Have plantar fasciitis..can this also be attributed to knee problems?

by Pam
(Norfolk, Nebraska)

I have written before about the surgery's I have had trying to fix my plantar fasciitis with no help...The second surgery I had was to stretch my achilles tendon which caused nerve damage to my lower leg. My calf muscle is now over an inch smaller then my other one.

Today I found out the results of a MRI, and I have a torn meniscus and a partial tear to my ACL. I have no idea how I hurt my knee. I was wondering if loss of muscle and also limping all the time would have anything to do with my knee problems. I am a mail carrier on light duty and I do about 3 1/2 hours of continuous walking a day.

RESPONSE
Hi Pam,
I suppose one could make an argument that the abnormal gait that was created with your plantar fasciitis and subsequent post operative problems could have contributed to your knee problems.
I would think the bigger issue might be the fact that you are a letter carrier and the fact that you walk as much as you do, over time, some of the joints from your lower back down could begin to wear out, just like tires on a car wear out over time. The more you drive, the quicker the tires wear out.
Lets face it, you are in an occupation that wreaks havoc on your feet and legs. The type of terrain that you walk, whether or not you carry a bag (I guess no one carries a bag anymore), the types of shoes that you wear, your overall weight and your general health, will all contribute to the breakdown of your musculo skeletal system over time.
Since you calf muscle is much smaller that tells me there has been muscle atrophy and this could certainly impact your knee, by changing your gait to some degree.
Most of the leg muscles originate from around the knee and so there is also the impact from that situation.
If you have had nerve damage to the muscles in the leg, even with therapy there is the real possibility that there will only be marginal improvement.
If your doctors are suggesting knee surgery (if the knee pain is that bad) then your calf muscles may further degenerate and there will be more down time after the surgery. If you do eventually have surgery, I would recommend starting therapy as soon as possible to try and avoid that situation.
Whether that impacts your ability to carry on as a letter carrier is a decision you and your doctors will have to make together.

Marc Mitnick DPM
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