Flat feet, fallen arches, pronation (all the same problem)
This mostly evidences as knee pain but here’s many causes of knee pain though. If you have one knee that hurts and the other never does, that’s likely a knee injury to the tendon, ligament, meniscus or cartilage. Unilateral or one sided are usually the knee itself. If you have both knees or alternating knee pain that’s going to be from flat feet and low back problems. This destroys both knees over time.
A third cause mostly in children but now seeing in adults is Lyme Disease. That's another post in the future to address that large topic.
The first situation, local single knee problems themselves, from some injury to the knee during your life, can usually be addressed early on by adjusting the knee and supporting it with strengthening and PT exercises and a brace. After years however, this becomes less helpful or less effective at relieving the problem. You can use cartilage building supplements to slow the damage. Chondroitin sulfate and glucosamine sulfate (mostly sold together in one supplement nowadays) is helpful.
Further diagnosis to sort out meniscus from cartilage from ligament, is best done with MRI. X-rays only show cartilage loss and how close you are to knee replacement.
Bilateral knee problems are unlikely to be caused by a trauma or injury. They are more likely the result of alignment of the tibia below the femur due to flat arches or alignment of the femur due to low back problems, like sway back.
This develops rather early in life. If your teenager is having knee problems on both sides, this is likely the case. Whether the cause is flat fee, swayback or both, this requires chiropractic care. Primarily to correct the swayback but also, the bones of the feet can be adjusted to correct a bit of the fallen arch.
High top tennis shoes or workboots helps this problem as well as arch supports. Most people with this problem have already figured out they just feel better in high top shoes and are already wearing them.
Arch supports are difficult but necessary for some. Kids are loathe to use them so, do what you can for them. It’s a battle I’ve noticed. Do what you can but there’s probably bigger things when raising kids.
As for adults, well you can be reasoned with. If you have knee pains or low back pains, this is simple and you should incorporate into your wardrobe. The arch supports available range from simple Dr. Scholl’s to custom molded orthotics fit to your foot. Having spent a few decades fitting custom ones for people, I’ve observed they ARE better than “off the shelf” versions but the difference in price is literally $3-400 versus $30. They aren’t ten times better. They are maybe 1.5 times better. That said, if you are significantly overweight, spend a lot of time on your feet like a UPS delivery driver or warehouse worker, you might be the person to invest in custom orthotics and have it pay off.
I don’t have any relationship with any of the companies that sell these. Foot Levelers are one of the best custom ones. Walk Fit are probably the best value off the shelf $30 version. The ones at Walgreens and CVS are fine to get started or to keep in your spare shoes.
Initially, you may have arch discomfort so use them as long as you can and try again the next day to go longer until they feel normal. It takes a few weeks.
The benefits are decreased knee and low back pain. Better golf swing and ball distance. Less foot problems.
Hopefully, you can find some help with this and keep you running and jumping.
Dr. Barrett
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