Shin Splints Tape for Medial Tibial Stress Syndrome

Shin Splints Tape – What is it?

Shin splints tape and shin splint taping techniques are commonly used to provide relief from the painful symptoms of the condition, which is medically referred to as medial tibial stress syndrome.

The tape used for shin splints is often very stretchy and sticky, and is designed to stay adhered to the skin for five to seven days. Your sports podiatrist may prefer a particular brand based on their experience and results with treating shin splints using tape. There are many colour and pattern options, but these do not affect the properties or efficacy of the shin splints tape.

What is shin splints?

Shin splints it is not a specific injury in itself, but an overuse syndrome. Shin splints is a term that is used to describe the pain that can be felt on the inside of the shin, which is the main symptom of the condition. Shin splints tape techniques can be used to alleviate some of the symptoms of the condition. These symptoms can include:

Shin splints often develop over time, and in many cases the patient has continued to exercise and push through the pain. This is not a condition that develops acutely, that is, overnight. Medial stress syndrome (as it is otherwise known) develops when then lower leg muscles constantly pull on the tibia. Surrounding the tibia, is a protective sheath which is called the periosteum. When shin splints develops, it is actually the periosteum that becomes inflamed and painful, as a result of the muscles and tendons constantly placing strain upon it.

Shin Splints Tape for Medial Tibial Stress Syndrome

What is the benefit of shin splints tape?

Shin splints tape- when applied correctly with sound technique- can offer almost immediate pain relief by supporting the lower leg muscles and reducing their pull on the periosteum of the tibia. A qualified sports podiatrist can instruct you on how to correctly apply shin splints tape so that it is effective for your symptoms. The tape may be applied in a spiral pattern around the lower leg and up around the shin, or down the length of your shin and then laterally (horizontally) across the most painful parts, depending on your practitioner’s preference and your condition. No matter how it is applied, the aim of taping for shin splints is to pull the muscles close to the bone, reducing the traction force on the shin, therefore supporting the structures and allowing the inflamed tissues to heal.

Treating Shin Splints with Methods other than Shin Splints Tape

Whilst shin splints tape application can be beneficial in the healing of medial tibial stress syndrome, most patients have the greatest success in treating their pain when they approach their treatment from more than one angle. Once your sports podiatrist has made a definitive diagnosis and ruled out any other possible causes of your shin pain, an individualized treatment plan can be devised. Treatment for shin splints will not only involve resolving the pain by reducing inflammation, but also identifying and attempting to correct biomechanical problems that are contributing to the problem.

Shin splints tend to respond well to rest, so one of the initial recommendations will likely be to cease, greatly reduce, or modify your training during your treatment phase. Shin splints tape can be used to support the associated muscles, ligaments and tendons through the healing process. Your sports podiatrist may recommend tailored orthotic inserts or particular types or models of footwear to support your foot and lower leg, reducing strain on the shins. You are also likely to be prescribed a stretching regime for your legs and feet, targeting the calf muscles in particular. Massage and myofascial release are also sometimes used in treating cases of shin splints.

Please be advised that the above information regarding medial tibial stress syndrome and shin splints tape is for education purposes only. It is not general medical advice. If you are experiencing symptoms of shin splints, you should make an appointment with a qualified sports podiatrist for a full assessment and correct diagnosis. You can make an appointment online at www.sydneypodiatrist.net.au or by calling 93883322.

Karl Lockett– sports podiatrist.

 

 

Sudden knee pain: What could the cause be and what should you do?

Why does sudden knee pain occur?

The human knee is a complex joint that is made up of many moving parts and because of its complexity, it is prone to injury, which can lead you to experience sudden knee pain.

The knee is made up of four bones: the femur, tibia, fibula and patella. The bones are connected by ligaments, including the anterior and posterior cruciate ligaments, and the medial and lateral collateral ligaments. Tendons connect the associated muscles to the bones, and bursae and menisci reduce friction and absorb forces. If one or more of these components become damaged through overuse, impact or injury, you may experience sudden knee pain.

 

sudden knee pain

 

What can cause sudden knee pain?

Sudden knee pain can be caused by a number of problems. Whilst it may seem logical that a particular ‘event’ such as an injury might be the only reason for sudden knee pain, this is not always the case. Overuse and strain over time can also lead to a point where something within the knee becomes damaged and causes you to experience sudden or sharp pain.

Some of the most common causes of sudden knee pain are summarised below.

Fracture
Fractures can cause sudden knee pain. The problem is commonly either a tibial plateau fracture, distal femoral fracture, or patellar fracture. The pain is usually sharp and severe and the patient is unable to move the knee. There is usually swelling present. Fractures of the knee can be the result of injuries or falls.

 

Torn or sprained anterior cruciate ligament (ACL)
When the ACL tears, there is usually a characteristic, loud “pop” heard. The associated sudden knee pain is usually sharp and severe but after some time may subside to a severe ache. Swelling of the knee typically develops within the hour of the injury.

Meniscal injury

Injuries to the menisci (pieces of cartilage in the knee) can be caused both by injury or overuse. A common way people damage their meniscus is with abrupt and forceful twisting of the knee. A grinding or clicking sound can sometimes be heard when the knee is moved. There may or may not be swelling present and locking is common.

 

Patellar tendonitis (Jumper’s Knee)
Tendonitis is the inflammation of the affected tendons, usually caused by repetitive strain. The pain is usually described as a dull aching with a feeling of tightness. There may be swelling present and difficulty moving the knee.

Runner’s Knee
Runner’s knee is the term used to describe the number of associated issues that can cause pain around or behind the kneecap. Patients often describe throbbing behind the kneecap with these conditions. Popping and grinding sounds are also common.

