Knee pain? Yes, but the problem is your ankle. Not the knee.
Video Transcript for those who’d rather read than watch the above Video.
Full transcript of the above Video:
Sirota Chiropractic Offices (00:01.779)
Hi, I’m Dr. Jon Sirota here in Wilton, Connecticut. Today I’d like to discuss the importance of a proper diagnosis. Too often, a patient will come to me with what was previously diagnosed as condition A, only to find out after three minutes with me that it has nothing to do with condition A at all, and it turns out to be condition B. The problem with believing it was condition A
was that condition A was A, not their diagnosis. Maybe at some point it looked like it could be that diagnosis, but with further imaging studies and MRIs and further information and paying attention to what the patient is saying and taking a really good history and asking good questions and listening to your patient, it turns out that it wasn’t diagnosis A, it was diagnosis B. I’m going to give you an example of a patient who came in with a cane.
And he was diagnosed with a knee injury. And the doctor, the orthopedist in this case, wanted to send him for an MRI. And he was all set to get the MRI. And this is only going on for about three months. The history of this patient was that he’s from Brazil, was in his country, and was walking on a beach. And when he got back on the airplane to come back home after about two weeks,
He started to notice Pain on the inside of his knee. So if this is your kneecap, it would be on the inside. If this were the left kneecap, it would be on the inside, and he had Pain in his left knee. It was on the medial side, the inside of his knee. He also had some trouble squatting. He felt like his knee couldn’t bend all the way, and he couldn’t squat down as much on the left side. He comes in with a cane. Now,
There was no history before that of any injuries to his knee. There was no trauma. He didn’t have a fall. It was just a lot of walking. So, as chiropractors, we’re trained to look at biomechanics. Well, what affects the knee? Well, from above, it could be the hip, but from below, it could be the ankle. And he was doing a lot of walking. So in my practice, when a patient comes in, we routinely check the feet, the arches of the feet to make sure that they’re
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even that they’re symmetrical within certain boundaries. Everybody has an asymmetry to some degree. We are not mirror images of each other. So in his case, his name was Jon, in his case, in Jon’s case, his right foot had a reasonable arch, his left foot had a less than sufficient arch. So, already before he left for Brazil on his vacation and walked a lot on the beach,
he was leaning to the side that had the lower arc,h which is his le, ft and when you have a situation like that you are going to cause strain on the inside of your knee because your shin will follow the lower arch and will internally rotate. So what this means is that if someone has a flat foot that is flatter on one foot relative to the other foot, the flatter of the two feet is going to have Pain in that knee.
So Jon had a problem with his left foot having a flatter arch. It caused excessive internal rotation when he walked on his knee. And it turns out that the proper diagnosis was not a problem inside the knee itself. It was in his ankle and his foot. All I did was adjust his arches, adjust his ankles, and we gave him an adjustment to the mortise joint, which is the
largest joint in the ankle. It made a big clunking sound. released. And what that did was that enabled Jon to be able to stand up and have his shin bone return to a normal neutral position and not get stuck in that internally rotated position that he had been accustomed to because of a lower arch on that foot for many, many, many years. Well, he walked out of the office without a cane. He was able to sit down and squat down without any problems.
What’s the point? The point here is twofold. Number one, you need a proper diagnosis, okay? Don’t take your word for it. Don’t take the word for it from an orthopedist all the time. Many times, MDs, including orthopedists and internists, routinely send you to physical therapy, and it would have done absolutely nothing for Jon. He didn’t need the MRI, so he canceled it. And the point is here that there’s A, a proper diagnosis that was missed,
Sirota Chiropractic Offices (04:51.421)
And B, that when you have problems, you have to look throughout the mechanical system. So if his knee hurts, you can’t just have blinders on and look at the knee. You have to look at the things that affect the knee. The ankle affects the knee,e and the arches affect the ankle. I have an office in Wilton. I have an office in White Plains. If anybody out there is suffering from knee problems, chronic hip problems that seemingly
are unable to be helped by PT, even though you’ve done it three or four times, and each time you went,t it was for 12 sessions, obviously you’re not gonna go back and do that again. So get a proper diagnosis, give me a call, easily found on Google, or you can reach me at 917-763-414, you can text me, and we can set up a consultation; it’s always free. My name’s Dr. Jon Cirota, have a great day.
