長母趾屈筋、長趾屈筋、足底腱膜への治療が歩行時の右膝関節の疼痛軽減に有効であった右変形性膝関節症患者の一症例

抄録

Recently, we encountered a patient with osteoarthritis of the right knee who complained of right knee pain during walking. We administered physical therapy to this patient. Pain due to hallux valgus in the right foot was noted as an underlying condition. Right knee pain during walking was attributable to the gait pattern, which was aimed at avoiding the pain arising from hallux valgus. The gait pattern of this patient was characterized by toe overlap due to flexion of the toes during the middle to late stance phase, resulting in loading of the body weight primarily on the toes closest to the 5^th (little) toe. During the middle to late stance phase, pain in the medial side of the knee was due to supination of the subtalar joint, external rotation of the leg and genu varus. Based on these findings, knee pain of this patient was attributed to a disorder of the foot, and therapeutic intervention was carried out on the flexor hallucis longus muscle, flexor digitorum longus muscle and plantar aponeurosis. Two months after the intervention, pain in the right big toe and right knee during walking had disappeared. Improving the foot function was more important for the alleviation of knee pain in this case than improving the knee joint function.