Orthotics for Runner's Knee (PFPS)

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  • tawandacat Runner's Knee (PFPS)

    • Age 55+
    • Female
    • 145 lbs
    • 5' 7"
    • Binalong Bay, Tasmania
    22
    Sep2016
    • Injury Status Cured
    • Physical activity per week 8+ hours
    • Chronicity 6-18 Months
    • Repeat injury? No

    Treatment Ratings

      Cured
      Barefoot Shoes, Proper Running Form
      Improved
      NSAIDs - Anti Inflammatory drugs, Ice, Strengthening Exercises, Cross training
      Not Improved
      Orthotics
      Worsened
      Supportive Shoes

    I had been running for years in really cushioned shoes (Asics Nimbus) When I was in my 30's I developed a sharp pain in my heels. I fixed this problem with orthotics as it was a quick fix to my problem. I ran with these orthotics in very cushioned shoes for 20 years. Then in my mid 50's I developed runners knee. I couldn't run anymore it hurt too much. So I started bike riding. I found that if I pointed my feet outwards (externally rotating the leg) when I peddled, it didn't hurt my knees. I took this concept back to my running. I read the book "Born to Run" By Christopher McDougall. I discovered that really padded running shoes gives the body a false sense of protection. When the brain doesn't perceive danger it does nothing to protect itself from repetitive actions like running with the knees misaligned as in my case, despite the orthotics. I switched to a mid barefoot shoe and got rid of the orthotics. I found the idea of using my feet and having a better connection to the ground profoundly interesting and helpful. I became very interested in posture and mechanical alignment of the body and how it correlates and affects performance. After reading the book "8 Steps to a Pain-Free Back" by Esther Gokhale. I signed up for the Gokhale Method Foundations Course. This is where I learned to walk a line with my inner heels on that line. This was the deal breaker for me. I found that this movement along with using my feet properly and engaging my glutes externally rotated the leg and aligned my ankles, knees and hips. I am now 58 years old and I am happily running again without any knee issues. Today, I just came back from a barefoot run along the beach. I haven't had knee problems for 2+ years now.


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  • 03
    Dec2015
    • Injury Status Cured
    • Physical activity per week 8+ hours

    Treatment Ratings

      Cured
      Physical Therapy, Orthotics, Stretching, Strengthening Exercises

    Mine was eventually cured with orange superfeet inserts.

    I went to the sports medicine guy and he very quickly diagnosed it as runners knee. He seemed a little too eager to diagnose it that way though, I think his only questions were "where does it hurt" and "how much do you run". As soon as I told him my mileage, 50-60 mpw, he thought it was runners knee. He directed me to a PT for strengthening and stretching and recommending orange superfeet inserts.

    I was pretty skeptical since his diagnosis came so quickly and my symptoms didn't really match everything I'd read about runners knee. Went to the PT. Did the exercises and stretching for weeks. No progress.

    Finally I was getting desperate and bought the $40 inserts. They worked like magic, within days the pain was less when I ran. It was completely gone within weeks.

    I'm still not sure if this guy was brilliant or lucked into the diagnosis. Even though runners knee is supposed to be felt at the front of the knee, he called it "referred pain".


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  • 19
    Jun2015

    Treatment Ratings

      Cured
      Physical Therapy, Orthotics, Surgery, Other
      Almost Cured
      Stretching, Acupuncture, Strengthening Exercises
      Worsened
      Rest, Platelet Rich Plasma Injection, Cortisone Injection

    I had 'runners knee' for years. Remember this is a catch all phrase to describe knee painwhere the cause isn't known. I agree that seeking out a good physiotherapist is the place to start. Ultimately for me I had an MRI which revealed nothing, but elected to have keyhole surgery which removed my plica and since then problem solved. No I hadn't heard of it either before the surgery... Took over a year to get to that point and then a few months recovery. Obviously surgery is a last resort. As an aside I'm not sure if running on forefoot is always the answer, but again for me increasing stride frequency has kept me injury free since, circa 3 years.