Gout

The onset of gout can cause sudden knee pain. Gout is caused by the build up of uric acid in the body, and commonly affects men in middle age and post-menopausal women. Gout causes intense pain and swelling which usually occurs intermittently for a few days at a time, known as ‘flare-ups’.

When should I seek medical attention for sudden knee pain?

If you cannot put weight on your leg because of severe or sudden knee pain, you should seek immediate medical attention. Similarly, if you have a fever or if your knee is red and hot. If your pain is manageable, you should schedule an appointment with a qualified sports podiatrist promptly so that your condition can be assessed and the appropriate treatment provided. Ignoring pain or pushing through it can exacerbate your injury or cause further damage due to an underlying condition. For your best chance at a timely and successful recovery, do not put off having your sudden knee pain checked by a specialist.

In the meantime, while you wait for your appointment, you can safely rest your sore knee at an elevated height where it sits above the level of your heart (on the couch with a cushion under your knee is an easy way to achieve this). You can apply an ice pack wrapped in a towel for up to 20 minutes at a time at regular intervals throughout the day.

What are the treatment options for sudden knee pain?

The type of treatment that you will require for sudden knee pain will depend entirely on the cause. Once your sports podiatrist has determined the reason for your knee pain, they may recommend a number of treatments, for example:

Please note that the information detailed in the article above regarding sudden knee pain is intended to be educational only. It is not intended, nor should it be taken as general medical advice. If you experience sudden knee pain, you should make an appointment with a qualified sports podiatrist as soon as possible so that they can make an accurate diagnosis and formulate an individualised treatment plan. Appointments can be made online at www.sydneypodiatrist.net.au or by calling 93883322.

Karl Lockett– sports podiatrist.

Knee Pain When Walking

Knee Pain When Walking: An Overview

Knee pain when walking is a common complaint, with over 25% of adults experiencing regular knee pain1. You may experience knee pain as you go up the stairs, when you try to bend down or squat, or sometimes even from simply weight bearing. The knee joint is comprised of a number of moving parts, which include the femur (thigh bone), the tibia (shin bone), the patella (knee cap), and a many ligaments, tendons, and cartilage and fluid-filled sacs (bursae), which work to reduce friction and allow for smooth movement. Painful conditions of the knee arise when one or more of these parts become damaged, restricting the range of motion (ROM). Damage can occur with an acute injury or repetitive strain and overuse. The treatment for your knee pain when walking will depend entirely upon what the diagnosis is.

What is normal knee range of motion (ROM) and how does it relate to knee pain when walking?

A limited ROM due to injury can cause knee pain when walking by putting abnormal strain on particular structures in the knee. Range of motion (ROM) refers to the range (in degrees) of the knee joint from full extension to full flexion. A straight knee (at full extension) is at 0 degrees, and a completely bent leg (full flexion) is about 140 degrees2. There are slight variations in the average variation of ROM between men and women, but also obviously individual variations from person to person. Normal walking, including up and down regular stairs, requires the knee to move between about 2-70 degrees of flexion2. Losing more than a few degrees of flexion in the knee causes a limp, poor gait, and puts a lot of pressure on the kneecap which over time can lead to damage in the cartilage. Losing degrees of extension is a bigger issue. As the knee extends, in the last few degrees of this motion, a mechanism known as the ‘knee-lock’ occurs, which allows the knee to support the person’s bodyweight despite the thigh muscles being relaxed. If the last few degrees of extension are missing, this mechanism cannot work, leaving the upper leg muscles and knee ligaments to bear the weight and force. This almost always results in biomechanical problems, knee pain when walking and bending, and risk of further injury.

Knee Pain When Walking

What causes knee pain when walking?

Broadly, there are traumatic and medical causes which lead to the development of particular conditions that cause knee pain when walking. Traumatic events include falling from a height, receiving a directly blow to the knee, or sudden or repetitive movements during sport. Medical factors that lead to knee pain when walking include obesity, degenerative conditions (such as osteoarthritis), autoimmune diseases (such as rheumatoid arthritis), gout, tumors, and infections.

What types of conditions cause knee pain when walking?

Spanning from the traumatic and medical causes mentioned above – there are a very large number of conditions that can cause knee pain when walking. Just a few of the most common issues can be categorised into:

Meniscal (Cartilage) Problems:

Medial Ligament Problems:

Anterior (Front) Knee Pain:

Other medical conditions that can cause knee pain when walking may include:

Diagnosing the Cause of Knee Pain When Walking

Your sports podiatrist will carry out a thorough examination in order to diagnose what is causing your knee pain when walking. The examination will begin with the podiatrist collecting a thorough medical and physical activity history. You may be asked about your regular occupation, any sports you regularly partake in, any relevant medical conditions that you have, and whether you’ve sustained any injuries to your legs recently or in the past. Your sports podiatrist will then proceed with a physical examination, which will include palpation (physically feeling) the knee joint and a testing a number of parameters such as muscle flexibility and ROM of the knee joint. Your sports podiatrist may also conduct a biomechanics assessment in order to aid them in their diagnosis of your knee pain when walking. In some cases, diagnostic imaging such as xray, MRI or ultrasound many be required in order to confirm or to rule out particular conditions.

The role of Biomechanical Assessment in Diagnosing Knee Pain When Walking

Biomechanical assessment is a valuable tool in assisting your sports podiatrist with diagnosing the cause of your knee pain when walking. A recent review of the scientific literature confirmed that biomechanical data can be used effectively to classify knee joint movement and therefore assist in the correct diagnosis of knee joint conditions3 The assessment involves placing markers on the subject’s legs and asking them to walk on the treadmill. A camera records the footage and specialised software assists the sports podiatrist to replay the footage in slow motion and analyse the patient’s gait in great detail. The results of the analysis help to identify gait abnormalities and structural imbalances and malalignments, which may indicate a particular condition and hence the possible cause of knee pain when walking.

