patella femoral dysfunction?

[jordansahls]

I need some input from other climbers on this one. Around 5 years ago, I got a pair of orthotics for my knees due to collapsed arches. I used those orthotics for everything. every walk to class, climb, hike, ect. in the last 5 years has been in those orthotics. I never had any knee problems minus the occasional ache after a long, steep descent. Anyway, they died around a month back, I completely shredded them to dust. I kept climbing, and now my knees have been aching all the time, especially after a climb or hike. I think that my joints had adjusted so much to the orthotics that I experienced a rebound effect after I stopped use.

 

So here is my dilemma, should I get another pair of orthotics (really expensive), or should I try something like Superfeet? I'm not sure if I should just go see the damned doctor, the last thing I want is a bunch of expensive testing. Thoughts, recommendations?

Edited October 22, 2009 by jordansahls

[denalidave]

Not sure if you already looked into it, but I was able to re-order new custom orthotics from the originally mold at a much cheaper price than the original since they already had the fit mold on file. It was still around $100 but that is money well spent in my book. I have not have had nearly the results w/Super Feet but maybe I did not get fitted right with them.

[jordansahls]

Thanks, I will definitely look into that.

[i_like_sun]

I need some input from other climbers on this one. Around 5 years ago, I got a pair of orthotics for my knees due to collapsed arches. I used those orthotics for everything. every walk to class, climb, hike, ect. in the last 5 years has been in those orthotics. I never had any knee problems minus the occasional ache after a long, steep descent. Anyway, they died around a month back, I completely shredded them to dust. I kept climbing, and now my knees have been aching all the time, especially after a climb or hike. I think that my joints had adjusted so much to the orthotics that I experienced a rebound effect after I stopped use.

 

So here is my dilemma, should I get another pair of orthotics (really expensive), or should I try something like Superfeet? I'm not sure if I should just go see the damned doctor, the last thing I want is a bunch of expensive testing. Thoughts, recommendations?

 

 

So this is actually a GREAT discussion topic.

 

There are basically three camps of kinesiologists when it comes to orthotics problems.

 

First Camp: Most physical therapists fall into this one. They would say "YES!!! GET NEW ORTHOTICS AS SOON AS POSSIBLE!!" Walking around without them will destroy your ankles knees hips and back!!

 

Second Camp: This is where most Kinesiology researchers stand. "No!! Orthotics will make your feet weak and make your problems worse by deactivating intrinsic foot muscles and alter biomechanics for the worse!!!"

 

Third Camp: And this is where I fall into. "Yes, get new orthotics" BUT "Don't allow yourself to become dependent on them".

 

In other words, you don't need to wear them 24/7 for EVERY activity. It is healthy for your motor control system to get a zero-control platform every once in a while (meaning a shoe that has no motion control). This is evident from studies on barefoot running. Eliminating the orthotic does allow you to develop motor pathways that elicit strength development, but if your arch is collapsed you might need an orthotic that "shows" your brain how to hold your feet.

 

Basically, the orthotic can serve two purposes:

 

1) To do what your PT wants, and correct your biomechanics by applying specific ground reaction forces on the bottom of your foot.

 

2) To give your brain a "model" on how to hold your feet, knees, hips and back.

 

You are probably correct in that your knee pain arose because of a rapid change in foot mechanics. You probably were so used to the orthotic that you were dependent on it. So, for the mean time my best guess would be that you should replace it to stop the pain. Then, practice walking and running without it form time to time, and see what you can do. You can also practice doing things like barefoot squats and lunges in front of a mirror, and really visualize how your foot arches, ankles, knees, hips and back are supposed to look and feel when things are working properly.. Then do the same thing with the orthotic, and compare each condition.

 

Hope that helps. I have shitty feet too.

 

Cheers.

[jordansahls]

Great post I like Sun, Very informative and helpful. I am wearing a pair of the green super feet for the meantime, and I am scheduled to go and see the physical terrorist here soon (I want to get strong for ski and ice season). I will mention my worries about "deactivating intrinsic foot muscles" as you put it, or in my case, re-strengthening those biomechanical pathways.

[fern]

put a towel on the floor of your kitchen in front of the sink and on the floor of your bathroom in front of the potty and anywhere else handy. Everytime you go #2 or wash your dishes take your shoes off and practice scrunching the towel up using your toes - alternate feet. You can make it harder by weighting down the far end of the towel (eg. with the shoes you just took off) and pull that weight towards you by scrunching up the towel.

 

Something about Superfeet that I have found, is that you need to try lots of different sizes - not in a shoe just stand on them on the ground, to find the ones that have an arch that feels best for your foot - it may not be your actual shoe size. I wear sz7 womens but my Superfeet in my ski boots are chopped down sz 9.5

[i_like_sun]

So last night for Halloween I was a 1980's rock climbing instructor, and part of my costume was that I wore really old rock shoes.

 

I spent 7 hours out clubbing, walking around in these old haggard climbing shoes that have ZERO support. Today, I'm finding that my knees are REALLY freaking sore because I had no arch support for all those hours. Because my feet are totally flat and I pronate pretty bad, spending all night in a shoe that literally splints my foot into a flat position made it such that even if I wanted to stand with my feet in a good position, I couldn't. I'm realizing that my patella probably wasn't tracking right because of this, and now I'm having that old knee pain I used to get before orthotics saved my life.

 

Just thought I'd share. Biomechanics are RAAAAAAAAAAAD