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Skeletal variations identified

The effect of skeletal variations is noted in the texts.

“Significant deviations from normal anatomical structure e.g. excessive pronation... can cause injuries. Even minor variations can do so if subjected to prolonged or repeated loading. During running excessive pronation (inward foot roll) is associated with increased stress on the supporting structure of the foot and increased work for the muscles so injuries... can occur. Excessive pronation may cause increased load on the whole of the lower extremity since it results in increased inward rotation of the lower leg. This can lead to a change of the Biomechanical work pattern of the thigh musculature so that the lower leg, knee and hip joint are subjected to increased load. Injuries associated include Chondromalacia Patellae (pain under Kneecap, irritation of the smooth articular cartilage when the Patella mistracks), Tibialis Posterior syndrome and Plantar Faciitis.”

”SPORTS INJURIES” (Petersen and Renstrom 2005).

and

“Excessive pronation contributes to pathology of the Metatarso-phalangeal joint (ball of the foot) and Hallux Valgus (angled in big toe). Increased forces on the medial (inside) aspect of the foot cause abnormal flattening of the medial longitudinal arch and increased strain on the Plantar Fascia ligament. It also leads to increased internal rotation of the Tibia causing a tendency to lateral subluxation (sideways dislocation) of the Patella and muscle imbalance in the Quadriceps and may lead to stress fractures of the Tibia and Metatarsal structures.”
’SPORTS MEDICINE’ (Brukner, P. and Khan K., 2005).

Knee pain/wear

The knee is an unstable joint, its alignment and lateral (sideways) stability is reliant on the foot and ankle below. Excessive foot roll causes the knee to turn out of alignment and collapse sideways on each step. This results in patella mistracking, articular surface wear and likelihood of serious injuries to knee ligaments and cartilage. Some people are even predisposed to occasional knee dislocations.

For this reason, attempting to correct knee alignment/function in isolation, either surgically or by muscle stretching and strengthening cannot be successful long term. Any joint or muscle problems in the leg need to be viewed as part of the entire functioning limb.

 

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