Treatment for Knee Pain When Walking

As you will have discovered, there are many different conditions that can cause knee pain when walking. For this reason, there are numerous treatments that may be recommended by your sports podiatrist, dependent on what is causing your pain. Some of the treatment methods that may be recommended to you might include:

 Please be aware that the information provided in the article above regarding knee pain when walking, is intended for educational purposes only and should not be taken as general medical advice. If you have knee pain when walking, you should make an appointment promptly with a suitably qualified sports podiatrist who will be able to make a diagnosis and provide you with an individualised treatment plan. Appointments can be made online at www.sydneypodiatrist.net.au or by calling 93883322.

Karl Lockett– sports podiatrist.

 References and Further Reading:

1 Bunt, C. W., Jonas, C. E., and Chang, J. G., (2018). Knee Pain in Adults and Adolescents: The Initial Evaluation. American Family Physician, 98(9).

2Rowe, P.J., Myles, C. M., Walker, C., Nutton, R., (2000). Knee joint kinematics in gait and other functional activities measures using flexible electrogoniometry: how much knee motion is sufficient for daily life? Gait & Posture, 12(2).

3Abid, M., Mezghani, N., Mitiche, A., (2019). Knee joint biomechanical gait data classification for knee pathology assessment: a literature review, Applied Bionics and Biomechanics.

 

 

Knee Pain Relief

Knee Pain Relief: An Introduction

Finding knee pain relief that is effective is important to the many people that suffer with knee pain. Knee pain is a very common complaint, and a symptom that affects people of all ages. Knee pain can be caused by problems associated with the bones of the knee (femur, tibia, fibula), the kneecap (patella), or the ligaments, tendons or cartilage in the knee, and can be aggravated by the actions of the surrounding muscles. Injuries to these structures can also cause knee pain.

 Depending on the cause of the pain, knee pain can vary greatly in severity and location. In most cases, there are also other signs and symptoms present (other than the pain itself). Some of these signs may include swelling, redness and warmth, stiffness, feeling of weak or unstable at the knee joint, not being able to fully extend or straighten the knee, or occasionally, ‘popping’, ‘crunching’, or grinding noises may result when moving the knee.

Knee Pain Relief

Knee Pain Relief: When to Seek Professional Advice

When considering knee pain relief, you should always consult with a suitably qualified sports podiatrist to discuss your condition prior to commencing any treatments. With the vast number of different conditions that may cause knee pain, it is imperative that you have a correct diagnosis before attempting any home remedies for knee pain relief, as not doing so may exacerbate your condition or compound your injury.

If you are seeking knee pain relief because you are experience any of the following signs or symptoms, you should seek prompt medical advice:

Your sports podiatrist will come to a diagnosis after a thorough examination. Their assessment will include a comprehensive history taking and physical examination of the knee. They may request that you have some medical imaging such as an x-ray, ultrasound or MRI so that they can view the internal structures of the knee in detail. Most often, your sports podiatrist will also like to conduct a biomechanical assessment on the in-house treadmill. This is a valuable tool that allows the podiatrist to identify any abnormalities or malalignments in the patient’s lower limbs. It often leads the sports podiatrist to the root of the problem of what’s causing the patient’s pain, which can greatly help in selecting appropriate knee pain relief and treatment options for the individual.

Knee Pain Relief and Treatment Options

Since there are so many different conditions that can cause knee pain, finding knee pain relief with treatments that work for you will largely depend on what exactly is causing your pain. Once your sports podiatrist has diagnosed the cause of your knee pain, an appropriate treatment plan can be tailored to your condition, taking into account your personal medical history, lifestyle and activity level.

Basic Considerations for Knee Pain Relief

When it comes to relieving your knee pain, there are some things that you can do that do not necessarily require a lot of effort or cost to you. Some basic considerations regarding knee pain relief to keep in mind include:

Aside from the basics above, there are a number of other ways to get knee pain relief, too. Mentioned below are just some of the clinically proven treatment options that your sports podiatrist may recommend.

Knee Pain Relief with Shockwave Therapy

Shockwave therapy is clinically proven for knee pain relief. The treatment involves using a hand-held probe to direct high-frequency sound waves into the affected knee. It is a mostly painless procedure (though some patients report feeling ‘pressure’ as the procedure is carried out). Shockwave therapy is scientifically proven to stimulate tissue healing by encouraging blood flow and tissue regeneration1. It also helps to break down scar tissue and provides many patients instant pain relief.

Knee Pain Relief from Braces and Orthotics

In some situations, your sports podiatrist may advise you to wear a knee brace or custom-made orthotics. These devices can assist with aligning the knee, or assisting the process of alignment through stabilizing and controlling the foot. Orthotics can also be useful in shifting the pressure to provide knee pain relief. This is often a useful approach in patients suffering with knee pain caused by osteoarthritis. There are a number of different types of support braces that may also be recommended in order to restrict the motion of the knee and support it as it heals from injury.

Knee Pain Relief through Physical Therapy

Physical therapy can provide knee pain relief in the longer term and prevent re-injury, or the problem occurring again, in many cases.  Your sports podiatrist will likely recommend some strengthening or stretching exercises for your legs, depending on the findings of their biomechanical assessment. The types of exercises or stretches that your sports podiatrist will choose will depend on what is happening biomechanically to cause you to feel knee pain.

Knee Pain Relief from Injections

In some severe cases, injections of medications or other substances directly into the knee joint might be advised for knee pain relief. These types of injections might include corticosteroid, hyaluronic acid or platelet-rich plasma.

Knee Pain Relief with Surgical Intervention

Surgery may be necessary in some cases in order to provide knee pain relief. Surgery is often seen as a ‘last resort’, or in cases of injuries that are unlikely or unable to heal with other treatment approaches. The types of surgery may include arthroscopy for examination and repair, or partial or complete knee reconstruction or replacement, where either just the damaged parts, or the entire knee is replaced with artificial parts. As with any surgery, knee surgery carries risks. It is important to consider the benefits and drawbacks of deciding to have a surgical intervention as opposed to non-surgical rehabilitation of your knee.

