reduce that sort of pain. If you also have a situation where you can’t bend your ankle sufficiently sometimes that will cause your knee cap to run out of alignment, alternatively if your hips aren’t working how we want them to sometimes that will cause a mis-alignment. So it’s finding which part of that is causing the problem.