Osteoarthritis In Weight Bearing Joints: A Conservative Option

Osteoarthritis as a Leading Cause of Foot and Ankle Pain

Osteoarthritis in our weight-bearing joints located within our feet, ankles, knees, hips, and back is the most prevalent form of arthritis and the leading cause of pain, mobility reduction and disability in Canada. An increasing percentage of the Canadian population is at risk of developing osteoarthritis of the knee or hip, and many will eventually need joint replacement surgery.

Osteoarthritic pain reduces physical activities, shortens sports professional careers, adds extra body weight, augments the probability to develop a secondary diabetic condition or coronary arterial disease. Current clinical management is often limited to prescribing pain medications and cautious waiting until referral for total joint replacement becomes necessary while the underlying cause is often left untreated. Cautious waiting corresponds to waiting until the tire is flat to replace it. As pain medications and over-the-counter supplements no longer bring relief, knee or hip joint replacement is believed to be the only option. While pain killers, supplements and joint surgery have a place in alleviating or treating osteoarthritis in weight-bearing joints, none of them eliminates the underlying cause.

Feet and Ankle Osteoarthritis

Medicine and Podiatric Medicine confuse aggravating factors with the primary cause

Associated with age, osteoarthritis in our weight bearing joints is thought to be inevitable or something we will all get to gray hair and wrinkles. The current thinking that age, weight, genetics, medical conditions (inflammatory or rheumatoid arthritis and fibromyalgia) and sports activities or injuries are the primary causes of osteoarthritis of the weight-bearing joints must be challenged. There is a difference between a primary cause and aggravating factors.

Age: how younger is your healthy left knee compared to your sore osteoarthritic right one?

Weight: how much weight your healthy left knee is carrying compared to your sore osteoarthritic right one?

Sports: how much sports activities your healthy left knee did compare to your sore osteoarthritic right one?

Genetics: how come your left knee is healthier than your sore osteoarthritic right knee?

In your opinion, what would overload knee joints the most over decades? Is it overweight? Or is it body weight abnormally shifted to the knee at each and every step taken, a few thousand times a day, over decades?

Foot and Leg Imbalance

This is the possible missing link and a primary cause of osteoarthritis in our misaligned weight bearing joints. Joint misalignment will take its toll unless properly assessed and treated.

Most people have flattening feet, not flat feet, and most also have a leg somewhat longer than the other. Since we are not born perfectly symmetrical or aligned, either one foot is flattening more than the other or one leg is longer than the other. Mechanical foot or leg imbalances are pushing our weight bearing joints out of their zone of optimal alignment so the more we move out of alignment, the more we are shearing cartilage off our feet, ankles, knees, hips and back joints.

Excessive foot flattening or overpronation and unequal legs result in increased mechanical stress secondary to imposed malalignment on the overlying knee joint. Excessive pressure from foot and leg imbalances clearly appear to be a critical missing link if not the primary cause of many cases of knee or hip osteoarthritis.

Foot and leg imbalance,  due to increased foot pronation or leg length inequality, repetitively creates joint compression, friction and premature wear and tear over years and decades. If tires are not balanced and aligned, they will wear and tear faster on one side: if our feet and legs are not balanced or aligned, each degree of misalignment may likely create premature and uneven wear and tear in our weakest weight bearing joint. Remember pronation is much like cholesterol: we need some to stay healthy but too much is not good. The knee on top of the worst flattening foot or within the longer leg is most often the most painful and the most affected by osteoarthritis!

Restoring foot and leg alignment with orthotics and foot lifts

These are the best conservative treatment option to calm down sore osteoarthritic knee, hip and back joints and to avoid or alter surgical procedures.

As the tower of Pisa did not get crooked from the top but from a poorly laid and subsequently collapsed foundation, the human musculoskeletal system is forced out of alignment by the unstable foundation of our body resulting from collapsing feet and unequal legs! This why it is far better to correct our alignment problems right at the foundation, rather than attempting to do so with ankle or knee braces and surgical procedures (whenever applicable). The most conservative way to do that is with the full-time wear of custom-made foot orthotics and heel to toes lifts placed under the foot at the base of the shorter leg.  Both medical devices should be prescribed by a doctor of podiatric medicine according to the findings derived from a comprehensive clinical and radiological exam. Due to your chronic ankle bone subluxation, you are most likely to shear cartilage off the joints not only in your feet and ankles, but also in your knees, hips and back. The ultimate goal of podiatric custom-made orthotics is put you back on the healthy cartilage that’s left in your ailing joint so you can go back to your preferred activities.