Knee Pain Relief: In Conclusion

The best way to get proven and effective knee pain relief is to speak to your sports podiatrist. With the many and varied causes of knee pain and hence the multitude of treatment options available, it is always best to seek a professional opinion prior to commencing any type of treatment for your knee pain.

Please note that the above article regarding knee pain relief, is not intended, nor should it be taken as general medical advice. The information is strictly intended for educational purposes. If you are seeking knee pain relief for an associated condition, you should consult with an appropriately qualified sports podiatrist so that you may obtain a correct diagnosis and discuss appropriate treatment options. You can make an appointment online at www.sydneypodiatrist.net.au or by calling 93883322.

Karl Lockett– sports podiatrist.

 References

1 Liao, C., Xie, G., Tsauo, J., Chen, H., Liou, T., (2018), Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders: a meta-analysis of randomized controlled trials, BMC Musculoskeletal Disorders, 19, 278.

Knee Pain Treatment

Knee Pain Treatment: An Overview

Understanding knee pain treatment is important in healing your knee and relieving your pain. Knee pain is a common problem in people of all ages. It may occur as a result of an injury- such as in the case of a torn ligament, for example- or it may occur due to a medical condition- such as arthritis.

Whilst some more minor conditions respond to basic knee pain treatment with conservative methods, in more severe cases or complex problems, more rigorous physical therapy or even surgical repair may be required.

Knee pain can vary in its severity and location, depending on what is causing the pain. Along with the pain itself, various signs and symptoms may also be present, such as swelling, stiffness, redness and warmth, feelings of weakness or instability in the joint, the inability to full extend or straighten the knee, and sometimes little ‘popping’ or ‘crunching’, grinding noises may be heard with movement.

Knee Pain Treatment

When should a professional opinion be sought for knee pain treatment?

You should always seek the opinion of a sports podiatrist for your knee pain treatment. You should make an appointment promptly if you experience any of the follow symptoms with regard to your pain:

Diagnosis is required before knee pain treatment can commence

Before your knee pain treatment can commence, a correct diagnosis is required. Sometimes the knee pain treatment of choice for a particular condition may be completely incorrect or may actually exacerbate another condition, and for this reason, it is imperative to seek medical advice from your sports podiatrist.

During your consultation, prior to formulating a knee pain treatment plan, your sports podiatrist will conduct a thorough examination. This will include:

Biomechanical Assessment before Knee Pain Treatment can Commence

Your sports podiatrist will most likely wish to conduct a biomechanical assessment and gait analysis on the treadmill (if you are able) prior to commencing a plan for knee pain treatment. The assessment involves placing removable markers on certain points on the patient’s legs, and recording video footage as the patient walks / runs on the treadmill. The video is played back in slow motion and using specialized computer software, an analysis of the patient’s gait (manner of walking) can be made. This is useful in identifying abnormalities and malalignments in the patient’s body, often pointing to the root of the problem that is causing the patient’s knee pain, assisting in selecting appropriate knee pain treatment options for the patient.

Diagnostic Imaging before Knee Pain Treatment can Commence

In some circumstances, your sports podiatrist may request some diagnostic imaging prior to commencing your knee pain treatment. This can aid in their diagnosis and ensure that you are provided with the most appropriate knee pain treatment plan. Some types of diagnostic imaging that you may be asked to have include:

 Knee Pain Treatment Options

Knee pain treatment will vary considerably depending on what exactly the cause of the pain is. Once your sports podiatrist has determined the cause of your knee pain, an appropriate treatment plan can be devised. The results of the biomechanical assessment are also very useful here, as they can be used to identify biomechanical issues that require attention in order to prevent problems recurring in the future.

There are so many varied options for knee pain treatment. Listed below are just some treatment options.

Knee Pain Treatment: Shockwave Therapy

Shockwave therapy is a revolutionary knee pain treatment, which works by using a hand-held probe to mostly painless direct high-frequency sound waves into an affected area. It is a method that is scientifically proven to stimulate healing by encouraging blood flow and tissue regeneration1, whilst helping to break down scar tissue. It also offers many patients almost instantaneous pain relief.

Knee Pain Treatment: Orthotics and Braces

Under some circumstances, your sports podiatrist as part of your knee pain treatment approach may advise custom-made orthotics. These can help with knee alignment through stabilizing the foot. Orthotics can also help with shifting the pressure to ease knee pain. This approach is commonly seen in cases of osteoarthritis amongst other conditions. There are various support braces that may also be used to restrict motion and support the knee as it heals.

Knee Pain Treatment: Physical Therapy

Often based on the findings of the biomechanical assessment, your sports podiatrist may recommend some strengthening or stretching exercises for your leg muscles as part of your knee pain treatment. The types of stretches or exercises they choose will depend on what is occurring biomechanically to cause your knee pain. You may need to correct movement patterns that are affecting your knees, or if you play a particular sport, you may need to assess and correct your technique.

Knee Pain Treatment: Injections

Injecting medications or substances directly into the knee joint may be required in some cases of knee pain treatment. These injections may include:

Knee Pain Treatment: Surgery

In some cases, surgery is required for knee pain treatment. This may be the case with severe injuries that are unlikely to heal with other treatment approaches and is hence seen as a last resort to knee pain treatment. Surgical options may include arthroscopic approaches for examination and repair, or partial or complete knee replacements, where the damaged parts or the entire knee is replaced with artificial parts made of metal and plastic. All surgeries carry risks, so it is important to consider the pros and cons of deciding to have a surgical reconstruction as opposed to a non-surgical rehabilitation of your condition.

