Bracing Your Knee?
Knee bracing is a supportive device which is extremely common for anybody who is having knee issues or concerns.
These knee products can vary in their designs, to help support an already injured knee, help aid in recovery, or can be used prophylactically to prevent injury.
The Knee Joint
The knee joint is not just a straightforward hinge joint , it has 2 main planes of movement:-
Flexion and Extension = Bending and Extending your knee joint.
Rotation = The tibia translates from externally rotated when at full extension, then rotates internally on the femur as the knee bends into flexion.
Having congruent , stable and pain-free range of motion at the knee, is pertinent to maintaining a healthy lifestyle.
Most commonly, overuse, age,weight gain and traumatic injuries cause structural damage to the knee that may limit its function.
A thorough understanding of knee anatomy and function, is essential to efficiently
diagnosing and treating knee pathology.
Knee stability is crucial to long term function.
There are many structures at the knee working synergistically to provide support to the knee articulation.
Probably the best known of the knee ligaments are the ACL and PCL , These two ligaments form an X within the centre of the knee joint connecting the Tibia and the femoral head.
The Anterior Cruciate Ligament (ACL) attaches from the back of the femur and attaches towards the front of the tibia therefor stopping the Tibia drifting forward from the femur.
The Posterior Cruciate Ligament (PCL) originates slightly forward of centre on the femur and attaches posteriorly on the tibia therefor supports the knee by stopping the tibia dislocating towards the back of the knee joint.
What Are Common Risk Factors?
- Family history – if a parent or sibling is diagnosed with diabetes type 1 or type 2 diabetes.
- Weight – the more fatty tissue is present, the more resistant your cells can become.
- Cardiovascular disease
- High cholesterol
- High blood pressure
- Poor diet
- Inactivity – Physical activity uses glucose as energy, making our cells more sensitive to insulin. Less physical activity puts you at a higher cardiovascular risk.
- Age – as we age, we tend to exercise less, lose muscle mass and potentially gain weight.
- Other health issues; having a history of gestational diabetes, poly cystic ovary syndrome
Why See A Podiatrists?
As health professionals, we are able to complete an annual risk assessment (of developing further complications) and examination in the same clinical setting of your routine general treatment appointment. We provide education and support in the patient’s management of diabetes related health conditions.
We complete a diabetic assessment, which includes a Doppler waveform assessment, monofilament, vibration, muscle and joint testing. Through examination this enables us to determine your risk of developing non-healing wounds as well as other complications. If a patient with diabetes is determined to be high risk of developing further complications, appropriate management can follow.
We want to make sure you have enough blood flow to your feet, enough feeling to detect if something changes, and no obvious muscle weakness’ which may require further management.
A doppler is a machine that can assess and measure the blood flow coming down to your foot, specifically dorsalis pedis (top of the foot) and tibialis posterior (inside of your ankle) pulses.
The blood volume and waveform’s are to assess whether you have adequate blood flow for healing and muscle activation.
We as podiatrists are also able to perform an examination using a monofilament. A monofilament is a device that is used to assess sensory nerves by applying direct pressure to 10 sites on each foot.
The monofilament applies 10 grams of pressure to different areas of the foot, as this is seen as the standard of what we should be able to feel.
A vibration tuning fork can also be used as another test to assess the level of vibration sensation in your feet.
Both the monofilament and vibration assessments are helpful to indicate a potential diagnosis of peripheral neuropathy, and then further monitor the progression of peripheral neuropathy. This is a helpful assessment as it forms a picture of how at risk a person with diabetes is at for developing non-healing wounds (ulcers).
From the evaluation of the assessments, we deem a patient low, medium or high risk of developing lower limb diabetic complications to complete a health management plan. We then notify the doctor of the result of these assessments.
Self Management Tips
Newly diagnosed diabetics will require more education and medical assistance to control diabetes and their overall health. A diabetes educator may be able to assist with this education.
It is also important to review with your doctor regularly so they can refer and manage any ongoing concern to prevent deterioration.
It is helpful to check your feet (or use a kind friend to help you) daily for any cuts, bruises, blisters, or other damage to your feet that you may not be aware of.
Educate the patient of all the risk factors mentioned above.