There have been several patients that have come into the office complaining of knee symptoms. Although the knee joint is outside the realm of podiatry, knee symptoms are often related to foot and ankle conditions. This is especially true in females. The medical literature shows that for the past several years, there has been an increase in knee-related pathologies in females. Many researchers have debated over the reasons why knee injuries occur more often in women than men. Some of the proposed reasons range from anatomical differences to hormonal differences. According to recent studies, females participating in sports are up to 4 times more likely to injure their knee than males participating in the same sports.
Researchers have theorized several factors that can explain why females participating in sport are at increased risk for developing knee pathologies; anatomic factors, biomechanical factors, and hormonal factors.
1) Anatomic factors: Females have a greater tibial-femoral angle. This is the angle formed by the axis of the femur (thigh bone) and the axis of the tibia (leg bone). Ideally, the axis of the femur should follow the axis of the tibia. However, because of the differences in hips between males and females, the tibia-femoral angle is greater in females. This often leads to more stress on the inside aspect of the knee.
The femoral notch is the area within the knee that contains the anterior and posterior cruciate ligaments. These ligaments provide internal stability to the knee joint. Differences in the femoral notch between males and females have also been theorized as a factor in injury occurrence.
The size of the anterior cruciate ligament among the sexes has also been speculated to be a factor in the risk of knee injuries. However, there is limited data to support this theory.
2) Biomechanical factors: In studies, female athletes were found to place more emphasis on their quadriceps muscle during sport-related activities. This puts them at increased risk of knee injuries. Using the hamstring muscles more often will reduce the likelihood of knee injuries.
Also, females tend to land more flat footed rather than their toes, which can contribute to the increased injury rate. Landing flat-footed causes the stress to be transmitted up the leg into the knee joint.
3) Hormonal factors: Female hormones do not increase the chances of sustaining a knee injury. However, female hormones, especially those involved in pregnancy, do affect the integrity of ligaments in the body. The hormones that allow for the passage of the baby through the birth canal can cause ligamentous laxity. This makes females prone to sprains and even ruptures of ligaments.
In summary, the foot and ankle have a direct role in the functioning of the knee. Excessive pronation and flat footed-ness can alter the biomechanical function of the knee joint leading to the development of symptoms. Females have a higher incidence of knee-related problems partly due to difference in anatomy and function. Correction of the foot and ankle condition can reduce the development of knee-related symptoms.
There have been several patients that have come into the office complaining of knee symptoms. Although the knee joint is outside the realm of podiatry, knee symptoms are often related to foot and ankle conditions. This is especially true in females. The medical literature shows that for the past several years, there has been an increase in knee-related pathologies in females. Many researchers have debated over the reasons why knee injuries occur more often in women than men. Some of the proposed reasons range from anatomical differences to hormonal differences. According to recent studies, females participating in sports are up to 4 times more likely to injure their knee than males participating in the same sports.
March 31st, 2009 at 4:34 pm
My 12 year old daughter is being treated by an orthopedist for pain in her right knee with physical therapy to streghten various parts of her leg and torso. (There was no single event leading to the pain and it has continued for several months as a chronic condition.) The physical therapist’s exam revealed over pronation in both feet and that her right tibia is 1/4 inch shorter than her left tibia. I have worn orthodics in both shoes to correct over pronation my entire life and wonder if my daughter’s knee problem would not be helped by orthodics and/or a lift to correct the tibia disrepancy. Is this a possible treatment for a 12 year old? Should we be seeing a podiatrist along with the physical therapist?