Other Considerations for Knee Pain Treatment:

When considering your knee pain treatment is important to keep in mind the following:

The information contained in the article above, regarding knee pain treatment, is not intended to be taken as general or medical advice. If you are experiencing knee pain, you should make an appointment with a sports podiatrist who will be able to offer a correct diagnosis and individualised plan for knee pain treatment. Appointments can be made online at www.sydneypodiatrist.net.au or by calling 93883322.

Karl Lockett– sports podiatrist.

References

1 Liao, C., Xie, G., Tsauo, J., Chen, H., Liou, T., (2018), Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders: a meta-analysis of randomized controlled trials, BMC Musculoskeletal Disorders, 19, 278.

2Spakova, T., Rosocha, J., Lacko, M., Harvanova, D., Gharaibeh, A., (2012), Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid, American Journal of Physical Medicine & Rehabilitation, 91, 411-417.

 

Knee Pain When Bending

Knee pain when bending: general information

Knee pain when bending is a common problem, with more than 25% of adults suffering from regular knee pain1. You might have noticed that your knee hurts when you bend it, when you walk down stairs or when you squat. The knee is a complex unit of moving parts, including the thigh bone (femur), the shin bone (tibia), the knee cap (patella), and a number of ligaments, tendons, and cartilage and fluid-filled sacs (bursae), which reduce friction and allow for smooth motion. When one or more of these components become damaged through acute injury or overuse, painful conditions can arise. The treatment for your knee pain when bending will largely depend on the diagnosis.

Knee Pain When Bending

Types of knee pain when bending

Knee pain when bending can be broadly split into two kinds: weight-bearing and non-weight-bearing. With weight-bearing pain, the knee pain when bending occurs when there is weight passing through the knee as you move through the bending motion. This includes situations such as squatting down (as in when you lower your body to sit on a chair) and when you walk up and down stairs. Weight-bearing flexion tends to be more painful due to the added pressure and compression on the structures in the knee. Non-weight-bearing knee pain when bending occurs when there is no weight passing through the knee with the bending motion. An example could be if you are sitting in a chair and simply flexing and extending the knee, or if you are standing and bending the knee off the floor, such as in a kicking motion.

What causes knee pain when bending?

There are a number of conditions that can cause knee pain when bending. The pain may come on suddenly following an injury, or it may develop gradually over time with chronic conditions. The most common causes of knee pain are:

Runner’s Knee (patellofemoral pain syndrome)

Runner’s knee is the broad term used to describe a number of conditions affecting the patella that cause knee pain when bending. The pain tends to occur just below and to the sides of the knee cap. Pain is usually worse when walking downhill. Sometimes a grinding sound can be heard with bending. Runner’s knee can occur as a result of overuse, impact, misalignment of the bones, weak muscles or muscular imbalances, or bio-mechanical problems with the feet.  Chondromalacia patella- a condition that causes the cartilage under the kneecap to break down- can also cause Runner’s knee.

Arthritis of the Knee

‘Arthritis’ refers to the inflammation of a joint. There are different types of arthritis, but osteoarthritis is the most common type that causes knee pain when bending. In patients with osteoarthritis of the knee, the pain is due to excessive friction in the knee, caused by thinning or wear of the cartilage, and the formation of bony lumps inside the joint. Osteoarthritis most commonly affects people that are over 65 years old, but there are many factors other than age that also contribute to the development of the disease, such as genetics, altered biomechanics, and overweight and obesity. The pain is usually worst first thing in the morning or after sitting for a period of time.

Knee Bursitis

Bursitis is the inflammation of the bursae. Bursae are small, fluid-filled sacs that are located between bone and soft structures to reduce friction when moving. In patients with bursitis, the knee pain when bending may be felt in various locations, depending on which bursa is affected. It is caused either by overuse or prolonged pressure / friction on the bursae, impact to the knee from a fall or strike, or excessive friction.

Housemaid’s Knee (prepatellar bursitis)

For people who spend a lot of time kneeling (such as tradesmen), Housemaid’s knee is a common cause of knee pain when bending. It is a condition that describes inflammation of the prepatellar bursa, which is the bursa that is located just below the kneecap at the front of the knee. The pain is generally in the front of the knee and it is common to have quite a large swelling anteriorly.

Meniscal Tear

Meniscal tears are a common cause of knee pain when bending. The meniscus is a thick and strong layer of cartilage that lines the knee joint, providing protection and allowing correct transmission of forces through the joint. If the meniscus becomes torn or frayed, this is known as a meniscal tear. Tears may occur with sudden twisting of the knee with a fixed foot, or through wear and tear. The resulting pain is due to inflammatory processes and reduced cushioning of the knee joint. Torn fragments may become stuck inside the joint, causing further pain and limiting movement. In patients with a meniscal tear, the knee will most likely be swollen and the patient’s movement will likely be restricted. The pain is usually especially bad when bending down or walking up stairs.

Baker’s Cyst

A swollen semimembranosus bursa at the back of the knee is referred to as a Baker’s cyst. This is usually related to arthritis, but it can occur with any condition that causes swelling inside the knee. Patients with a Baker’s cyst tend to experience knee pain when bending and straightening their knee, and a little bulge that feels like a small water balloon can often be felt at the back of the knee.

Other causes of knee pain when bending

Whilst the conditions mentioned above are some of the most common causes of knee pain when bending, some less common causes may include

Treating knee pain when bending

Almost any type of injury or problem with the knee joint and its associated structures can cause knee pain when bending. Your sports podiatrist will be able to recommend the best treatment course for you once a diagnosis has been made. It is imperative that you seek medical attention for a correct diagnosis for your knee pain so that you are not exacerbating the cause of the problem. As a last resort / temporary measure you can proactively manage your knee pain by taking over the counter NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen, applying wrapped ice packs to your knee for 20 minutes at a time, and comfortably elevating your sore knee as you sit, to reduce inflammation and relieve pain.

