The Knee Renew Program-Arch Evaluation​
Welcome to part one of our three step Knee Renew correction system. The proper implementation of this program could help resolve and correct years of abnormal structural alignment, increase lost mobility, and reduce restrictive knee pain.
An essential component of the Knee Renew program is excessive foot pronation, a leading cause of knee dysfunction and pain. It has been projected that 70% of the population is affected by excessive foot pronation. The figure (above) illustrates a normal arch with normal foot alignment on the bottom and a pronated arch with lateral foot flair on the top.
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If excessive pronation occurs in either one or both feet, the toes may turn outward, an inward rolling or rotation of the ankle will occur followed by an internal rotation at the knee. This structural deviation may create an apparent leg length discrepancy or short leg.
Foot pronation leads to degenerative changes
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Foot pronation not only places asymmetrical forces on the ankle and knee joints, but will also affect the hip and spine. This configuration creates an open wedge formation on the medial side of the knee joint and a narrowing of the joint space on the lateral aspect.
As the knee joint assumes greater compressive forces, restriction and pain will develop. Over time, the effect of these compressive forces on the hip, pelvis, and spine could result in abnormal biomechanics progressing to early degenerative changes, pain, and damage. The process will continue until the proper bio-mechanical corrections are made.
Initial arch evaluation position​
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To evaluate the arch for foot pronation, the person being evaluated will stand in a normal posture looking straight ahead. The examiner will place their index finger perpendicular to the arch as shown. The examiner will then move their index finger into the arch noting how much of the first segment of the finger disappears under the arch.​
If more than the first segment of the finger slides under the arch as shown in the illustration, above-right, it is considered a high arch. This kind of arch accounts for 15% of the population. If the arch is excessive and in conjunction with an apparent bow leg position, or varus knee, it can create uneven compression forces on the knee.
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This configuration creates an open wedge formation on the lateral side of the knee and a compression or narrowing of the joint on the medial side of the knee as shown above to the left. Prolonged asymmetrical compressive forces can lead to accelerated degeneration and pain located on the medial side of the knee.
Lateral Shoe Inserts
If more than the first segment of the finger slides under the arch as shown in the illustration, above-right, it is considered a high arch. This kind of arch accounts for 15% of the population. If the arch is excessive and in conjunction with an apparent bow leg position, or varus knee, it can create uneven compression forces on the knee.
This configuration creates an open wedge formation on the lateral side of the knee and a compression or narrowing of the joint on the medial side of the knee as shown above to the left. Prolonged asymmetrical compressive forces can lead to accelerated degeneration and pain located on the medial side of the knee.
If less than one finger segment slides under the middle of the arch, it is considered flat feet or pronation. This will cause an open medial knee compartment and a compressed lateral knee compartment. Medial arch support shoe inserts attempt to correct and support the pronation and minimize the abnormal compressive force. Inserting the shoe supports reduces the internal rotation of the ankle and knee while reducing the abnormal forces placed upon the knee compartments.
Arch Support
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Our 3/4 Orthopedic metatarsal arch support relieves pressure from the ball-of-foot. The stability cradle supports the arch and heel for greater comfort. The top layer is made of an anti-microbial fabric. The cushioning system absorbs impact at heel strike for control of plantar fasciitis. The orthotic shoe insole provides comfort and relieves pain due to standing or walking for prolonged periods making them the perfect solution for flat feet and plantar fasciitis.
Arch Evaluation - Normal Foot Arch
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If no more or less than the entire first segment of the finger slides under the arch, then the arch may be considered within normal limits and no further action may be needed.
Flat Arch
High Arch
Normal Arch
Now that the arches of the feet have either been found within normal limits or have been corrected with lateral inserts or orthopedic arch supports, we will turn to the next leading cause of knee pain, leg length discrepancy, part two of the Knee Renew Traction Program.
The various arch supports discussed above can be found under the shop heading on our website.
Although this three-part system includes excellent guidance on how to improve the compressive forces that affect knee pain, the only way to determine where the compressive forces are concentrated with complete accuracy is with an x-ray. If you do not have an x-ray to determine where the compressive forces are concentrated, or are unable to correctly interpret your x-rays, then the primary consideration is where the knee pain is located.
For example, if the knee pain is located on the inside of the knee, a lateral shoe insert should be utilized as explained above. If the knee pain is located on the outside of the knee the medial arch supports should be utilized. Leg length discrepancy should then be evaluated as will be discussed in part two. It is important to note that while the information presented in this system provides valuable information on reducing knee pain at home, it should not be used in place of a medical diagnosis.
Remember, your feet are your foundation