Old foot pain leading to knee pain

Hello,

I had a 10,000 lbs forklift run over my foot 31 years ago that compressed pretty much every bone in my foot (it ran up my foot covering all my toes across the top of my arch to the outside of my ankle where it slid off). The doctors said I bruised all the bones and muscles. No bones were broken though.

I wore a wire cast for 2 weeks and used a cane for 3 months. It was over 6 months before I could walk without limp and I could not stand/walk for long periods of time.

Since then I have never been able to run very far before my foot started hurting and it has gotten worse as time went on until about 12 years ago if I ran for 50 feet I would be limping for pretty much the rest of the day so I made sure I stopped running for anything.

About 10 years ago my foot started hurting just from walking/standing for short periods of time. The pain went away after a short time sitting/lying down. About 7-8 years ago the pain started not going away. About 5 years ago I broke down and started using a cane and now pain is a constant companion. Right now it varies between about 4-6 on a 10 scale (sometimes 7 if I walk a lot) so I take lots of aspirin.

In the last year or so my knee has started aching.

My question is my knee going to keep getting worse and how bad?

Is there any literature on the net regarding this? I have tried searching the web about it but I keep finding injury lawyers or knee injuries alone.

Any help would be appreciated.

Thank you,

Paul

[Boozybird]

Hi Paul,

Sorry to hear about this long standing problem with your foot. It's hard to cope with this level of immobility and pain. You don't say what treatments you've had to try to rehabilitate the foot over the years? It's certainly time to get some knee attention to keep the muscles strong and joint mobile. Please share what types of treatment you've had over the years - what worked (if anything!) and what didn't! May be people will have some others suggestions then... Best wishes - keep strong. 😜

[Frustated in reply to Boozybird]

Hi there, you may well have what is called 'referred pain', this may be because you are not walking properly because of the pain in your foot, and therefore you are putting strain on your knee. It is a vicious circle. I too have a painful foot, and when in pain and not walking properly (and not using my crutches) I get pain in my other knee, hip and toes. It may be that you have some degenerative change in the joints on your injured foot, which is causing the pain. You may need to go for further investigations on your foot and start investigations on your knee. Hope you get some help.

[Hidden in reply to Frustated]

In regards to the foot. I had forgotten to mention that I can actually stand with no pain (other than the ever present constant pain) for periods of time as long as my weight is only on the heel. It is when I have weight on the front of my foot (like what happens when a person is walking or running) that the pain gets worse.

The forklift weighed 9970 lbs (with another 200 lbs for the driver) with most of the weight on the back solid tires. They estimated that somewhere around 3500-4000 lbs rolled over my foot. With a 6" wide tire and a contact surface of about 1/2-3/4" wide that meant it was exerting somewhere around 777-1332 PSI on my foot.

If I remember correctly the doctors eventually told me the forklift did crushing injuries to the muscles, bones and nerves in the front part of my foot to where there was a good chance I would probably have weakness in that foot for the rest of my life.

BTW, according to a radiologist I talked with a few years ago the emergency room doctor who looked at the X-rays when my foot was injured screwed up (or was just plain lazy). He got the X-rays back when I was talking with him and he just held them up to the florescent lights in the ceiling, looked at them for about 5 seconds each and told me I had no broken bones. According to the radiologist he should have been using a magnifier to check for hairline fractures because all the small bones in the foot makes it hard to check for them. He certainly should have at least used a light box and spent a lot longer that 5 seconds each.

Paul

[Hidden in reply to Boozybird]

The doctors had me doing running and various foot exercises but after 3-4 months of therapy there was no improvement. This was tried several times over the course of the years.

Many thanks for your wishes.

[bentleyfoxer]

The long years walking with a cane or with difficulty without it has led to muscle and joint imbalances which your knee has been taking on board . Now after so many years the knee is getting old and worn and can no longer cope with the extra stresses and strains without pain. You need to seek physiotherapy for it to address your gait and strengthen the muscles so there is less strain on your knee. I wish you well

[Hidden in reply to bentleyfoxer]

Thank you for your advice. Hopefully I have not waited too long. I don't want to deal with the same amount of pain in my knee as is in my foot.

Thanks.

[Boozybird in reply to Hidden]

Hi Paul, can you get some expert help from a good physio with foot expertise? Or a podiatrist with patience and experience? If you are happy tsking weight through the heels then there must be some scope for orthotics to offload pressure through the forefoot? I would be sceptical about this if I hadn't myself been helped with such an adjustment to my shoe relieving all pain. Are you comfortable barefoot in the house? If the bones weren't broken ( I know you doubt the X-ray of the time ) then is it possible that you have lost all accessory foot movement over time resulting in super stiffness of the feet? Anyway, as regards the knee, catch this problem while its young. There are plenty of exercises to keep good alignment and strength in the knee as long as there's no swelling? Find an expert. Don't give up hope. 😜

[Hidden in reply to Boozybird]

This happened while I was in the US Navy.

The VA had me go to an in-house join specialist for the exercises to try and strengthen it but no luck.

The foot itself is not stiff. I can wiggle all my toes and rotate it with little/no added pain other than the constant pain.

It's only when trying to walk and put pressure on the front that the pain increases.

I have tried building up the heel portion inside my shoe before with pieces of shoe foam so more of the weight would be on the heel instead of the toes but there was little/no difference whether I was just standing or walking. When I was standing I was already putting most/all of my weight on my heel anyways so it did not make too much of a difference then. When I was walking you normally push off from the front part of your foot so it did not help at all then.

About the only way I can see doing away with the cane is to basically wear a brace to hold my foot immobile in relation to my leg so when I walked and pushed off with the front of my foot all the weight would be transferred to the back of my foot/leg/ankle. In other words a cast (either plaster or metal).

I will be making an appointment to see my doctor for a referral to a join specialist later this week.

Paul

[Boozybird in reply to Hidden]

Hi Paul, the shoe support would be to support the arch and forefoot. A heel wedge wouldn't work but presumably create more tension in the forefoot. An orthotic would unload stress and strain in the forefoot and support the arch. The nerves running through the foot would have space and hopefully send fewer pain signals. I have been amazed at the reduction in pain from such a simple measure. Do you have pain barefoot? Can you get a referral to a podiatrist? It's worth a try. 😜

[Hidden in reply to Boozybird]

I should be getting a referral this week.

When barefoot I have the constant pain and pain while walking but no extra pain while standing as long as I keep my weight on my heel like I do while wearing shoes.

[Boozybird in reply to Hidden]

I hear what you're saying about the severity of the original injury but technology has come on a lot and surely it must be possible to create a foot support that can cradle the arch and offload the forefoot to make you more comfortable! Glad you've got a referral. Do persist! The knee should improve with more normal gait!

[Hidden in reply to Boozybird]

Thank you very much for the advice.

I hope so on the knee.

Paul

[johnsmith]

This suggests that may be posture is a problem. Another problem is putting too much weight on the walking stick. The more pressure applied to the walking stick the more interference with walking and the more problems with pressure applied to the knee.

An Alexander Teacher could help you develop better postural habits.

Hope this helps