Like the neck, shoulder and arm, the low back, hips, pelvic (sacro-iliac) joints, knees, ankles and feet are a system that should work together in a balanced and coordinated way. So problems in any of these areas must be looked at with reference to the system of which they are only a part. The entire nerve supply to the hip, thigh, knee, leg, ankle and foot comes from the low back, so low back spinal problems that disturb leg function are common.
Problems on one side of the body tend to cause adaptation on the other, so it is common to find an ankle problem on one side, together with a knee problem on the other; or a knee problem on one side together with a hip problem on the other. A great many of these functional problems can be corrected by regular exercise of the right sort, and attention to anatomical detail in terms of diagnosis.
There is nothing quite like knee pain to decrease your quality of life and functionability; you cannot temporarily change your height without good knees (gardens always seem to be on the floor!), and stairs are everywhere. Contrary to popular belief, you will not wear your knees out by using them a lot (the exception to this is where they’re already damaged) – the opposite is true; they’ll ‘rust out’ quicker than they’ll ‘burn out’. The main problem with knees is poor use – we learn to bend our backs instead of our knees when trying to reach down – maybe this is due to being in a hurry, we don’t know. Children naturally bend their knees and squat, whereas adults tend to buckle at the waist. Therefore two problems develop – overuse of the low back, and underuse of the knees; the orthopeadic department’s bread and butter.
Secondly, most people don’t need to move to earn a living any more– nearly everyone has a sedentary occupation, drives a car and watches too much TV/computer – again, leading to underuse of low backs, hips and knees. Use it or lose it. Add to this; poor footwear, and stress and tension, and we have a myriad ways of developing lower extremity dysfunction.
We will always try non-invasive ways to improve function before considering injections, orthopaedic appliances or surgery – but be prepared to exercise!
