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FOOT HEALTH Footwear/Biomechanics

Do Orthotics Help Knee Pain: What to Know About Insoles for Knee Pain Relief

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Knee pain can be frustrating to live with. Whether you have knee pain from arthritis, meniscus tears, or patello-femoral pain syndrome (Runners knee), it can limit your activities significantly.  

If you have knee discomfort, you may feel pain, stiffness, and even cracking in the knee with activity. Knee pain can be exacerbated by certain foot conditions.

So do orthotics help knee pain?

Orthotic inserts can be beneficial in helping reduce knee pain that occurs when standing and moving. Orthotic inserts can help redistribute pressure in the knees allowing for pain reduction. This is especially true if you have flat feet. Supportive inserts should be worn constantly to see maximum benefit.  

In this article, you’ll learn about the benefits of wearing foot orthoses for knee pain. 

orthotic inserts

How Are Orthotic Inserts Beneficial in Reducing Knee Pain?

Although pain can occur anywhere in the knee, the most common area that people experience pain is along the inside of the knee. 

About 60 to 80 percent of the load is distributed through the medial (inner) compartment of the normal knee during stance (1).

This area can become arthritic and the excess load placed on this area can cause pain. If you are flat-footed and roll inwards as you walk, you may be placing additional load on the inner knee. 

Flat feet have been associated with more frequent knee pain and cartilage damage in people with knee osteoarthritis (2).

Orthotic inserts help to correct the alignment of your feet and ankles, as well as change the way you walk and put pressure in specific areas.

If you wear the proper orthotics for your foot structure, it naturally improves the alignment of your knee joint as well. 

Not only that, orthotics can also help improve posture, which also can also be beneficial for knee pain. 

Orthotic inserts help with shock absorption. 

Now-a-days, there are many materials that are used to construct orthotics. Certain materials like EVA (Ethylene Vinyl Acetates) are great for shock absorption. 

knee pain running

What Are the Best Orthotic Shoe Inserts for Knee Pain?

If you experience knee pain on the inside of your knee joint, lateral wedge orthotic inserts with an arch support can be beneficial in reducing pain. 

This means that the outside portion of your orthotics should have a small wedge, with the inside portion of your orthotic tapered down. 

This will assure that less strain is placed on the inner knee when you are standing and walking. 

The lateral wedge should be 4-5mm thick. A wedge thicker than that can feel uncomfortable. 

So you may be wondering…if you are trying to tilt the foot inwards to alleviate knee pain, won’t you have worsening foot and ankle pain by causing the foot to rotate too far inwards? 

Studies have shown that people who suffer from knee pain feel more comfortable wearing inserts that have arch support in them in addition to the lateral wedge. 

A study was done in the Journal of Orthopaedic Research on 26 patients who had knee arthritis (3). They studied knee/ankle/foot biomechanics and also assessed comfort level in patients who wore lateral wedges in their shoes versus lateral wedge orthotics with arch support. 

What they found was that their patients felt more comfort when wearing lateral wedges plus arch support. 

A custom fit orthotic would be the best option for your feet and knees. You can visit your local foot doctor and request custom orthotics with a lateral wedge. 

Your doctor will take a mold of your feet and design the orthotic inserts for your foot structure. Custom inserts will last 5-10 years depending on how much you wear them. 

Pro-tip: Check with your insurance first to see if orthotic inserts would be a covered option for you. Custom orthotic inserts can be pricey and can vary from $300 to $800 depending on where you go.

What if You Can’t Get Custom Fit Orthotics? 

I would recommend buying a lateral base heel wedge on Amazon listed here. This lateral base heel wedge is ¼” thick on the outside. 

Place it underneath your shoe liners. This should help relieve some pressure along your inner knees and lower back.

If you have pain in the outside of your knee and cannot get custom inserts, I would recommend you wear orthotic inserts that have arch support in them, such as the Powerstep Protech insert

You can wear this insert for 6 months to 1 year before replacing them. It has a firm arch with a deep heel cup. The material is firm but still helps with shock absorption. 

knee pain jogging

Can Insoles Cause Knee Pain?

Orthotics are not a good option for everyone who suffers from knee pain. If you have severe arthritis in the knee, a severe injury, or nerve pain in the knees, orthotics may not be beneficial. In these cases, orthotics can cause your knees to hurt more. 

Not only that, wearing inappropriate orthotics for your foot structure can cause pain. If you have flat feet, you would require a different orthotic than someone who has high-arched feet. 

Even if you get custom orthotics, you may need minor adjustments made to the orthotics. You should make sure to see your foot doctor to confirm that the orthotics fit correctly. 

