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My Family Podiatry Team

Alleviating Knee Pain with Custom Orthotics: Insights from a Knee Pain Podiatrist



How Can a Podiatrist Help Reduce Knee Pain with Custom Orthotics?


Commonly in the clinic, we encounter two major subgroups of patients presenting with knee pain:

  • Athletic Population: Typically teenagers or active adults undertaking running and jumping sports, usually aged between 10-30 years.

  • Older Adults: Those suffering from pain and stiffness, most commonly due to osteoarthritis, typically aged above 50.


Custom foot orthotics can do more than just treat foot and ankle pain. There is an increasing body of research demonstrating their effectiveness for helping manage knee pain. They are able to assist through preferential loading and altering how forces are distributed between the three major joints. This specialised approach in knee pain podiatry ensures that patients receive targeted relief tailored to their specific needs.


Knee Anatomy:


In simple terms, there are three major joint compartments of the knee:

  1. Patellofemoral Compartment

  2. Medial Compartment

  3. Lateral Compartment



Patellofemoral Compartment


This compartment is often involved in the younger, athletic population, with Osgood-Schlatter disease and Patellofemoral pain being the most common diagnoses. Custom orthotics with an accurate arch contour and medial wedging (a wedge placed on the inner side of the foot) can often reduce compression through the patellofemoral joint, improving knee pain associated with these conditions.



Medial Compartment (Inside of the Knee)



This is the most common region affected by knee osteoarthritis. Customised foot orthotics with lateral wedging (a wedge on the outside of the foot) can shift some of the weight and pressure to the healthier part of the knee, reducing stress on the medial compartment and allowing for smoother, more comfortable movement. This is particularly useful for patients where their arthritis is not significant enough to undergo surgery or those who would like to try and delay the need for surgery as long as possible.


Lateral Compartment (Outside of the Knee)


Less commonly, if the outside of the knee is primarily affected, a medial wedge (a wedge on the inside of the foot) is used. This adjustment helps in redistributing the pressure away from the lateral compartment, providing relief from knee pain and improving overall joint function.


Other Treatments for Knee Pain


Outside of custom foot orthotics, there are a number of other techniques your podiatrist may use to reduce pain in your knee and improve function. These can include:


  • Shockwave therapy: This can be particularly effective with patella tendinopathy and there is increasing evidence for its use in knee osteoarthritis.

  • Tailored strengthening program: Muscle imbalances in the leg can impact the knee, increasing pain and making activity difficult. Your podiatrist can develop an exercise program designed to strengthen the muscles surrounding the knee and provide support.

  • Strapping: In some instances, strapping can be applied to the knee to assist in tracking which may reduce pain. While typically a temporary solution, this can assist in your return to activity or in performing rehabilitation exercises with less pain.



Summary


While custom orthotics should never be the only treatment for knee pain, they are often a very beneficial adjunct treatment option to reduce stress in key areas. Incorporating knee pain podiatry strategies with custom foot orthotics can significantly enhance patient outcomes, providing a comprehensive approach to managing and alleviating knee pain.

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