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Hi all, my first posting here. I am finishing up my Doctorate in Physical Therapy and am having horrible knee pain when running around the hospital doing my last rotation. There was no trauma, started about a year ago and is getting worse from just walking. I have collapsed arches, VERY pronated STJ in both feet, and I unfortuantely have tibial varum. Lets just say my tibial tuberocities are like a good 2cm lateral compared to the center of my patella. (not sure if I'm considered bowlegged if just my tibias are laterally rotated.) The pain moves around on my left knee. Feels like sandpaper under my patella (poor tracking) and sometimes have dull aches at my medial joinline..and now sometimes pain on ant. medial tibia? I am a complete mess and totally now REGRETTING choosnig a career as a physical therapist as you know we are on our feet about 75% of the work day seeing patients espeically in hospital bedside setting. ugh! I got custom orthotics ($500) they were molded, (not casted) while I was in a sitting position. This guy is in manhattan supposedly very good...i think they are helping but hasn't corrected the problem? Should i play around with wedges? heel wedges? I don't think the orthotics are right but I don't know what to say to ask them to be modified?? Any ideas to decrease my knee pain would be so helpful as I am sure there are mechanical issues at fault here.
thanks so much.
Larry

 

Yes. Not much to lose. Use the feedback and feedforward.

I don't think your orthotist/podiatrist would value any of your advice/input (just my hunch).



Ron
Physiotherapist (Masters) & Podiatrist

 

Did your podiatrist assess your muscles.?

Rectus Femoris, ITB and VMO can all have a role in knee pain. A streching and strengthening program may be beneficial and combined with your your orthoses you may have a better result.

 

VMO - where's that? V. medialis sure but there is no muscle called VMO. The oblique muscle bulk is large yes, but if you dissect a cadaver you'll see it's all one muscle....

tight hamstrings are a major cause of knee pain due to compression of the patella, try stretching your hamstrings, also gastrocs and soleus (if tight)....you should see a difference. Great to hear you have orthoses.

Hope this helps!

 

How do tight Hasmstrings compress the patella?

 

tight posterior muscles prevent full extension of the leg and a shorter stride length......both increase forces at the knee