The information provided regarding knee pain when bending, in the article above is intended for educational purposes only and should not be taken as general advice. If you are experiencing knee pain when bending, you should seek medical attention from a suitably qualified sports podiatrist who will be able to diagnose your condition and devise an individual treatment plan. You can make an appointment online at www.sydneypodiatrist.net.au or by calling 93883322.

Karl Lockettsports podiatrist.

 1 Bunt, C. W., Jonas, C. E., and Chang, J. G., (2018). Knee Pain in Adults and Adolescents: The Initial Evaluation. American Family Physician, 98(9).

Morton’s Neuroma Treatment

Mortons Neuroma Treatment Information

Many people are interested to learn about Morton’s neuroma treatment options, as it is a common and usually very painful condition. The condition has many names: Morton’s metatarsalgia, Morton’s disease, Morton’s neuralgia, plantar neuroma, or intermetatarsal neuroma, however all these describe the one same condition: a non-cancerous (benign) growth of nerve fibres that develops usually between the third and fourth toes of the foot.

Morton’s neuroma causes pain in the ball of the foot. Patients often describe the pain as a “burning hot needle”, which can start suddenly during walking. There may be numbness of the toes and pins-and-needles (medically referred to as paresthesia).

Morton's Neuroma Treatment

Morton’s Neuroma Treatment Options

The Morton’s neuroma treatment of choice will be determined by your specialist podiatrist, following close consultation with you, and will largely depend on a variety of factors such as the severity of your symptoms, how long these symptoms have been present, and whether or not any conservative treatment has been tried.

The earlier the condition is diagnosed, the sooner the Morton’s neuroma treatment can begin, and the less likely it is that surgery will be required to treat the condition. Usually, home treatments, or conservative therapies will be suggested as a first attempt to relieve the pain.

Morton’s neuroma conservative and home treatments:

Conservative and home-remedies for Morton’s neuroma treatment are based upon the principle of reducing pressure on the neuroma in order to reduce the level of pain. Some of these treatments may include:

Morton’s neuroma treatment: injectables

In cases where the pain is severe and symptoms are persistent, your podiatrist may recommend corticosteroid or alcohol sclerosing injections as a form of Morton’s Neuroma treatment.

These are steroid injections that can be injected directly into the site of the Mortons neuroma. They work to reduce pain and inflammation. There is generally a limit as to how many injections are recommended, as there are some possible side affects with these.

Alcohol sclerosing injections:

Studies on the efficacy of Morton’s neuroma treatments have demonstrated that alcohol injections at the site of the neuroma can reduce the size of the growth as well as relieve the pain.

Mortons neuroma treatment: surgery

Surgery may be advised in cases where other Morton’s neuroma treatments have been tried to no avail, and painful symptoms have persisted for 9-12 months. Surgical treatment involves removing the bundle of nerve fibres or relieving the pressure on the painful nerve by cutting the surrounding ligaments or fibrous tissues. Surgeons may take one of two approaches: the dorsal approach, or the plantar approach. There are benefits and drawbacks to each, but generally, with a dorsal approach, the surgeon makes their incision at the top of the foot. This means that the patient is able to walk almost immediately following surgery (since the stitches are at the top). With the plantar approach, the incision is made in the sole of the foot. This way, the neuroma can usually be easily accessed and removed without disturbance to the surrounding tissues, however stitches in the bottom of the foot mean that the patient is generally on crutches for around 3 weeks following surgery. For some patients, the resulting scar tissue from the surgery makes it uncomfortable to walk. All surgeries carry some risk of infection and the potential for some resulting side effects. Your surgeon will discuss these details with you prior to choosing to undergo surgery for your Mortons neuroma treatment.

What to Expect Following Morton’s Neuroma Treatment

Individual recovery times will vary depending on the severity of the condition and which Morton’s neuroma treatment the patient has received. For some patients, simply changing their footwear to something wider or less tight, or using over the counter pain killers is enough to relieve their pain over time.

Recovery times following surgical Morton’s neuroma treatment vary. Recovery is usually quite fast with nerve decompression surgery, and often the patient is able to walk almost right away with the comfort of a padded shoe. In surgeries where the growth is removed, recovery time may be 1-6 weeks, depending on where the incision is made and whether or not crutches are required to assist walking. In both cases, it is recommended that the affected foot is elevated above the level of the heart as often as possible throughout the day, and the foot must be kept dry to allow the wound to heal.

In a small number of cases, Morton’s neuroma may recur following the initial treatment.

Please note that the information detailed in the article above should not be taken as general advice and is for informational purposes only. If you have been diagnosed with Morton’s neuroma and wish to discuss your options for Morton’s neuroma treatment, then you should consult with an appropriately qualified podiatrist to discuss your concerns. Appointments can be made online at sydneypodiatrist.net.au or by calling 02 93883322.

Karl Lockett – sports podiatrist.

Chronic Jumper’s Knee

What is Chronic Jumper’s Knee?

Chronic jumper’s knee is the common term used to describe patellar tendinosis. It generally occurs when a patellar tendonitis has persisted for more than around 6 weeks, when it is then referred to as ‘chronic’ and sometimes alternatively called chronic patellar tendinopathy. Chronic jumper’s knee is characterized by degenerative changes in the patellar tendon. This is the tendon that connects the kneecap (patella) to the shin bone (tibia) in the leg. The patellar tendon’s role is to work with the muscle in the front of the thigh, the quadriceps, allowing you to extend the knee when you kick, run and jump. Chronic jumper’s knee weakens the tendon causing long-term pain.

What causes Chronic Jumper’s Knee?

