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Hi guys,

I'm a current podiatrist student and helping out with my local running club, I've been seeing a runner who is having a nightmare with injuries. I'm looking some advice on what else I can offer as I've suggested corrective exercises and also rest, but problems keep coming back.

The client has a knee injury at the moment which started about six weeks ago in the right knee on the inside during a 14 mile run (after 8 miles) wearing a mild pronation shoe (saucing pro grid 6) along with a sole insole for support. I done a gait analysis and suggested he should be wearing a neutral trainer as he supinate.

Prior to this he was wearing brooks adrenaline and saucony progrid (mild pronation trainer). He had seen a local sports podiatrist for posterior shin splints and Achilles tendinitis on both legs and now has picked a knee pain on right leg and now on the left, assuming its runners knee. All within the last 12 months.

He has also been to a physio and said it was runners knee and another podiatrist who said he supinates and needs orthotics due to his gait. But wears sole insoles. I'm just a bit limited and treating to gain some experience any help guidance would be great.

His lower legs are slightly bowed.

I haven't a clue where to go from here or what to do, any help/advice would be greatly appreciated.

Thanks

 

To figure out any diagnosis you start with a history. You have some history there. (Enough? What motion, activity, or position makes pain worse? What else has he done to treat it.....) Next you do a physical exam. If this subject is willing you can learn all that you can about the knee exam and then practice that on your subject. You also need to do a foot exam. Then if you have an idea of what you are looking for you could order some imaging.

Other things to think about. How does STJ supination cause knee problems. Is the STJ supination the cause of the problem, or is the problem caused by whatever is causing the STJ supination. What causes STJ supination? Is it STJ supination or is the rearfoot inverted and maximally pronated. How does genu varum (Bowed legs) affect joint forces at the knee? What anatomical structure is injured? (What part of the knee) What increases force and what decreases force on that anatomical structure?

Terminology issues. What do you mean by a pronation shoe. Do you mean anti pronation shoe? (what makes an anti pronation shoe an anti pronation shoe?)

Eric