Knee osteoarthritis (KOA) is a very common condition that is a significant cause of disability in older adults, often resulting in knee replacement surgery. There are several contributing factors to KOA, and perhaps one of the most important issues is excessive force exerted on the knee joint by improper biomechanics of the foot and ankle.

A 2019 systematic review and meta-analysis reported that the forces across the knee are not transmitted equally during walking, with the inside of the knee joint bearing greater loads than the outer knee joint in most individuals. This leads to breakdown of the cartilage faster on the medial side of the joint, which leads to KOA. One identified cause of this is called ankle pronation, which is an excessive rolling-inward of the ankle that occurs during the stance phase. The stance phase, is the phase of walking when our entire foot is planting on the ground, versus the swing phase when the foot is swinging forward into the next step. This ankle pronation results in the knee knocking inward, which is technically called external knee adduction movement, or EKAM.

If you are suffering from knee pain, it is a great idea to consult with your doctor of chiropractic. When assessing a patient, doctors of chiropractic are specially trained to expand their examination to regions of the body outside of the area of chief common, as it’s common for dysfunction in one body part to affect another. As we have just addressed, we can see that ankle pronation could be the cause of added stress being placed on the knee, potentially leading to the need for a knee replacement, if such issue is a prolonged issue. 

Chiropractic treatment for the KOA patient can include manual therapies to restore proper motion to the affected joints, specific exercises to strengthen weakened muscles, and nutritional recommendations to reduce inflammation. If ankle pronation is suspected to contribute to the patient’s knee condition, then an orthotic insert may also be necessary. As with many musculoskeletal conditions, it’s better to seek care sooner rather than later. The earlier the treatment can be provided, the faster and more likely there will be a satisfactory outcome.


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Dr. Augustine of Augustine Chiropractic in Wesley Chapel, FL, has over 31 years of experience treating patients for their neck pain and their ailments through personalized chiropractic care treatments. The locally owned and operated chiropractic clinic offers both in-office treatments and at-home therapy regiments to help people recover and heal from auto injuries and other conditions. The staff is dedicated to providing alternative and therapeutic solutions for better overall health. Give them a call today at (813) 994-6008 to schedule and appointment and visit their website to learn more about their services!