- Limb Length Differences
- Poor Shock Absorption
- Forefoot Abnormalities (Varus, Valgus, Bunions, Hammertoes)
- Excessive Pronation, and
- Excessive Supination
Our health care is more and more becoming problem focused alone. This means that you go to a doctor with a sore knee, and your knee will be examined (but nothing else). This is a time problem physicians face, so work with them by asking smart questions. Go after the cause of why the knee was injured in the first place. Even when the primary cause is obvious, always look for other causes or contributing factors. One bit of wisdom I love to share is that it is common to have 3 , 4, or 5 factors causing an injury to occur. So I try to at least look for 3 possible causes and work from there at the first visit. I will give an example of this at the end of this point.
Remember, pronation alone will not injure your knee. You need to look at what causes your knee to be the weak link? The next 95 of the 100 guidelines will improve your ability to recognize possible strategies if your treatment is not improving.
If you use a lift for a short leg, or have a short leg, I will explore this area.
If you have had shock absorption issues developing stress fractures, having osteopenia or osteoporosis, pound when you walk, I will explore this.
If you have forefoot abnormalities sometimes diagnosed by bunions, hammertoes, metatarsal calluses, or pain in the front of your foot, I will explore this.
If you over supinate, roll your heel outward as if spraining your ankle, break your shoes down to the outside, have hip or low back pain, chronic ankle sprains, tailors bunions (5th metatarsal), I will explore this.
And if you over pronate, I will explore all the methods available to help you avoid the 33+ injuries associated.
If we break this down to its basics, the following occurs:
- You develop pain.
- You see a health care provider for advice.
- The health care provider works in 3 areas all at once.
- Attempts to identify the problem (make a diagnosis)
- Attempts to look for a cause to reverse
- Attempts to initiate treatment
- It is difficult to identify the problem, so xrays, injections, MRIs, bone scans, ultrasounds, and surgeries may be performed.
- Several causes or aggravated factors initially not considered need to be identified and treated.
- Various treatments lead to aggravation of symptoms, or no help, and other avenues of treatment need to be explored.
Before I close, let us take look at Achilles tendinitis. There are numerous causes including tightness, weakness, technique faults, poor shoe selection, short leg, over pronation, etc. When I see a patient with this, I try to quickly check out leg length issues, tightness issues, and weakness issue. There I am dealing with 3 possible causes at once, and after several months, if the patient is feeling better, I look good. Hope this helps.