Today’s Blog post is on an ankle problem disguised as a knee problem.
Why a Proper Diagnosis Matters for Knee Pain. Look at the Ankle.
Too often, patients are told they have one problem when the real cause of the Pain is something else entirely.
This happens more often than people realize. A patient may arrive having already been told they have a specific injury or diagnosis, only to discover, after a more detailed examination, that the actual source of the problem is elsewhere. That difference matters. A great deal of unnecessary imaging, ineffective treatment, wasted time, and prolonged Pain can happen when the diagnosis is incomplete or simply wrong.
At Sirota Chiropractic Offices, one of the most important parts of the evaluation process is not just identifying where the Pain is located but also determining why it is occurring in the first place. Pain in one area of the body does not always mean that area is the true source of the problem. In many cases, the body compensates for a mechanical issue elsewhere.
The Problem With Focusing Only on the Pain
A common mistake in healthcare is narrowing the focus too quickly.
If a patient has knee pain, many providers will concentrate only on the knee. If an MRI is ordered, the knee is imaged. If physical therapy is prescribed, treatment may focus only on strengthening or mobilizing the knee.
But the body does not work in isolated compartments.
The knee is influenced by what is happening above it and below it. The hip affects the knee. The ankle affects the knee. The foot and arch mechanics affect the ankle, which in turn can affect the knee.
When the entire mechanical chain is not evaluated, the true problem can easily be missed.
When Knee Pain Is Not Really a Knee Problem
One patient came into the office using a cane after being diagnosed elsewhere with a knee injury. An MRI had already been recommended.
The symptoms had been present for about three months. There was no trauma, no fall, and no direct knee injury. What stood out in the history was that tPainain began after extensive walking on the beach during a trip to Brazil.
He developed Pain along the inner aspect of his left knee and had difficulty squatting or fully bending the knee.
At first glance, it might appear to be a knee problem.
But during the examination, something important became clear.
When the arches of the feet were evaluated, the right foot had a normal arch, while the left foot had a noticeably lower arch. That difference in arch structure changed the way the shin rotated during walking.
Because the left arch collapsed more, the tibia rotated inward more than normal, placing increased stress on the inner side of the knee.
In other words, tPain appeared in the knee, but the mechanical problem began in the foot and ankle.
Why the Correct Diagnosis Changed Everything
Once the true source of the problem was identified, the treatment plan changed completely.
Instead of chasing a knee injury that was not truly present, the focus shifted toward restoring proper ankle mechanics. After adjusting the ankle and improving motion in the mortise joint, the patient experienced immediate improvement.
He was able to walk without the cane and squat down with far less discomfort. The MRI that had been scheduled was no longer necessary.
This is the power of a proper diagnosis.
A correct diagnosis does not simply label a condition. It determines the correct treatment strategy and often prevents unnecessary imaging, procedures, or prolonged treatment.
Why Biomechanics Matter
Chiropractic training places significant emphasis on biomechanics, the study of how joints and muscles interact during movement.
If one part of the body is not functioning properly, another area often compensates.
A collapsed arch can alter ankle motion.
An altered ankle can affect shin rotation.
That rotation can place abnormal stress on the knee.
Over time, the patient feels knee pain even though the knee itself may not be the original problem.
Looking at the entire kinetic chain is often the key to understanding how Pain developed in the first place.
When Standard Treatment Is Not Working
Many patients go through multiple rounds of treatment without improvement. When that happens, it is worth reconsidering whether the original diagnosis was correct.
If you are experiencing knee pain, hip pain, or persistent musculoskeletal problems that have not improved with treatment, a more complete biomechanical evaluation may help identify the real cause.
Sometimes the answer is not where the Pain is located.
Sometimes the answer lies in how the body is moving.
Proper Diagnosis at Sirota Chiropractic
A proper diagnosis is the foundation of effective treatment.
At Sirota Chiropractic Offices, patients are evaluated with attention to the body’s entire mechanical system, not just the location of symptoms.
This broader perspective often allows the real source of the problem to be identified and treated more effectively.
If you are experiencing knee pain or chronic joint problems that have not improved, consider scheduling an evaluation.
Dr. Jon Sirota provides chiropractic care in Wilton, Connecticut,t and White Plains, New York, helping patients restore proper biomechanics and return to normal movement.