Chronic jumper’s knee is an overuse injury that is caused by repeated stress on the patellar tendon. Athletes who participate in sports that demand repetitive and explosive jumping, kicking and landing actions, such as volleyball, basketball, dancing and soccer are commonly diagnosed with jumper’s knee, although the condition can also occur with other physical activities, such as running or even weightlifting too.

When the patellar tendon is subjected to the intense forces of jumping and landing over and over again, the stress results in tiny tears in the tendon. The body attempts to repair these tiny tears through natural inflammatory processes. Acute (short-term) patellar tendonitis, or jumper’s knee, often occurs following an injury and involves an active inflammatory process by the body. If treated correctly, recovery time is generally 3-6 weeks. However, if it is left untreated and the affected leg continues to be used, as the tears multiply, they cause intense pain from inflammation and weakening of the tendon. Over the period of weeks and sometimes months, chronic jumper’s knee develops, where degenerative changes occur in the tendon. Some of these changes include the development of abnormal blood vessels, and at the cellular level include the absence of inflammatory cells in the tendon, poor healing, and disorganization and poor quality of the collagen fibres, which often present as decreased tensile strength.

It is commonly accepted that many factors can contribute to the development of chronic jumper’s knee. These include intrinsic factors (those that are pertaining to the person or athlete themselves) such as strength imbalances, postural alignment, structure of the feet and flexibility. However extrinsic (outside) factors such as the physical load on the leg, repetition, intensity, frequency and duration of exercise are thought to be the primary cause contributing to this overuse syndrome.

When it occurs in older people, chronic jumper’s knee is usually a result of degeneration that happens due to repetitive micro-damage over time, or sometimes an acute injury to the tendon that hasn’t allowed adequate healing. These types of traumatic patellar tendinopathy are, however, much less common than overuse injury.

What are the symptoms of Chronic Jumper’s Knee?

Whilst every patient experiences symptoms differently, some of the most common symptoms of chronic jumper’s knee are:

For the syndrome to be chronic, these symptoms will have been present for at least 6 weeks.

Initially the pain may be felt at the beginning of physical activity or after an intense workout. If the condition is left untreated, the pain usually worsens and inhibits the patient from playing their sport. As the condition progresses to become chronic jumper’s knee, daily routine activities such as climbing stairs or getting on and off a chair may start to become a problem.

Some of the symptoms experienced with chronic jumper’s knee may resemble those seen with other conditions too, so it is always best to speak to your sports podiatrist for a correct diagnosis.

Chronic Jumper's Knee

How is Chronic Jumper’s Knee Diagnosed?

Chronic jumper’s knee, or patellar tendinopathy, is generally suspected when a patient has had symptoms that have lasted for more than 6 weeks. Your sports podiatrist will make enquiries about your past health, your symptoms and your exercise program. They will conduct a thorough physical examination to confirm the diagnosis. For patients with severe symptoms or if there is no improvement with early conservative treatment, an MRI or ultrasound may be recommended so that the structures inside the knee can be visualized at great detail, and a treatment and rehabilitation plan can be devised.

Treatment options for Chronic Jumper’s Knee

You can begin your treatment for chronic jumper’s knee at home, simply by resting the affected leg. RICE (rest, ice, compression, elevation) can be used if there is swelling.

Once you have consulted with your sports podiatrist and confirmed your diagnosis and extent of the injury, they will be able to recommend a treatment protocol for your individual condition. Treatment for chronic jumper’s knee usually follows one of three approaches: conservative, injection-based, or surgical.

• Conservative treatment:

Conservative treatments are non-invasive. Some examples include: -Bracing, which can be used to relieve pain without restricting movement.

-Eccentric exercise has been an essential component of conservative therapy for chronic jumper’s knee for many years, and there is a substantial amount of clinical evidence to support the efficacy of this approach. Your podiatrist will be able to recommend whether this is an appropriate approach to therapy for your condition, and if so, they will guide you through particular controlled exercises that are safe and beneficial. A main goal of exercise for treatment and rehabilitation for chronic jumper’s knee, is to strengthen the quadriceps and stretch the hamstrings.

-Extracorporeal Shockwave Therapy (EST) delivers a targeted pressure sound wave into the affected tendon. The pressure breaks down scar tissue and causes micro-trauma, signalling the brain to direct healing processes to the area. Shock wave therapy also stimulates the release of pain-relieving substances into the blood.

Recovering from Chronic Jumper’s Knee

The time it takes to recover from chronic jumper’s knee largely depends on the extent of the injury and the condition of the tendon when the treatment protocol is commenced. It is reasonable to expect that it will take at least a few months, but up to 6-8 or more months to fully recover, depending on the individual circumstances. Your sports podiatrist can discuss expected recovery time with you during your consultation.

Chronic Jumper’s Knee prevention

To reduce your risk of developing chronic jumper’s knee, you can take the following steps:

Please note that the information contained in this article should not be taken as general advice. If you think you have chronic jumpers knee then you should consult with a suitably qualified sports podiatrist. Appointments can be made online www.sydneypodiatrist.net.au or by calling 93883322.

Karl Lockett – sports podiatrist.

 

Shin Splints Exercises

If you’re a runner, you’ll be happy to know that you can prevent and treat that nagging pain in your lower leg with shin splints exercises, shin splints tape and shin splints massage.

How to Prevent and Treat Shin Splints

Overuse and repetitive stress is usually to blame for shin splints, which is characterised by pain stretching from the posterior / medial / anterior shinbone sometimes all the way to the ankle.

But it’s also possible to get shin splints by walking. Simply increasing your distance or frequency of walks or runs can cause pain.

Rest is the first course of action, but long term stretching and strengthening the feet, lower legs, hips and core with specific shin splints exercises may prevent the condition from returning.

Shin Splints Exercises

You can treat and prevent shin splints with a range of shin splints exercises.

