Medical Studies Regarding The Use Of Foot Orthotics In Treatment Of Knee Pain
How To Choose The Right Size Of Knee Brace
A brace that’s too small for you can cut off your circulation or even aggravate pain. And, if it’s too loose, it will be useless. It’s imperative that you choose the right size.
If you can try your brace on before buying, you should be able to slide two fingers under the straps or the sleeve.
If you can do this easily, choose a smaller size. If you can’t do it, choose a bigger one.
But, if you’re going to buy it online, check the size chart of the manufacturer. Most brands have their own sizing, so a large sleeve in one brand can be a medium or an extra-large sleeve in another.
How Do You Know If You Need Orthotics For Runners Knee
In an ideal world, this decision would be made by a qualified medical professional, such as a physiotherapist or podiatrist.
However, the current understanding is this: the more flexible your foot, the more likely you are to benefit from orthotics. This means it is not as straightforward as having a “flat” or pronated foot.
If you are a runner with a foot that looks much flatter when you are standing on one leg versus two, this indicates that orthotics are worth exploring. Another clue is if you are a runner with very stiff ankles.
Try doing a squat: if you cannot get your hip below your knee without your heels coming off the ground, then orthotics may be for you.
Do Orthotics Hurt Or Help Knee Pain
Knee pain can be frustrating, debilitating, and confusing.
What helps and what hurts? How do orthotics fit into the equation?
Some anecdotal claims insist that orthotics might make knee pain worse–and that’s the last thing you want to happen. Others insist that orthotics can be a lifesaver.
What’s the truth about the link between your feet and your knees? How much can orthotics help with knee pain–and can they ever hurt?
Let’s find out!
How Foot Posture Affect The Joints In Your Legs
To understand foot posture, you need to understand bone structure. There are two bones that connect the knee to the foot. The larger bone is the tibia. This is the main shin bone in the front of the leg. The bottom of the tibia forms the inside ankle bone. The smaller lower leg bone is the fibula. The base of the fibula forms the outside ankle bone. The ankle joint hinges on the lower foot like the hinge on a door; it doesn’t rotate, it hinges directly in line with the foot.
Back to the stocking foot exercise. If the foot is positioned in neutral and the knee is bent, the knee will track forward over the foot, as it is intended to track. When the foot is pronated the shaft of the lower leg will rotate inward. When the knee is bent the knee will track in an inward, misaligned, direction.
Moving up the leg above the knee, a pronated foot causes the leg to rotate inward which means that the thigh rotates inward which affects the hip socket. The pelvis then has to tip to allow the hip socket to rotate which in turn misaligns the lower back.
Notice the chain reaction? It starts with a misaligned foot posture and affects every joint all the way up to the lower back.
80% of the human population has pronated feet and the average person takes 10,000 steps a day. That means that lots of people are going through life with misaligned knees, hips and lower back!
Why Do Orthotics Hurt My Feet
If you’ve got a pair of orthotics and you are finding that they are making your feet sore, achy, or cramped, then you may be wondering: why are my orthotics hurting my feet?
It can feel discouraging to find that your orthotics are making your feet sore — but there are solutions!
There are many reasons why your orthotics could be hurting your feet. Identifying the correct reason can help you start to manage your pain and find strategies to reduce it. In this article, we’ll explain some of the top reasons why your orthotics might be hurting your feet and give you some ideas for fixing the problem.
Remember that the best way to figure out why your orthotics are hurting is to book an appointment with one of the Certified Orthotists or Certified Pedorthists att Applied Biomechanics in Guelph. Our team of experts can help with custom orthotics and bracing solutions for a variety of biomechanical problems. Schedule your appointment with us today!
What Causes Knee Pain
Many factors can contribute to achy knees. Weakness, instability or excess forces from exercise and other activity – and sometimes specific conditions or diseases – they all can be a cause of knee pain. Most commonly, however, knee pain comes from everyday exertions that put stress and strain on your knees.
Other common causes of knee pain include:
Activities That Worsen This Condition & How Orthotics For Knee Pain Can Assist
- Strenuous labor
- Sitting in the bent-knee position
- Kneeling for long
There are two pads of cartilaginous tissue in your knee joints that disperse friction between the shin bone or tibia and the thigh bone or femur. These are called meniscus and are found on the inside and outside of your knees. In some cases the meniscus may tear away. Its broken or torn piece may get stuck in the knee joint. This in turn leads to pain, swelling and of course decreased movement.
Muscle imbalance is another major reason for this kind of knee pain. Your inner quadriceps are weaker than the outside ones and thus the latter tend to pull your knee caps toward the side. This muscle imbalance leads to mal-tracking of the patella which would otherwise be running properly in its groove. This condition leads to cartilage erosion and pain and is also called patella tracking disorder. The best way to address this problem is by performing certain exercises that strengthen your weak muscles.
