I experience knee pain every time they run - pain in the knee cap (patella?) I pronate terribly! And I do wear orthotics. I'm new to this running thing, and am worried that I'm not going to be able to make it much past 6 miles. I LOVE running! But I'm worried that if I keep up running 4x/week I'll be damaging my knees. I've begun icing my right knee after I run.
Are there doctors at the Sunday/Vancouver meetings who I could talk to?
Thanks!
Andrea

Andrea,
A little more info from you can help me help you, faster. What is your age, weight, height? Is it just one knee or both? Who prescribed the orthotics a podiatrist, orthopedist, or chiropractor? Was your pronation problem causing pain in the knees, ankles or feet? Did they give you any strengthening exercises for your knees?

Usually the common cause of pain under the knee cap is deactivation of the gluteus muscles and a quad dominate gait cycle. With most people who have jobs that require prolonged sitting, their body thinks that the gluteus muscles are actually a padded cushion for sitting on instead of the primary extensor of the femur. The gluteus then becomes lazy and deactivated requiring the quads to become overworked, putting the quad insertion (the patella) in a postion of high stress and tension which leads to injury.

Follow up my questions and I will be able to help more.
Cheers,
Dr. Jake

I'm 32. 5'3" and about 125 pounds. It's both knees - but it seems like they alternate really hurting after a run. I ran last night and the left knee feels "tweaked" or twisted. The orthotics are about ten years old and I got them from a podiatrist. My left leg constantly hurts from hip to ankle for about the first 2 miles of long runs, and my right leg feels ok, besides some knee pain. On my right side, it's my foot that is at issue - multiple stress fractures, foot surgery, and a broken toe the first day of Vancouver Fit. I'm just a mess really.
As you guessed - I do sit all day at work.
I love running - just not the pain I'm in those first 2 miles and after!

I am not a doctor or any kind of medical practitioner. I have, however, worn orthotics for 15+ years and something you said set off alarms for me.

I have never seen an orthotic designed to last ten years. Mine have been made of various materials, but about 3 good years is the most I expect -- the ones I'm wearing now are probably good for 2 years or so. The lab that made your orthotics should have provided this information along with them. I've certainly worn orthotics beyond the recommended life, and I can tell you that will eventually cause pain. Your left leg sounds just like my right when an orthotic is worn out and no longer providing good support.

I'd try a new pair, and because I have had changes in my own feet I'd recommend having a new exam and fitting instead of using your ten-year-old information.

Robin, who knows the joy of a good orthotic!

Thanks for the information. I haven't used my orthotics for years because I just wasn't phycially active for years. After I had foot surgery I was going to get new orthotics but insurance didn't cover any of the cost and I didn't have $300-$400 to shell out for custom-fit orthotics. I'll have to see if my current insurance covers them now.
I appreciate your help and advice!!

Andrea,
I agree that you should definitly get new orthotics. Ten years is way too long. Another piece of the puzzle may be to have your leg lenght checked. With a lot of one sided complaints it is frequently the case that there is an anotomic short leg. A heel lift therapy can then by applied. (A six dollar wedge of rubber that can go under the orthotic). This helps to balance out the body and muscles to coordinate and perform more optimal. The gold standard for determining the difference in leg length is a scanogram or CT scan that measures each bone in the legs to determine the difference. The more economical version is a standing AP pelvis X-ray where the Radiologist can measure the height difference of the femur head in the socket.
Is there any chance you can make it over on a SAT to Pfit for a week and have one of the Dr.s check your leg length and determine if further evaluation is neccesary? If not have them check your leg legnth when getting your orthotics.
I hope this helps.
Dr Jake