PatelloFemoral (Kneecap) Pains – When to Use Orthotics (foot supports)

Certain sore kneecap cases will benefit from foot orthotics.

Br J Sports Med. 2008 Sep 30. [Epub ahead of print] A clinical prediction rule for identifying patients with patellofemoral pain who are likely to benefit from foot orthoses: a preliminary determination. Vicenzino B, Collins N, Cleland J, McPoil T. abstract

Orthotics most likely to work if:

1) >25 years age

2) height < 165 cm = 5′ 5″

3) Worst pain VAS <5.3/10

4) mid foot width is 11 mm wider when weight bearing. I know there are ink pad devices but I have a cheap temperature sensative (color changing) sheet that might work here.

If your have 3 of the above, then there is an 86% (vs 40%) chance of an orthotic helping.

The orthotic used was:

1) Varying degree of hardness depending on comfort

2) Six degree wedging medially (called posting) = 5 mm height medially if heel 2″ width or 6.6mm if heel width is 2 1/2 inches.

3) Mid arch support

4) Thickness depending on depth of shoe (sometimes need to get special deep inlay shoes) – I just tell them to get a runner with a insert that is removable.

Closest I can come to prefab would be the Alimed Five degree posted:

FREEDOM Posted XPE Orthotics ($19.00)

link here

Any comments?

 

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