  1. Toe Curls

Crouch down on your knees with your feet together keeping your toes tucked under

  1. Shin Stretch

Sit on your shins with the tops of your flat feet on the floor. Put your hands behind you and gently lean back.

  1. Calf Raises

Stand up on your heels as high as you can for a set of 25 calf raises.

Anterior Shin Splints

If your shin pain increases when lifting your toes up while your heels are on the ground, anterior shin splints are the likely cause. One of the best shin splints exercises for anterior shin splints is to carry out the 2nd exercise listed above, as this will stretch the muscles nicely and release the tension. The pain from the shin splints may easy instantly but should improve more generally over time.

Shin Pain not Shin Splints

Pain in the lower leg can also indicate a stress fracture, so shin pain not shin splints may be something for a professional to diagnose. It’s important to differentiate with a physician such as a sports podiatrist whether your shin pain is due to a more serious injury such as a stress fracture. Sharp pain when you press into the shin can suggest a crack in the bone but a sports podiatrist will confirm with a physical and diagnostic assessment which may include a bone scan.

Posterior Shin Splints

Posterior shin splints will show up as pain on the inside rear (posterior) part of the shin bone. Flat feet can be the culprit for posterior shin splints, which can be treated with the use of custom orthotics prescribed by a sports podiatrist to support and control your feet.

Shin Splints Tape

Can shin splints tape can help speed up your recovery? The shin splints tape is presumed to help relax the affected muscles, relieve pressure and increase support to the foot and lower leg. More research is required in this department.

Shin Splints Tape Method:

  1. Position the foot at a 45-degree angle.
  2. Tape around the lower leg moving around the outside and finishing with a gentle crosswise shin splits tape inside the leg.

Shin Splints Massage

Deep muscles of the lower leg are affected by shin splints which is why shin splints massage can help with soreness and recovery. Tight calf muscles are a common cause of shin splints, so getting a shin splints massage can release that tension. Beyond soft tissue manipulation, shin splints massage may also involve cryotherapy (ice) along the tibia for anterior shin splints. For posterior shin splints, cryotherapy is also possible but more difficult because of the deep posterior muscle placement.

In all, the use of shin splints exercises, shin splints tape and shin splints massage can assist both runners and walkers to get back on their feet after suffering the common complaint of anterior shin splints or posterior shin splints.

sports podiatristKarl Lockett

www.sydneypodiatrist.net.au

93883322

Shin Splints exercises

 

Foot Facts on Mortons Neuroma

Our feet keep us moving, but one painful condition which can slow us down is Morton’s neuroma.

This neurological issue affects the ball of your foot, most commonly between the third and fourth toes.

Named after American surgeon Thomas George Morton, this thickening of the tissue around the nerves connecting to the toes often feels like you’re standing on a pebble in your shoe.

Interestingly, Morton’s Neuroma is predominantly seen in females, who are 10 times more likely to experience this painful foot problem of the metatarsals (foot bones).

Mortons Neuroma Symptoms

So, what does it feel like to have Mortons neuroma? The pain in the toes can feel like cramping pain, radiating across the third, fourth and fifth toes of the foot.

Mortons neuroma symptoms may also present as burning pain in the ball of the foot. The pain generally worsens with activity or wearing tight fitting shoes.

Some people may experience numbness in the toes as Mortons neuroma symptoms. For sprinters, the pain is often felt as they push off from the starting block.

Mortons Neuroma Test & Diagnosis

The Mortons neuroma test requires the physician to conduct a range of motion tests, putting pressure on the spaces between the toe bones to try to replicate the pain.

Applying direct pressure between the metatarsal bones will produce pain symptoms and a palpable ‘click’ between the bones. This Mortons neuroma test is referred to as the Mulder’s Sign.

This Mortons neuroma test is important to rule out arthritis, joint inflammations or a stress fracture.

Another clinical test can include an ultrasound for Mortons neuroma referred by a sports podiatrist to get a better look at the internal machinations inside the foot.

Mortons Neuroma Causes

Mortons neuroma causes can be anything that contributes to compression or irritation of the foot nerves. One of the most common offenders is the type of shoes you wear, especially high heels which squeeze the toe forward.

Physical foot deformities such as bunions, flat feet or hammer toes can also be behind Mortons neuroma. Activities such as running, basketball, or squash, which repetitively injure the ball of the foot, are other potential Mortons neuroma causes.

Mortons Neuroma Treatment

Depending on the severity and duration of your problem, Mortons neuroma treatment varies. Mortons neuroma treatment can include the use of a Mortons neuroma pad. The padding technique provides support for the foot arch and lessens the pressure on the nerve as it lifts and separates the metatarsal bones.. As part of Mortons neuroma treatment, custom orthotic devices prescribed by a sports podiatrist can also provide the support required to reduce pressure and compression.

Mortons Neuroma Exercises – do they work?

There is no clinical research that conclusively supports the practice of any Mortons neuroma exercises. Some practitioners will advise you to stretch the plantar fascia, grip your heel in one hand and place the other hand under the ball of your foot. Then gently pull back the front of the toes toward the shin. It is unclear as to whether these stretches work. Another suggested stretch in the range of Mortons neuroma exercises is the bottle roll, running a glass or plastic bottle along the bottom of your foot. It can be said that this technique is better suited to Plantar Fasciitis.

 Mortons Neuroma Surgery

In severe cases where patients don’t respond to initial Mortons neuroma treatment, surgery is required to fix the problem. The condition’s namesake, surgeon Thomas George Morton, devised the successful operation to alleviate the painful pressure and compression between the bones. Mortons neuroma surgery involves either removing the nerve or removing the pressure on the nerve by cutting the surrounding ligaments at the base of the affected toes.

sports podiatristKarl Lockett

www.sydneypodiatrist.net.au

mortons neuroma

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