Disclaimer: The information provided in this post is for educational purposes only. This is not a substitute for a medical appointment. Please refer to your physician before starting any exercise program.
The Best Insoles for Anterior Knee Pain and Patellar Dysfunction
The knees are complex joints that play a central role in our ability to exercise, labor, and perform routine activities. With so much repetitive use, there’s no wonder knee injuries and knee pain are common. Knees have many functions, including stabilization, maintaining balance, weight-bearing, and the overall task of enabling the successful bending and rotation required for most of us to go about our daily lives. When you’re suffering from knee pain, however, normal activities like running, climbing and descending stairs, or movements required for work or recreation, can be difficult and uncomfortable. Though there are a variety of reasons for knee pain, one common cause to look out for is Patella Tracking Dysfunction, also known as Patellofemoral Syndrome.
What is Patellofemoral Syndrome?
Patellofemoral Syndrome is a condition in which the patella, or knee cap, shifts during the bending and straightening of the leg. The patella is meant to glide smoothly along a groove in the femur called the trochlea, and, in fact, there are many components in the knee that help to keep it tracking properly. Problems with any of these components can lead to a “tracking” dysfunction, which causes friction and therefore pain. The pain associated with Patellofemoral Syndrome is “anterior knee pain” because––as the name suggests––it is felt in the front of the knee, or in the patella region.
Patellofemoral Pain Syndrome Explained
Anatomy of The Knee and Patella Region
The patella is an almost diamond-shaped bone at the front of the knee that acts as a “cap,” protecting the inner workings of the knee joint. This includes the ends of the femur (thigh bone) and tibia (shin bone), along with tendons, ligaments, cartilage, and other soft tissue. Cartilage lines the underside of the patella, helping it glide smoothly along the trochlear groove located on the end of the femur. The tendons and ligaments help to stabilize the patella and keep it in its proper place.
Symptoms of Patella Femoral Syndrome
Pain is the most commonly reported symptom of Patellofemoral Syndrome; however, it’s important to note the type and location of the pain, as well as when it improves or worsens. Some signs the pain may be a result of Patellofemoral Syndrome are as follows:
- The pain is a dull ache and is localized under, in front of, or around the knee cap
- The pain is worse with exercise that requires frequent bending and straightening of the knee
- The pain is worse sitting with bent knees for a prolonged period of time
- There is clicking, popping, or grinding of the kneecap
- The onset of the pain occurred after a change in frequency or intensity of physical activity, such as a sudden change in an exercise routine
- In severe cases, the knee cap may be dislocated resulting in extreme pain and swelling
Diagnosing Patellofemoral Syndrome
Diagnosising Patellofemoral disorder is done by exclusion more than by specific testing. Your physcian may order x-rays or an MRI but these are often not needed and may not provide any valuable information needed to diagnoose other than to rule out intra-articular pathology.
Diagnostic criteria for Patellofomeral pain syndrome includes:
- Pain behind the knee cap or around the knee cap AND
- Reproduction of symptoms with squatting, stairs, prolonged sitting, and other activities with the knee joint loaded
- Exclusions of other coniditions that may cause anterior knee pain
Do Orthotics Help with Anterior Knee Pain
Depending on the cause of your anterior knee pain, orthotics could be all you need to eradicate your symptoms. For optimal knee function and the appropriate positioning of the patella during movement, it is important to maintain healthy hip and leg alignment, which will also prevent prolonged pronation. In turn, proper alignment of the foot and ankle helps to correct overall alignment and has a positive impact on knee health. Although pronation is normal––it is the inward rolling movement of your foot as you step down, and an important motion for absorbing shock (and protecting the knee!)––over-pronation or prolonged pronation, which can be caused by injuries and biomechanical issues, can impede the normal patellofemoral range of movement. Orthotics support the arch of the foot, keeping the whole leg in alignment and therefore preventing patella tracking dysfunction and relieving pain.
What to Look for in an Orthotic for Anterior Knee Pain
- Comfort – Make sure they are properly fitted to your shoes and your feet and are comfortable enough to wear throughout the duration of your activities.