Orthotics should be worn gradually over the course of a week. Wear them for no more than 1-2 hours the first day, 2-3 hours the second day, and so on. After a week, your feet should be somewhat used to them. 

If you wear new orthotics all day long the first day, your knee pain may become worse.

orthotic fitting

Should You Wear Orthotics All the Time to Relieve Pain in the knees?

When you wear orthotic inserts regularly, it is essentially changing the way you walk and redistributing pressure. Once your feet are used to wearing orthotics, you will likely need to wear orthotics daily. 

It’s best to wear your orthotic inserts in athletic shoes during the day. If you have slippers that you wear at home, you can try placing your orthotic inserts in your slippers to provide some support. 

Stay consistent to see the best results. 

orthotics

How Often Should You Replace Your Orthotics?

Custom-made orthotic inserts generally last 5 to 10 years.  

Over-the-counter inserts such as Powerstep inserts can last anywhere from 6 months to 1 year depending on activity. 

If you notice a sign of wear in the orthotic or lack of arch support, it’s time to replace them.  

When Should You See a Medical Doctor for Your Feet?

While orthotic inserts can provide relief for knee pain, there are certain instances where it is advisable to seek medical attention for your feet. If you experience persistent or severe knee pain that does not improve with the use of orthotics or other conservative measures, it is important to consult a medical doctor.

Additionally, if you have underlying conditions such as severe arthritis in the knee, a significant injury, or nerve pain in the knees, orthotics may not be the appropriate solution, and a medical doctor can help determine the best course of action for your specific situation.

Furthermore, if you are unsure about the suitability or fit of your orthotics, it is recommended to visit a foot doctor for an evaluation and potential adjustments to ensure proper alignment and effectiveness.

Your foot doctor will have the expertise to assess your condition and provide appropriate guidance for your foot and knee health.

Conclusion

In conclusion, although knee pain can be uncomfortable to live with, you can take action to alleviate some of the discomfort. Orthotic inserts can be a great option to help stabilize your feet, improve posture, and help reduce pressure in the knees. It’s a fairly simple conservative treatment option that can be beneficial in reducing chronic knee pain. 

Related article: A Detailed Guide On How Bad Shoes Can Cause Foot Pain

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References

  1. Johnson F, Leitl S, Waugh W. The distribution of load across the knee. A comparison of static and dynamic measurements. J Bone Joint Surg Br. 1980 Aug;62(3):346-9. https://pubmed.ncbi.nlm.nih.gov/7410467
  2. Gross KD, Felson DT, Niu J, Hunter DJ, Guermazi A, Roemer FW, Dufour AB, Gensure RH, Hannan MT. Association of flat feet with knee pain and cartilage damage in older adults. Arthritis Care Res (Hoboken). 2011 Jul;63(7):937-44. https://pubmed.ncbi.nlm.nih.gov/21717597/
  3. (Hatfield GL, Cochrane CK, Takacs J, Krowchuk NM, Chang R, Hinman RS, Hunt MA. Knee and ankle biomechanics with lateral wedges with and without a custom arch support in those with medial knee osteoarthritis and flat feet. J Orthop Res. 2016 Sep;34(9):1597-605. https://pubmed.ncbi.nlm.nih.gov/26800087/).
  4. Jones RK, Chapman GJ, Parkes MJ, Forsythe L, Felson DT. The effect of different types of insoles or shoe modifications on medial loading of the knee in persons with medial knee osteoarthritis: a randomised trial. J Orthop Res. 2015 Nov;33(11):1646-54. https://pubmed.ncbi.nlm.nih.gov/25991385/
  5. Budarick AR, Bishop EL, Clark ML, Cowper-Smith CD. Preliminary Evaluation of a New Orthotic for Patellofemoral and Multicompartment Knee Osteoarthritis. Rehabil Res Pract. 2021 Sep 6;2021:5923721. https://pubmed.ncbi.nlm.nih.gov/34540291/
  6. Bennell KL, Bowles KA, Payne C, Cicuttini F, Williamson E, Forbes A, Hanna F, Davies-Tuck M, Harris A, Hinman RS. Lateral wedge insoles for medial knee osteoarthritis: 12 month randomised controlled trial. BMJ. 2011 May 18;342:d2912. https://pubmed.ncbi.nlm.nih.gov/21593096/
  7. Hetsroni I, Finestone A, Milgrom C, Sira DB, Nyska M, Radeva-Petrova D, Ayalon M. A prospective biomechanical study of the association between foot pronation and the incidence of anterior knee pain among military recruits. J Bone Joint Surg Br. 2006 Jul;88(7):905-8.https://pubmed.ncbi.nlm.nih.gov/16798993/

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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