When knee pain makes you afraid to walk

What follows combines several patients' visits into one composite story. It is not about any one person, and anything that could identify someone has been removed.

How do patients usually come to us?

Patients tell us their knees are swollen and painful, every step is hard, and going down stairs makes them nervous. Often the lower back is uncomfortable too.

Because it hurts, they walk less; because they walk less, their legs get weaker; and then it hurts more. They come to us after living inside this loop.

Isn't it enough to look at the knee?

We need to look at where the weight on the knee is coming from. If the feet aren't doing their job, that strain travels straight up to the knee.

When you walk, your toes should press into the ground and push off, but some people's toes barely touch the ground. Then the impact isn't spread out and is concentrated only on the heel and the ball of the foot.

We compare it to repairing only the pillar while the foundation is shaky.

What do we look at?

We measure how weight lands on the soles of your feet as you walk. We check whether your toes touch the ground and where pressure concentrates.

We look at the knee too: whether it's swollen, how far it bends and straightens, and how the legs are aligned.

How do we treat it?

We make custom insoles that support the arch and help the toes press naturally into the ground. When the foot grips the ground properly, less weight goes to the knee.

Along with this, we support the legs with herbal medicine. With age, the tissues around the joints dry out and circulation slows, and in that state, support alone isn't enough.

We increase walking little by little. We don't suddenly tell someone who couldn't walk because of pain to walk a lot.

How did things go?

First, the spot where weight lands during walking changes. When people say stairs feel less scary, we take that as a sign things are heading the right way.

As people walk more, their legs get stronger, and as they get stronger, the knees hurt less. From here, things start helping each other.

What are the limits of this approach?

We don't tell you that worn cartilage will grow back. What we work on is the weight placed on that joint and the strength around it.

If your knee is badly swollen and warm, gives way suddenly while walking, or catches and locks while bending and straightening, see an orthopedic doctor first.

To people with the same symptoms

1. There's a loop: it hurts so you can't walk, and not walking makes it hurt more.
2. If the feet aren't doing their job, the strain travels up to the knee.
3. Repairing only the pillar while the foundation is shaky means it keeps coming back.
4. We increase walking little by little.
5. We don't tell you that worn cartilage will grow back.

We look at the whole chain, from the feet up through the knees and lower back. If you only treat the spot that hurts, it comes back a few days later.

If your first steps in the morning hurt, or nothing changes even after switching shoes, come see us once. We don't look only at the feet; we follow the chain up through the knees and lower back.

There are many possible causes, so the same treatment can lead to different courses for each person.