Here at Footlogics we supply orthotics for knee pain, which help to treat and correct the issues in the foot that may have a direct connection to swelling or discomfort in and around the knee. We work to provide our customers with premium orthotics that will help them to participate in the activities they enjoy without being held back by nagging pain and discomfort.
What Type Of Orthotics Are Best For Runners Knee
This is where the question can get tricky – There is no one size fits all approach with orthotics. The best advice I can give you is to see a specialist musculoskeletal podiatrist, who takes a keen interest in running.
However, if you do choose a pair of off-the-shelf orthotics , it is important that you find the orthotic comfortable.
If you have a flexible foot, you are likely to benefit from an orthotic with a significant medial arch support, similar to a stability shoe.
If you have stiff ankles, you are likely to benefit from an orthotic with a ‘heel raise’, which will increase the heel-to-toe drop of your running shoes. You can learn more about heel-to-toe drop in this article about running shoe seleciton.
I do hope this article helps you decide whether or not you wish to try orthotics as a treatment option for your patellofemoral pain. If so, I’d suggest speaking to your physio about it. Good luck!
» » Running Injuries » Do Orthotics Work for Runner’s Knee?
Dr. Brad Neal
Can Orthotics Cause Injuries
Orthotics are not risk-free. The risk is not large, and so not much needs to be said about it. However, good or bad, they can be difficult for a body to adjust to, disrupting fine-tuned postural adaptations and forcing new ones which either feel awkward just because they are unfamiliar, or because they are just uncomfortable .
Some people find the cure to be worse than the disease. If you’re trying to treat something like, say, runner’s knee, I don’t recommend trying orthotics during a flareup when a backfire could be the most harmful.
And yet it’s impossible to tell the difference between temporary and lasting discomfort with new orthotics or footwear. The only way to find out if it’s just a matter of getting used to it is to try. Feeling worse for a while is fine if it pays off, but a terrible outcome if it does not.
I had a pair of hiking boots that I really wanted to love: beautiful, expensive boots that seemed to fit perfectly, and so sturdy. It was liking wearing cozy tanks! But they also consistently made my right foot ache about 20 minutes into every hike in a way that no other boot or shoe ever had before, or ever has since. I kept those boots for years, trying them hopefully each hiking season. The pain was as reliable as sunrise. Who can say what it was about those boots? What subtle interaction with my body? Nearly impossible to diagnose, I imagine. It was trivial but inevitable.
Do Custom Orthotic Shoe Inserts Really Work
According to a study recently published in the Journal of Physical Therapy Science, orthotic insoles can indeed improve the pressure and pain associated with flexible flatfoot.
A Canadian review of orthotics published in the online PainScience journal found custom orthotics to be helpful in treating a variety of conditions including plantar fasciitis, arthritis, diabetes and a condition associated with pain in the ball of the foot knows as metatarsalgia.
Other painful foot conditions for which custom shoe inserts are prescribed include Achilles tendonitis, bunions, hammertoes and misalignment.
When prescribed by your podiatrist and used together with other treatments, custom shoe inserts often do provide relief from foot pain. If they don’t seem to be working for you or are causing more foot pain, it’s time for another call to your podiatrist.
How Do Hinged Knee Braces Work
A hinged brace is more rigid than a sleeve. It’s usually a bulky structure made of plastic or metal, with straps to keep it in place.
Some have a dial that restricts the movement of the knee. Surgeons use this to help your knee heal after ligament surgery.
Their bulky structure protects the knee from direct impact. Like during contact sports or in the vulnerable period immediately after surgery.
Some hinges support the knee and help redistribute the pressure within the joint. This can be helpful in meniscal injuries.
A hinged brace might be best for people:
- With moderate to severe knee injuries – like tears on ligaments.
- That underwent knee surgery.
- With severe knee arthritis.
Caveat Emptor Many Orthotics Are Poorly Made And For The Wrong Reasons
Foot, ankle, knee and hip biomechanics are complex. Extremely complex. It’s not rocket science — it’s actually much harder. And gait analysis is an art as well as a science. In my opinion, non-specialists just cannot possibly navigate this maze successfully with every patient. Orthotics should not be prescribed without a thorough examination — at least a half hour, and more if the case is complex.
Yet across North America — and I’ve seen it myself here in Vancouver — you can find lab-coated charlatans hawking corrective shoe inserts in shopping malls, using flashy displays and entertaining technology to “assess” or “scan” your feet with lasers or infravision … anything at all that will distract you from their lack of skill and real knowledge.
Unfortunately, many orthotics sold to consumers may not be worth more the clay the mold was made from. The effectiveness of orthotics is uncertain no matter who prescribes them, which I’ll get into below. and — two similar professions — have the best chance of providing a useful prescription, because they are only professionals trained in both lower body anatomy, kinesiology, pathology and the actual fabrication of custom foot orthoses. All other professionals are obliged to order orthotics from an external supplier.