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  • 08
    Jun2011
    • Injury Status Recovering

    Treatment Ratings

      Improved
      Orthotics, Supportive Shoes, Stretching, Foam Rolling

    I have been dealing with knee problems for the past several months. Good shoes with padding and perhaps SuperFeet which are an off the shelf orthotic to align the foot (your 1st shock absorber) will help.

    Stretching or ideally using a foam roller to reduce muscle tension from the calves to the hips is another piece of what made it possible for me to do a 10K last weekend.

    The feet, knees, hips are all interrelated. If the calves are tight, they pull on the achilles tendons which can affect the way your feet work. If the hips are tight (whose aren't), the knees become the main shock absorber when you are running.

    UTube has many wonderful videos on how to use a foam roller to loosen the hips, stretch the quads etc. It hurts at first, but quickly becomes addictive because you feel so much better when the deep muscles let go, allowing everything to work more efficiently.


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  • 22
    Feb2011
    • Injury Status Cured
    • Chronicity 18+ Months

    Treatment Ratings

      Cured
      Proper Running Form
      Not Improved
      Physical Therapy, Orthotics, Strengthening Exercises

    I had runner's knee symptoms in my right knee for three years. I got custom orthotics, went to physical therapy, and did knee strengthening exercises religiously. None of that helped much, though. The knee problem reduced me from marathoning to 20 mpw of easy jogging. If I tried to do anything more ambitious, my knee would start acting up.

    I finally got rid of the knee painby switching from heel striking to forefoot striking. The knee pain disappeared, and I have not had any knee problems since. I'm back up to 60 mpw and thinking about a marathon this fall.

    I know a lot of people don't like to think about changing their form, but it worked for me. It took a few months to adjust to it, but it was well worth it. If nothing else is working for you, it is something to consider.


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  • 20
    Mar2010
    • Injury Status Cured
    • Physical activity per week 8+ hours

    Treatment Ratings

      Cured
      Physical Therapy, Orthotics, Stretching, Strengthening Exercises

    Mine was eventually cured with orange superfeet inserts.

    I went to the sports medicine guy and he very quickly diagnosed it as runners knee. He seemed a little too eager to diagnose it that way though, I think his only questions were "where does it hurt" and "how much do you run". As soon as I told him my mileage, 50-60 mpw, he thought it was runners knee. He directed me to a PT for strengthening and stretching and recommending orange superfeet inserts.

    I was pretty skeptical since his diagnosis came so quickly and my symptoms didn't really match everything I'd read about runners knee. Went to the PT. Did the exercises and stretching for weeks. No progress.

    Finally I was getting desperate and bought the $40 inserts. They worked like magic, within days the pain was less when I ran. It was completely gone within weeks.

    I'm still not sure if this guy was brilliant or lucked into the diagnosis. Even though runners knee is supposed to be felt at the front of the knee, he called it "referred pain".


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  • 30
    Apr2006
    • Injury Status In Pain
    • Chronicity 0 - 6 Months

    Treatment Ratings

      Not Improved
      Orthotics, Brace, Supportive Shoes, Stretching, Strengthening Exercises, Cross training, Supplements

    I've been off since late December, after a hard 10-K (and a PR) that pushed my chondromalacia over the top. In the meantime, I've been doing the elliptical machine to say in at least some shape.

    Recently, it seems that I've plateaued and am just not getting better. I had been unable to run for a few months, and now can ran (very) short distances before being in pain.

    Things I've done:

    1. Strengthened my quads (still doing it)
    2. Taken glucosamine (didn't work, so stopped)
    3. Replaced my shoes (helped a little)
    4. Stretched my IT band, hamstrings, quads, etc.
    5. Worn a knee brace (and used it a few times, but it didn't help)
    6. Replaced my orthotics

    It's been 5 months. Is this taking too long to recover?


