At least 1 in 4 people with knee cap pain is likely to benefit from foot orthoses.
A simple test can show if you are likely to benefit:
Is pain decreased when squatting whilst wearing orthotics?
Research suggests that shoe inserts will significantly help reduce pain in anywhere between 25 and 50% of people with knee cap pain over the first 6-12 weeks of treatment. They may also help in the longer term too.
Traditionally, shoe inserts have been provided to people because they have flat (pronated) feet. However, there is a lot of debate about whether this is the right approach. In people with knee cap pain, having flatter feet does not predict strongly whether or not shoe inserts will help. Equally, shoe inserts can help people who are not considered to have flat feet.
A couple of studies have reported that people with flexible feet measured using a specific device are more likely benefit from shoe inserts if they have knee cap pain. This is something you could discuss and assess with the assistance of your physiotherapist or podiatrist.
One of the simplest ways to work out if shoe inserts will help is to try them during an activity that normally causes pain. If the inserts immediately reduce your pain, then they are likely to help. If they do not immediately reduce pain, they are unlikely to help you. It is that simple!
In one study, this test was the strongest predictor of success with shoe inserts given to people with knee cap pain. In the same study, the amount of foot movement (pronation) occurring during walking also predicted success, but not as well.
If shoe inserts are customised specifically for you by a podiatrist, they can be quite expensive. However, research tells us that this is not necessary for most people with knee cap pain.
Less expensive prefabricated shoe inserts (usually less than $100) can be used to treat knee cap pain. If you complete your rehabilitation exercises given to you by a physiotherapist and get stronger, shoe inserts may only be needed for a short time.
Some physiotherapists have the knowledge and skills to provide you shoe inserts and you should discuss this with the physiotherapist treating you. If not, they can refer you to see a podiatrist to help.
Barton 2010. The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review.
Barton 2011. The immediate effects of foot orthoses on functional performance in individuals with patellofemoral pain syndrome.
Barton 2011. Clinical predictors of foot orthoses efficacy in individuals with patellofemoral pain.
Lack 2014. Outcome predictors for conservative patellofemoral pain management: a systematic review and meta-analysis.
Mills 2012. A randomised control trial of short term efficacy of in-shoe foot orthoses compared with a wait and see policy for anterior knee pain and the role of foot mobility.