By Shawn VanderBrook, PT, DPT, OCS
I am going to start this off with a simple, yet profound statement about the knee joint and how it works. Ready? The knee is the victim of the foot and hip.
These wise words from a patient’s professor sum up my philosophy of how best to address knee pain and dysfunction in the physical therapy world. It may sound a little strange to some of you, but I really want you to take this to heart, because this knowledge can help you manage your knee pain at any age and help anyone manage a multitude of knee injuries.
Let’s start with the structure of the knee. The knee is a “hinge” joint with a locking mechanism called the “screw home” that improves knee stability when standing fully straight. Due to this structure, the knee is not designed to be the primary control of the leg’s rotational motion. The knee’s main function is to bend backward and forward.
So what joints are the primary controls for rotational motion of the leg? Go back to our thesis statement: The hip and foot/ankle joints are the primary controls for rotational motion of the knees.
This is such an important concept to get across because it can completely change the way you have been addressing your knee pain. Injections, medications, and surgeries are all simply used to manage pain and only last a temporary amount of time. If no focus is paid to the hip and foot/ankle joint complexes, then everyone who is treating you is not providing long-term solutions.
The first and foremost way to address pain is to improve hip stabilizer strength. This means that you should be performing exercises to improve your body’s ability to keep the knee in proper alignment and prevent abnormal wear and tear in one side of the knee joint or the other. This can be achieved with simple exercises prescribed by a physical therapist, based on which muscles are the weakest at the hip.
The second way to address knee pain and abnormal alignment is to address foot/ankle position with multiple types of interventions if needed. One simple intervention is attaining proper footwear and orthotics (custom or over the counter) to ensure your foot has adequate support. Other interventions could include ankle stabilizer strengthening exercises and stability exercises to improve control of your foot position and decrease abnormal stresses acting on the knee. These exercises can again be prescribed following a thorough examination from a physical therapist.
Knee pain is far more complex than most health care professionals may admit. The knee joint is part of a team comprised of the joints above and below it. If the knee’s “teammates” are not doing their jobs, then the knee joint becomes the unhappy “victim.” The hip and foot/ankle joints must always be assessed and addressed with any knee complaint, otherwise individuals with knee pain can only lean on short-term fixes, such as injections or medications, instead of engaging with long-term solutions that fix the root of knee pain.
Don’t continue to struggle with knee pain; Take action today and meet with a physical therapist and engage in long-term solutions that can last a lifetime!
Shawn VanderBrook, PT, DPT, OCS
Cardin and Miller Physical Therapy
Shawn VanderBrook, PT, DPT, OCS is on staff at Cardin and Miller Physical Therapy. He received his bachelor’s degree in exercise science at Slippery Rock University and his doctorate in physical therapy at Slippery Rock University. Shawn enjoys treating a variety of orthopedic and musculoskeletal conditions. He completed an orthopedic residency program at St. Francis University and is now an Orthopedic Certified Specialist. While at St. Francis, he worked with a variety of Division I athletes and community members, and gained useful experience rehabbing complicated surgeries, sports injuries, overuse injuries, and concussed athletes under the St. Francis concussion protocol. He has also received intensive training on treating complex foot and ankle injuries and to also manage and modify custom orthotics. You can contact him at firstname.lastname@example.org or visit www.cardinmillerpt.com.
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