Knees.

[hellomolly]

I went to a physical therapist recently and was told I have a mild patella tracking disorder in my left knee. Basically the inside thigh muscle is weaker than the outside thigh muscle and that causes my patella (kneecap) to "track" to the outside, instead of straight up and down as it should. This causes pain and discomfort and a really unpleasant 'rice crispies' sound when I bend my knee. The kneecap doesn't dislocate, though, as it does in more extreme cases...

She said my uber-flat feet are contributing to the problem. I absolutely can't afford $400 custom orthotics, so I have purchased a pair of Sole inserts and new, more supportive running shoes (PT said my shoes were probably not stable enough for my feet). I'm also doing PT exercises to strengthen that weak muscle, but it will take at least a month before that has any sort of effect. I am also taping my knee (using two types of medical tape to basically pull my kneecap in the right position and support it there).


I was wondering if anyone has any experience with this sort of problem (patella tracking disorder, that is) and if they have any suggestions as to what worked for them to remedy the problem? Specific types of shoes, inserts, exercises, therapies, etc etc etc. Note that this is different from illiotibial band syndrome and runners knee, etc.... though things that worked for those problems might help me too!

[Pedaling Fool]

I personally believe weightlifting/resistance training is under rated as a form of exercise. Most exercise regimens focus on cardio, which is important, but does not do much for the skeletal system. As people age you see many with back and knee problems I personally believe that if many of them had started a weightlifting regimen earlier in life would have prevented much of their ailments.

I had really bad knee problems over 10 years ago. The doc told me there’s nothing I could do, because it’s just normal aging and one day I would need surgery. However, I got started in weightlifting and I credit that with relieving much of my knee problems. I still have knee problems, but only periodically and probably from overdoing it a bit. I’m also very active at cycling and running, but I know the weightlifting keeps the knee in check.

"Pain Medication" does nothing, but mask the problem. I never take them; I just use the pain to guide me in what to do or not to do.

http://www.medicalnewstoday.com/articles/77017.php





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[Pedaling Fool]

...

She said my uber-flat feet are contributing to the problem. I absolutely can't afford $400 custom orthotics, so I have purchased a pair of Sole inserts and new, more supportive running shoes (PT said my shoes were probably not stable enough for my feet)....
BTW, I either run barefoot or with cheap walmart-special shoes, nothing special and no insoles. I've never bought the super-expensive running shoes. For the most part, they're all just a money-maker for business.

[fredmugs]

I personally believe weightlifting/resistance training is under rated as a form of exercise. .

I will confirm this as well. I used to get horrible knee pain and had to wear knee baces that really slowed me down. I started doing really hard workouts on an exercise bike starting at 30 minutes and working my way up to 60 minutes. I no longer have any knee pain and where a 15 mile day was complete misery I can now knock out 20+ mile days no problem.

[Kerosene]

You've got to be very careful with knees, as everyone is different and solutions tend to differ also.

However, patella tracking disorders are pretty common and should be able to be remediated with PT and a targeted weightlifting regimen. Unless your flat feet are abnormally deformed, then you shouldn't need the $400 custom orthotics; just make sure that you get the right $30-$70 orthotic that addresses your uber-flatness. I went the expensive route for my high arches, but later on I found it was overkill as I'm not that far out of the norm.

Contrary to fredmugs above, I would discourage you from starting any hard hike/bike workouts very soon. Certainly start biking, but start with light resistance and limited duration, building slowly to ensure your muscles and joints are ready for it.

Listen to your physical therapist, make sure your insoles work for you, and then keep on top of your exercises afterward while you increase the intensity of your cardio/weight workouts.