Good for her. But many professionals jump at this dodgy chance to make more money.
Foot Orthotics For Knee Pain & Pain Relief
Just like knee braces, foot orthotics is very light on your budget and proves very helpful in knee pain treatment. They are ideally used in conjunction with other forms of knee pain treatment and therapies especially strengthening exercises. Orthotics work to prevent internal leg rotation by re-aligning our feet and ankles which is a primary cause of patella mal-tracking.
Many studies claim the success rate of orthotic insoles to be high in various patients suffering from patello-femoral knee pain. Experts at the University of Queensland conducted a study recently that showed a comparative analysis of results in 2 patient groups. The first group was given a combination treatment of physiotherapy and orthotics and the other one received only physiotherapy. The former showed significant improvement with regards to knee pain as compared to the latter.
Orthotics are worn by leading athletes as it ensures proper alignment of their feet, legs and knees. Footlogics orthotics correct overpronation to restore proper knee function. It works by eliminating one of the primary causes of patello-femoral pain. If you too suffer from fallen arches and/or too much rolling inward of your ankles, orthotics can provide you with significant knee pain relief.
Running And Walking Shoes That Try To Be Like Orthotics
More expensive running and walking shoes all try to absorb shock in various ways, and then there are also many designs intended to “correct” or compensate for common biomechanical issues like pronation … just like orthotics. Most of these designs are supposedly all about injury prevention, and this hope is behind countless gimmicky, expensive shoes with no clear benefit for consumers. That’s hardly surprising, because there is no clear link in the first place between running injuries and the kinds of anatomical quirks that these shoes supposedly control.
Running injuries are just as common as they were twenty years ago, despite all the fancy footwear, and typical “prescriptions” of running shoes — the kind you can get from an “expert” shoe seller — are definitely not evidence-based.
These are the interesting shoes that Dr. Kerrigan’s company makes, “the first & only footwear with a midsole that provides compression & release, when & only when it should. Despite what we’ve been led to believe, no foam, plastic, air, gel, or metal ever achieved this.”
What You Should Bring To Your Appointment
If you have knee x-rays showing the extent of any arthritis, it would be helpful to bring those with you to your appointment. If you do not yet have xrays of your knees you many need to get them before orthotics are made. If you have arthritis of both compartments of the knee, we want to know that ahead of time as those patients may not tolerate foot orthotics well.
- Bring a pair of shorts or pants that you can roll up above the level of your knee.
- We will likely perform an analysis of your gait , your foot function and your knee.
- Following the exam we will explain whether it is likely that orthotics will help your knee pain.
- If orthotics are prescribed, once you receive them, know that it may take several visits to wedge the orthotics in a way that best decreases your pain.
How To Relieve Knee Pain
Your best knee pain treatment will depend on the underlying cause of the pain. Often, a combination of rest, ice, compression, and elevation of the affected knee can help to alleviate some symptoms. Over-the-counter pain medications can also help to provide some knee pain relief.
Unless you have a more serious, chronic condition, there are some simple tips that can help you get the knee pain relief you need:
- Use insoles or inserts that provide a combination of shock absorption, cushioning and support for your feet, which in turn can help relieve knee pain and move more comfortably. Dr. Scholl’s Orthotics for Knee Pain are clinically proven to relieve and help prevent general knee pain as well as Runner’s Knee and Knee Osteoarthritis.
- For those with flat feet, orthotics prescribed by healthcare professionals may provide relief for sore knees, by reducing the physical stress on the knee and improving foot and leg alignment. Braces may also be used to support and protect the knee.
- It is best to contact your doctor if you are:
- Having difficulty putting weight on your knee.
- Unable to flex or extend your knee to its full extent.
- Experiencing significant swelling.
- Experiencing a fever alongside knee swelling, redness, and pain.
- Finding your knee gives-way or can’t support your weight.
Understanding Foot Biomechanics To Develop Orthotics For Knee Pain
We believe that the most common causes of Patello-femoral pain are age, injury, and trauma, whereas nobody pays attention to faulty foot biomechanics. This surprisingly plays an important role in causing this pain as most health practitioners are of the opinion that our manner of walking, and the position of our feet and ankles affect our legs, knees, and hips and even lower back up to a large extent.
Studies suggest that close to 70% of the population has a condition called over-pronation. This means that their ankles tend to roll inwards and that the arch is low when the foot lands on the ground while we are walking. Experts say that this over-pronation affects our feet and also causes our lower legs to rotate.
