Influence of Pelvis Dysfunction on Knee and Foot Pain
Recent research has shown a statistically significant link between problems with the function of the pelvis and incidences of knee pain. There is also a very strong link between pelvis dysfunction and foot and lower back pain.
This short article explains the concepts presented above, the potential implications for pain and injury and what can be done to resolve things.
Firstly, I want to explain what we mean by pelvis dysfunction. The pelvis is a highly complex structure with many functions, and when we talk about pelvis dysfunction we mean that the structure as a whole is not operating optimally.
A very common result of the pelvis not working properly is a functional leg length discrepancy.
When we walk, the pelvis alternately changes the leg length of the left and right legs. The leg that is behind is longer than the leg in front. But of course this changes as we walk or run. If the pelvis is not functioning properly, this alternation between a long and short leg does not happen properly, or indeed at all, and hence we are left with a discrepancy.
This does not necessarily mean that there are noticeable symptoms at the pelvis; indeed it is very common that there are none. Also, the dysfunction can be in place for some time before tangible symptoms (e.g. pain) start to occur. We call these situations low-intensity, long-duration over-use.
Unless the integrated components making up the pelvis are working correctly, the body looks to other areas to compensate for the deficiency. And the most common areas of compensation are the lower back, the knee and the foot.
We now know from the very latest research at Chichester University that such dysfunction significantly increases the forces going through the knee and hence the foot which in turn significantly increases the risk of serious knee injury such as anterior cruciate ligament (ACL), medial collateral ligament (MCL) or meniscus tear problems – in some cases by as much as 8 times.
At the knee, it is common to observe someone having to bend the knee either forwards or inwards to compensate for a longer leg.
And at the foot, it is quite common to see “over-pronation” or stiffness in supination compensations; again, to compensate for a longer leg.
There is also very often a need to compensate for such a discrepancy through the spine, as the brain always wants to keep the eye-line horizontal and will do whatever it takes to achieve this.
These compensatory effects are often compounded in many fitness and sporting activities e.g. running on a camber or navigating track bends, cyclists seated for long period of time, or gym or exercise regimes involving repetitive forces or stretching through the spine, pelvis or knees.
The key here is to identify a dysfunctional pelvis and correct it, in order to reduce the overload through the knee to the foot and hence reduce the risk of a serious “over-use” injury.
The great news is that such problems can be identified and corrected relatively easily by a qualified Intrinsic Biomechanics Coach.
Once the issue has been identified, a corrective exercise and/or specialised soft tissue regime can be implemented to correct the pelvis, undo the resulting muscle imbalances, resolve the leg length issues and then bed in the proprioceptive changes needed for the brain to undo the various compensations, both up and down the body, which may have been in place for some considerable time.
It is very important to remember also that what we are talking about here are low-intensity, long-duration over-use issues and therefore when a correction regimen is put in place, it takes time for the body to adjust to “normality”.
The primary point being made here therefore, is don’t wait until you start to experience pain in the back, knee or foot, as this will take much longer to “undo”.
Consider getting your pelvis and related intrinsic biomechanics checked out by a qualified Biomechanics Coach BEFORE the problems arise, meaning that you significantly reduce the risk of serious or painful injury in the future.
Future articles in this series will explore what interventions are required to sort out a dysfunctional pelvis, a leg length discrepancy and adverse loading through the knee.
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