-Lateral knee pain in a Nordic skier

Take a good look at these pictures and what do you see?

-In the first picture, when his knees are in the sagittal plane, note the position of his feet. He has very cavus arches and a steep first metatarsal angle. There is a mild forefoot varus present.

-In the second set of pictures, note the position of the knee when the feet point straightahead, like they would be when skiing or slightly angled outward like they would be with Nordic skate skiing. Can you see how the knee points way outside of the sagittal plane? Can you imagine somebody pushing off in a skating motion and trying to push off of this knee? Talk about patello femoral discomfort and tracking issues!

-Of other significant note, he has an anatomically short left leg which is tibial.

-Remediation included making sure he could get his first ray down to the ground along with a 3mm full length valgus post in his left boot which will push the knee somewhat medially as he pushes off, as well as compensating partially for his leg length discrepancy. We will see how he does…

#internal#tibial#torsion#internaltibialtorsion#kneepain#crosscountryskiing#valgusposting