Knee, Ankle and Foot Conditions/Pathology

You should always seek a professional healthcare provider if you are unsure of your pain for assessment and management. You may have been diagnosed with one or more of these however they may not tell the whole story about your pain. Often the pain is from something else. The findings on your scans may be incidental. Should you have lower limb pain which is not getting better you should seek a healthcare practitioner to examine you.  

The knee has 3 structures that are typically injured.: the ligament deep inside the joint (Anterior Cruciate Ligament); the ligament on the inner side of the knee (Medial Collateral Ligament) and the shock absorbing cartilage (meniscus).   How you were injured often tells us what structures are likely to be the culprit of your pain.  When the knee has been operated on it is important to have rehabilitation to regain any movement and strength that has been lost. Physiotherapy prior to surgery has shown to have positive outcomes in the rehabilitation. 

The ACL structure limits the shin bone (Tibia) from moving too far forward from the thigh bone (Femur). If the ACL injury/tear is stable and does not require surgery the main rehabilitation would involve strategies to minimise the strain on the ligament and strengthen your hamstrings. Surgical repairs commonly use another part of your body (Autograft) to repair the ACL. In some instances they may use donor tissue (Allograft) to repair your ACL

The MCL structure limits the shin bone (Tibia) from moving too far towards your midline from the thigh bone (Femur). If the MCL injury/tear is stable and does not require surgery the main rehabilitation would involve strategies to minimise the strain on the ligament and strengthen your hip and ankle.  

This structure helps absorb shock. It is a special type of cartilage and when damaged it may require some changes in your movement or body to offload it until it heals. This is sometimes repaired with surgery and will require physiotherapy to rehabilitate 

This structure is like a rope helps transfer the pull of the muscles from the front of your thigh (quadriceps) through your knee cap (patella) to your shin (Tibia). The patellofemoral tendon may be injured by exceeding its capacity or through trauma. Pain is normally felt between the knee cap and shin.

Pes anserinus is latin for goose's foot. This area looks like a goose's foot on the inside of the knee where 3 tendons meet. 2 of these muscles start from the back of the thigh and 1 starts at the front! 

Much like the patellofemoral tendon these tendons can be damaged which will change the structure of the tendon which may require rehabilitation for it to strengthen.

Bursa are fluid filled sacs which lubricate and cushion the area to reduce impact and friction to the Pes anserine region. Knowing which muscles or movements that may irritate the area will help avoid irritating the area.

Not a disease in the sense of the flu; it is thought to be developmental. There is an increase in tension which causes irritation where tendon meets bone (apophysitis) The front thigh muscles (quadriceps) attach at the top of the shin (Tibial tubercle). This happens more often in male adolescents and commonly a bump appears from the irritation.

ITB syndrome pain is normally felt at the outside of the knee region.. The ITB starts from the upper outside portion of the thigh. It normally slides past the bony parts on the outside of the knee with the help of the lubricating cushion (bursa). The band sliding across a bump is thought to irritate the region causing pain.

For a diagnosis of knee OA you would need an X-ray. Degeneration of the lubricated soft bone (cartilage) in the joint will be diagnosed from the x-ray by showing a decrease in joint space. Physiotherapy can clinically assess, diagnose and treat all stages of OA to decrease the pain and minimise loss of function.

This is an umbrella term for pain around the shins (tibia). It can be on the inside (medial) and sometimes outside (lateral) of the shin. These muscles and tendons around the shin that help you control the movement and stability of the foot and can be injured through a variety of factors like: overuse, an accident, biomechanics, footwear, the type of floor you train on etc.

These account for about a fifth of all sporting injuries and are common injuries from day to day accidents like a small slip off a curb/step. A minor sprain will often be self limiting and will get better on its own. 

Normally the sprain will be on the outside of the ankle the anterior talofibular or calcaneofibular ligament are normally the culprits.

If ankle sprains are a common occurrence and/or if the ankle pain has lasted for a while this is something that you should address with your physiotherapist. The pain could be perpetuated because of muscle weakness and stiffness from not just the ankle but from other areas or the way you move. 

This is a common pain in the foot. It is normally felt on the bottom of the heel and possibly the instep/arch of the foot.

Pain can be felt in the morning when you first put weight on it as it is thought to stiffen overnight in a shortened position to suddenly stretch. It can also increase in pain with prolonged inactivity/activity in weight bearing. 

The plantar fascia is a structure that starts at the heel (calcaneous) and spans to the base of the balls (metatarsal heads) of the feet. This thick tissue helps hold the arch of the foot up. This can be overloaded and can create your pain. There are 26 bones in the foot and many structures which affect the shape and stability of the foot which may contribute to your pain.