Orthotics for Runner’s Knee (Patello-femoral Pain Syndrome)

Several studies have shown that very specialized foot orthotics can be helpful at reducing pain in patients who suffer from runner’s knee (also known as patella-femoral dysfunction).

Foot Orthotics to Relieve Pain Associated with Runner’s Knee
A number of studies have shown a direct relationship between pronation of the foot and runner’s knee. When the foot pronates (flattens) the leg rotates in toward the other knee. When this occurs a force is put onto the knee that disrupts the relationship between the patella (kneecap) and the femur (thigh bone) – thus the name of Patello-femoral Pain Syndrome.

The role of orthotics in treating runner’s knee is to reduce the flattening of the foot in order to prevent the leg from rotating in and thus maintaining better alignment of the knee cap.

We are experts at designing orthotics for patients with runner’s knee. Contact us today to make an appointment for an evaluation in our Seattle foot and ankle clinic.

Your Appointment

• If you have knee x-rays, it would be helpful to bring those with you to your appointment. We want to make sure that you do not have arthritis of the knee. Orthotics for knee arthritis are made very differently than those for runner’s knee. If you do not yet have xrays of your knees you many need to get them before orthotics are made.
• 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 (how you walk), your foot function and your knee. Following the exam we will explain whether it is likely that orthotics will help your knee pain.
• Once you receive your orthotics, it may take several visits to wedge the orthotics in a way that best decreases your pain.
• If you have long-term knee pain and have not yet had it evaluated by your primary physician, orthopedist, rheumatologist or physiatrist, we will refer you to the appropriate doctor. Orthotics can be a good tool to help reduce knee pain in some patients, but they are just part of an overall treatment plan.

References
• Eng JJ, Pierrynowski MR: Evaluation of soft foot orthotics in the treatment of patellofemoral pain syndrome. Phys Ther 1993;73: 62-68
• Way MC: Effects of a thermoplastic foot orthoses on patellofemoral pain in a collegiate athlete: a single-subject design. J Orthop Sports Phys Ther 29:331,1999
• Johnston LB. The effect of three shoe wear conditions on lateral patellar displacement in subjects with anterior knee pain (thesis). Chapel Hill, NC: University of North Carolina; 2001
• Pitman D, Jack D: A clinical investigation to determine the effectiveness of biomechanical foot orthoses as initial treatment for patellofemoral pain syndrome. J Prosthet Orthot. 2000; 12;110-116
• Saxena A, Haddad J: The effect of foot orthoses on patellofemoral pain syndrome. J Am Podiatr Med Assoc Vol 93, No 4 July/August 2003
• Manter JT: Movements of the subtalar and transverse tarsal joints. Anatomy Record 80:397-410 1941
• Nigg BN, Cole GK, Nachbauer, W: Effects of arch height of the foot on angular motion of the lower extremity in running. Journal of Biom 26,909-916,1993
• Nawoczenski DA, Cook TM, Saltzman CL: The effect of foot orthotics on three-dimensional kinematics of the leg and rearfoot during running. J Orthop Sports Phys Ther 21:317-327, 1995
• McCulloch M, Brunt D, Vander Linden D.:The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. J Sports Phys Ther 17:2-10, 1993
• McClay I: The evolution of the study of the mechanics of running. Relationship to injury. J Am Podiatr Med Assoc Vol 90,133-148, 2000
• Tiberio D: The effect of excessive subtalar joint pronation on patellofemoral mechanics: A theoretical model. J Orthop Sports Phys Ther 9:160-165, 1987

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Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
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