Runners Knee

What is it?

Runner’s Knee is a general term referring to pain around the front of a runner’s knee.

What causes it?

If the pain is anteromedial in location, the source of the problem may be over-pronation. The internal rotation of the tibia associated with over-pronation, may cause the knee to fall into a functional valgus orientation during the stance phase of gait. This in turn will compromise the ligaments on the medial aspect of the knee. Furthermore the abnormal motion will result in abnormal pressures behind the patella, leading to a more specific knee malady referred to as chondromalacia patella. What is the treatment?

If over-pronation is the biomechanical fault in question, then orthotics designed to normalize the movements of the subtalar and transverse tarsal joints will solve the problem rather quickly.

Sacroiliac Syndrome

What is it?

Sacroiliac syndrome is a painful inflammatory condition of the sacroiliac joints. The patient generally experiences pain in the buttock and thigh regions. It is typically aggravated by sitting for long periods.

What causes it?

Quite frequently is caused by an injury such as would be sustained by a fall on the buttocks or during a lifting activity. However there is some evidence to suggest that a chronic irritation from abnormal foot mechanics is also a possible cause. When a foot over-pronates, it creates a tendency towards internal rotation of the lower limb. Due to the anatomy of the hip joint, this internal rotation translates into an extension of the pelvis (PSIS’s rotate upward while ASIS’s rotate downward). If the mechanics of the feet are not symmetrical, then conflicting rotations may occur at the two sacroiliac joints. This appears to set up a chronic irritation of these joints leading to the inflammation.

What is the treatment?

Spinal manipulation will be effective if the cause was traumatic in nature. However if the cause is poor foot mechanics, manipulation will only resolve the symptoms temporarily. To address the issue at hand, correction of the abnormal foot mechanics may be accomplished with orthotic prescription. Once the offending pathomechanics are dealt with, spinal manipulation should show long lasting effects.