Here are some interesting statistics we found at The Center for Orthopedic and Neurological Care and Research web-site..
- By 2030, total knee replacement surgeries are projected to grow 673% to 3.5 million procedures per year.
- About 60% of all knee replacement operations are performed on women.
- Approximately 85% of knee replacements will last for 20 years.
- Nearly 1/2 of American adults will develop knee osteoarthritis in at least one knee in their lifetime.
- 80% of osteoarthritis patients have some degree of movement limitation.
- More than 90% of people who have knee replacement surgery experience a dramatic reduction in knee pain.
Replace your shoes - Save your knees
Could it be this simple. It actually is, and you may be able to use the shoes you have.. When you walk, two opposite forces face off across your knees. Internal and external rotation of your legs are driven by your hips. When you step forward, your legs are naturally rotated inward. When you come through mid stance and push off, your legs are rotated outward. That's normal for people who have normal range of motion in their hips. About 80% of the population over-pronate, so when their feet are weight bearing, the arch will drop and the ankle will rotate inward. The worse the over-pronation, the more internal rotation you'll experience. The picture becomes clear. From mid stance when the hip rotate outward, the foot still tries to force an internal rotation, and the knee is forced to absorb the opposing forces.
One of the most frequent knee pain issues is fractured meniscus. The meniscus in the knee forms two connected cups that allows the bottom of the Femur to slide easily over the Tibia. When the knee is exposed to chronic torque the meniscus cups start fracturing. The current option is arthroscopic surgery where tiny instruments are inserted into the knee space, including a camera and snippers to remove the fractured portions. On average, this surgery is estimated to relieve pain for 10 years after which your surgeon expects you to come back for another arthroscopic procedure or a total knee replacement. What about naturally removing the torque from the knee?
Iliotibial (IT) Band Syndrome
The Iliotibial band is fascia that attaches between the hip and the tibia. Just like Plantar Fasciitis, which is fascia connecting all 5 phalanges to the heel bone, the IT band has a wide attachment to the Ilium and a smaller attachment to the Tibia, so just like in Plantar Fasciitis, the pain from excessive tension lands at the smaller attachment site - the lateral knee. This too comes from over-pronation creating additional tension in the fascia as well as an internal rotation of the Tibia so the fascia literally stretches around the lateral Femoral Condyle (the two knob like bone shapes that form the upper half of the knee joint). Combine rub and tension, and you'd expect a problem. Steroid shots and physical therapy is the most frequent remedy for severe cases, and surgery is an option for the worst cases. What about naturally removing the torque that cause the problem in the first place?
Condromalacia (Runner's Knee)
Contromulacia is essentially a functional problems that develop because the knee cap is being pulled to one side from a torque in the knee. The knee cap is there tp protect the small space between the condyles of the femur to prevent injuries to the ligaments that holds the knee together. Since it is attached across the knee with essentially vertical ligaments attaching above and below the knee, a torque in the knee will cause it to track incorrectly and cause a rubbing injury. Interesting isn't it. The common denominator so far is a torque across the knee from over-pronation.
It is not uncommon for us to receive calls from people who have been told their knees are bone-on-bone. Osteoarthritis at it's worst. Your options are listed as living with pain medications, injections, walkers and the big one - knee joint replacement. Before you give the OK to a big procedure like knee joint replacement consider this. Torque in the knee from over-pronation will lead to very focused pressure points. This is why the meniscus fractures in certain locations. Just like in any mechanical device, focal pressure will create a wear spot. We believe this condition is too frequently diagnosed as bone-on-bone, and if it is bone-on-bone, it is in a small spot. What if you remove the torque and balance the weight bearing of the knee over the full surface as would be the case if you did not over-pronate.
The conclusion, of the inventor of the ProKInetics Insoles and a large number of neuromuscular medical practitioners we work with, is that the torque in the knee created by over-pronation is a major issue, not only for the knee, but for the hip ligament and muscles as well as for your ankles and metatarsals. Take metatarsalgia as an example. The foot is trying to twist inside the shoe and with excessive pressure on the second metatarsal head, a callus develops that can become very painful. If your're not wondering how can I get rid of the torque by now, you have read as much as you need, because that's what follows.
Over-pronation is not the same as fallen arches. Fallen arches is only a visual verification of the fact that you over-pronate. The actual problem is that you are not properly weight bearing on the first metatarsal head, essentially the big toe joint or ball of foot behind the big toe. As your first metatarsal tries to become weight bearing, the foot has to roll inward causing the arch to drop, the ankle bone to slide forward and downward while also rotating internally. The external rotation of the hip is supposed to supinate your feet when pushing off, but for many, the foot just continues to over-pronate. It has been documented that form many, the first metatarsal does not become fully weight bearing until 88% of the weight bearing cycle is completed. Relative to the full weightbearing cycle the time from heel strike to foot flat and weight bearing is relatively short (less than 10%). For most of the rest of the contact cycle, the torque exists across the knee.
How to eliminate the pain
Most foot problems are considered to be mechanical. Visiting the average podiatrist, you’ll get steroid shots to kill the pain by reducing swelling and/or custom arch support orthotics. These solutions are but temporary because they do not address the root cause. What if we could make the weight bearing in the forefoot distribute more evenly across the full width of the foot? What if we could naturally prevent the foot from lengthening because the first metatarsal was not fully supporting of our weight when it needs to be? What if….
If the root causes are mechanical, and the feet are controlled by the central nervous system and the brain, wouldn’t it make good sense if we can get the brain to do something different. If the real cause is standing and walking on flat surfaces, and the brain getting lacy because one step is like the last which was like the last, what if we could at least make the brain do something different that will cause less problems even if repeated over and over again.