[RayBan]

You may want to look at a Cho-Pat knee brace- they make several kinds for different joint/muscle conditions and describe the function of each on their site along with the most common knee issues/potential remedies via bracing and exercise. http://www.cho-pat.com

[Berserker]

I agree with the other posters that said that weight training may be the answer, and at the least should help a good bit. I have the same problem and also went to physical therapy for it. The physical therapist tought me some good exercises to build up the muscles. Those helped some, but I didn't start getting decent results until I just went "old school" and started doing things like leg curls. I will also note that around that time I started walking regularly, and maybe 6 months after that I really started to notice the pain subside. I now walk regulary, and have been for a few years. Don't get me wrong, my knees still get sore occasionally, but not nearly as much as they used to. Oh yeah, and don't forget to stretch regularly...I'm terrible at remembering to do that.

One other thing I wanted to mention is that I was having issues around the same time with my ankles and feet getting sore. I tried all kinds of inserts and a custom pair of orthotics, and the walking (and walking specifically on trails) was the only thing that totally resolved that issue. I think my feet are "normal" in that I have a arch and whatnot (i.e. they're not flat), so this may not be applicable to your problem with your feet. I just thought is worth mentioning.

[TIDE-HSV]

I second all said above about weight training. I'm sitting here with leg elevated and ice on my right, formerly "good" knee, scheduled for meniscus surgery next Wednesday. The left one has had three surgeries - ACL and two meniscus. IOW, knee problems and I are old enemies. I have extremely high arches, as do many people with partial Cherokee heritage. I've used orthotics virtually my entire life, or at least from age six, when I broke one of my left metatarsals. The OTC orthotics have never helped me - they just don't even reach the bottom on my feet. Many years ago, I used to use podiatrists and be fitted for the rigid plastic orthotics, which perform well for me (some need some cushioning, or "give."). If I were still using a podiatrist, the cost would indeed be around $400 today, possibly more. A few years ago, on the recommendation of a friend, I ordered orthotics over the net. To my surprise, when the box of crushable foam arrived, it was exactly the same device as I'd used in the doc's office - one just stands on the foam in the box and it makes a custom mold of one's foot. At the site I ordered from, I just checked and their price is $189.90 - expensive, but not $400. That site is http://www.ourhealthnetwork.com/customorthotics/. There are other sites using the same technology. I haven't comparison-shopped in years, so there may be better deals out there. Just a suggestion...

[Elder]

The is an outstanding new footbed. www.orthosole.com (http://www.orthosole.com)
Great shock absorbing footbed with customizable arches.
It has a thermo plastic heel counter with gel shock spot. Adds stability, has helped friends with unstable knees.
$49.95

[TIDE-HSV]

The is an outstanding new footbed. www.orthosole.com (http://www.orthosole.com)
Great shock absorbing footbed with customizable arches.
It has a thermo plastic heel counter with gel shock spot. Adds stability, has helped friends with unstable knees.
$49.95

That's a great price. I'll check out the site. I have some just about to wear out...

[TIDE-HSV]

After looking at the Orthosole method, I'd doubt that they have enough adjustment for my feet. I've tried similar with less than optimum results. However, the OP has the opposite problem - flat feet, so they might do the job for hellomolly...

[Kerosene]

The OTC moldable insoles only go so far. If your feet our well outside the norm (e.g., very high arches, broken or deformed feet or toes, etc.) then the crushable foam molds are the way to go.

[gumball]

In addition to training noted above, I would suggest you check out the Cho-Pat. There are many similar knee bands that work just as well--Wally World carries them for about $12/knee. They go right under each patella and steady it. I have the same issue and a fellow runner suggested these--I decided to wear them on the trail and, viola, haven't had a problem with knees since.

[Ladytrekker]

I have been doing high intensity training (boot camp style workouts) for about 7 weeks. My knees have been my worst enemies during these workouts. I found that any exercise that had me going sideways or twising my knees such as kareokes just put them in such pain so I don't participate in them and lunges really hurt them, however, I can do squats and wall sits and my knees are finally getting much stronger I have really noticied a difference in them. We do 30 to 40 mins of cardio, then weight lifting, core and stretching. I really recommend it because you get it all in one workout I do this 3 times a week.

[Blissful]

I have this and switched to blue superfeet (which took a while to get used to), Brooks trail runners that help overpronation, and I now wear a cho pat brace (the dual one) on my left knee. No trouble at all with my last hike.