Our knees are not meant to rotate but to form a link between our upper and lower leg. They function as a hinge joint that is designed to flex and extend forward our lower leg. However, in many cases when our foot rolls inwards, it is called over-pronation and it forces our lower leg to rotate, which places abnormal stress on our knee joints. This results in deterioration of the knee function.
This inevitably leads to abnormal wear and tear of the knee cartilage resulting in long-term damage and sharp chronic pain. Most physiotherapists in the US have now started to include feet assessment in knee diagnosis as more and more cases of people suffering from over-pronation are coming up.
Insoles No Help For Knee Osteoarthritis
Nearly a third of Americans will develop osteoarthritis of the knee before age 70. With no “cure” beside knee replacement on the horizon for this painful joint condition, relief often has to come from pain pills. Assistive devices such as wedge insoles are often prescribed as a less drastic, side effect-free treatment option. But do they really work? A research review indicates that these shoe inserts do little—if anything—to relieve arthritis pain.
The review looked at the use of lateral wedge insoles for medial knee osteoarthritis, which affects the inner part of the knee. Lateral insoles are thicker at the outer edge of the foot. Slightly tilting the foot is thought to reduce the load on the inner knee joint.
Walking directs more force to the inside part of the knee than the outside part . The medial compartment is where osteoarthritis usually appears first. “A lateral wedge insole is intended to reduce pressure transmitted through the lower leg to the medial compartment of the knee during walking,” explains Dr. Robert Shmerling, clinical chief in the Division of Rheumatology at Beth Israel Deaconess Medical Center, and associate professor of medicine at Harvard Medical School.
The findings echo new osteoarthritis treatment guidelines released by the American Academy of Orthopaedic Surgeons in May. Based on current research, the AAOS said it couldn’t recommend lateral wedge insoles for people with medial knee osteoarthritis.
Treating Knee Pain From The Ground Up
Evidence suggests that foot orthoses can help relieve painful knee symptoms and possibly even help prevent injury. The key may be pronation control, which in turn affects tibial internal rotation and frontal plane alignment.
The medical literature was silent about the mechanical origins of knee pain until, in my opinion, the athletic medical community recognized a possible causal relationship between hypermobile foot joints and knee pain in runners. Knee pain had previously been considered the result of osteoarthritis and was thought to have no other etiology except ligamentous damage resulting in unstable knee joints. The effect of foot motion was not a consideration. Now, however, the literature reflects a more complete understanding of the pathomechanics of mechanically induced knee pain and the role of foot orthoses in treatment.
The mechanical origins of a patient’s knee pain can often be brought to light by attempting to alter the mechanics of the lower extremity to see if symptoms improve. Strapping, taping, hamstring-strengthening exercises, wedge padding and prefabricated orthoses offer inexpensive diagnostic tools to ascertain that the symptoms also are mechanical in origin . 1-4
Figure 1. Pronation of the subtalar joint with subsequent collapse of the midtarsal joint creates internal rotation of the tibia and produces a significant rotational torque on the knee. Orthotic control of the foot limits both the amount and velocity of the internal rotation.
Arthritis Pain Relief And Shoe Inserts
Learn how orthotic inserts can help reduce foot pain for people with rheumatoid arthritis and osteoarthritis.
Arthritis Pain Relief and Shoe Inserts
When your feet hurt, it’s hard?to think about anything else, and everyday activities that involve standing or walking for more than a few minutes can become overwhelming. Making good shoe choices can prevent problems, but for many of those who are already suffering, orthotics – shoe inserts designed to ease foot pain and correct structural issues – may provide much-needed relief.
How Shoe Inserts Reduce Foot Pain
Foot pain is common. One in four adults have a problem with their feet. And among people with certain types of arthritis, including rheumatoid arthritis and osteoarthritis of the knee, hip, ankle or foot, it’s even more prevalent.
Foot discomfort and structural problems such as the hammertoes and bunions caused by the inflammation of RA and lupus also can spread beyond the feet, leading to shin pain, knee pain and lower back pain.
Orthotics redistribute weight and relieve pressure on sensitive areas of the feet, provide cushioning that reduces stress, or biomechanical load, on the lower body, and correct gait and structural abnormalities, says Marian Hannan, associate professor of medicine at Harvard Medical School and co-director of Musculoskeletal Research at the Harvard-affiliated Institute for Aging in Boston.
Custom Orthotics for Arthritis and Related Conditions
Benefits Of Orthotics For Knee Pain
When your orthotics are a good fit for you, they will not cause knee pain. They will cushion and support your feet while making it easier to maintain good posture. Because no two people have an identical musculoskeletal system, customization is key to obtaining high-quality orthotics.
The “break-in period” can take time. You may have to wear your custom orthotics, identify small problems, and have them reshaped or adjusted gradually. In the end, you should be able to obtain orthotics that are perfectly suited to your body and your lifestyle which relieve pain and help prevent injury.