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  • 17
    Jan2003
    • Injury Status Recovering
    • Chronicity 18+ Months

    Treatment Ratings

      Almost Cured
      NSAIDs - Anti Inflammatory drugs, Orthotics, Ice, Brace, Strengthening Exercises

    Well, I guess I'll chime in to the group therapy session. I had problems which basically prevented me from running for just under two years (including several abortive comebacks, where I got too enthusiastic too quickly). It didn't need to be that long -- using some of the advice you get here, along with competent physio and so on, should allow you to come back much more quickly. When things do start to get better, my main piece of advice would be to return to running very gradually. When I finally managed to come back, it was through up building up from 5min of jogging every second day up to 30-40 minutes four times a week -- and that took several months.

    One random insight: I found that fast running didn't hurt my knee any more than slow running -- it was the length of time I spent running which would trigger soreness. So once I had built up a little background, I was able to regain fitness quite quickly by running fairly hard, but with very low mileage. There a point where I was running two longish interval sessions (on grass) and a tempo each week, plus a 30-40 minute easy run to complete the week. (I know the Lydiard contingent will shake their heads, but I wanted to get fit quickly for eligibility reasons.)

    As for getting to that point, the two exercises described above sound pretty good. I did similar things, along with just about anything anyone has ever tried (cho-pat, taping the knee, plenty of physio modalities like ice, ultrasound, and so on, anti-inflammatories, glucosamine, an MRI which was negative so I didn't bother getting scoped...I think the custom orthotics done by a gait analyst [running, not walking gait!] were the most helpful thing.)

    So the good news is that I have made a full comeback, running higher mileage and racing faster than ever. The bad news is that right knee is starting to feel a bit creaky again.


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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Orthotics

    As others have said, runner's knee has lots of different causes and can appear in different ways. For me it got better after I saw a doctor, physio and then podiatrist and got some custom orthotics. Problem was flat feet.


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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Orthotics

    I had terrible runner's knee until I went to a Sports Medicine clinic and was prescribed ORTHOTICS....
    Made all the difference...


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  • 03
    Dec2015

    Treatment Ratings

      Cured
      Strengthening Exercises
      Worsened
      Orthotics, Cortisone Injection

    For what its worth . . .

    Patella pain syndrome June/July of '06. Went to ortho for examination. said nothing really wrong. Gave me a shot. said wait a couple of days and go run. After a couple of days my knee still hurt. Waited a couple more weeks. knee still hurt. Told ortho I wanted an MRI. He said no need for an MRI because there was nothing structurally wrong with my knee. I waited a few more weeks - more knee pain. Finally got an MRI on a Saturday. On Monday Ortho called me at work and said he reviewed the results and it was just as he origianlly diagnosed. Then he called me a pussy and told me to go run that evening.

    Eventually I worked my way back into reasonable shape and noticed that my right knee torqued while running. Took out my custom orthotics (for previous shin pain) and have not had any knee problems since.

    Do your rehab/strengthening exercises and possibly try a new shoe.


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  • 01
    Oct2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Strengthening Exercises
      Improved
      Orthotics

    Lots of core work has really helped my running. I also get custom insoles from Profeet.co.uk in Fulham - it's hard to be sure how much difference it helps, but I've run 2000+ km per year the last few years without injury.


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  • 01
    Oct2015
    • Injury Status Cured

    Treatment Ratings

      Almost Cured
      Orthotics
      Improved
      Patellar tendon strap
      Not Improved
      Physical Therapy

    I think I get it because my foot tends to point inward. I have spent lots of money on physio, but the exercises are tedious and it's difficult to tell they are working. I cut down my running to about ten miles a week, and although I am not as fast, I am not injured nearly as much. I also wear a knee strap, which might help; it does not hurt anyway. I am a bit suspicious that running lots of laps around 400m tracks does not help. I tried bare-foot type running shoes in the past. They made me change my running style, but I still got knee problems. I have tried orthotics too. My knee problem cleared up quickly, but I became prone to twisting my ankle.


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  • 16
    Nov2011
    • Injury Status Cured