- Arch support and height – The right height and support for the arch are important factors, but keep in mind that you don’t want the support to be so rigid it doesn’t allow for healthy pronation.
- Cost – Don’t let the price determine the orthotics you choose. Cheap or expensive, if they aren’t the right insoles for you, they could end up doing more harm than good.
- Shock Absorption – Padding, especially at the heel, will absorb shock and lessen the impact on your joints.
- Cushioning – Comfort is important for footwear, and cushioning certainly adds comfort; however, do remember that a combination of rigidity and flexibility is advised for the best support.
The Best Insoles For Anterior Knee Pain
Superfeet Blue Insoles
Summary: The Superfeet Blue Insoles Medium Arch are made with high-density foam, a stabilizer cap for structure, a heel cap for keeping the foot in place, and a medium profile that offers quality support and fits a variety of shoes.
- Excellent heel support
- Fit shoes well
- Some customers say they take a while to break-in
Physix Gear Sport Full Length Orthotic Inserts
Summary: The Physix Gear Sport Full Length Orthotic Inserts are designed with performance in mind. The arch support, durable materials, and non-slip technology make these a great choice for athletes.
- Thin enough to fit a variety of shoes
- Great for anyone looking primarily for arch support
- Very little cushioning
Giotto Orthotic for Anterior Knee Pain
Summary: The Giotto Orthotics boasts versatile support, durability, heel stability, antimicrobial material, and semi-rigid arch support. In addition, the orthotics come with a 30-day unconditional replacement or refund.
- Lasting arch support
- Don’t require much breaking in
- Excellent heel stability
- Some customers report they are not ideal for wide feet
FootBalance QuickFit Control Insoles
Summary: The FootBalance QuickFit Control Insoles are moldable foot supports that provide a custom fit and assist with proper alignment and posture. They fit well in tight-fitting performance footwear such as cleats, skates, ski shoes, and so on.
- Comfortable custom fit
- Great for sport footwear
- Full refund within 30 days of purchase
- Not as ideal for wide feet
Tread Labs Stride Insoles
Summary: The Tread Labs Stride Insoles are semi-custom orthotic inserts with stabilizing heel support and firm and flexible arches to help with alignment and pronation issues.
- Good shoe fit
- Great arch support
- Great heel support
- Not ideal for wide feet
- Some customers report that while walking the rubber and plastic produce squeaking sounds
Anterior knee pain is inconvenient at best and often debilitating. But pain is a sign that something is wrong, and in the case of anterior knee pain, that something is often misalignment causing patellofemoral tracking dysfunction. To eradicate pain, it’s necessary to get to the root of the problem, and for many, the solution to anterior knee pain is simply finding the right orthotics to support their feet and ankles and improve overall alignment.
“Patellofemoral Pain Syndrome.” American Academy of Orthopaedic Surgeons, Feb. 2015, https://orthoinfo.aaos.org/en/diseases–conditions/patellofemoral-pain-syndrome/ Accessed 24 Sept. 2019.
Juhn, Mark S. “Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment.” American Family Physician, 1 Nov., 1999, https://www.aafp.org/afp/1999/1101/p2012.html Accessed 24 Sept. 2019.
“Patellofemoral Dysfunction.” Sydney Orthopaedic Trauma and Reconstructive Surgery, n.d., https://orthotrauma.com.au/knee-conditions/patellofemoral-dysfunction/ Accessed 24 Sept. 2019.
Barclay, Tim. “Knee Joint.” Innerbody, 16 July 2019, https://www.innerbody.com/image/skel16.html Accessed 24 Sept. 2019.
Gross, Michael T., Judy L. Foxworth. “The Role of Foot Orthoses as an Intervention for Patellofemoral Pain.” Journal of Orthopaedic and Sports Physical Therapy, issue 11, vol. 33, pp. 661-670, November 2003, https://www.jospt.org/doi/pdf/10.2519/jospt.2003.33.11.661
Accessed 24 Sept. 2019.
Appold, Karen. “Reasons Orthotics Help Knee Pain.” Chiropractic Economics, 2 July 2015, https://www.chiroeco.com/7-ways-orthotics-can-help-knee-pain/ Accessed 24 Sept. 2019.