Foot orthotics can be crossed off the list for knee pain care for runners. A new study adds evidence to the theory that orthotics is the driving force of knee pain during running –partly because orthotics impair proprioceptive responses.
Proprioception (biofeedback) remains a critical element underlying selective neuromuscular strengthening through enhancements in muscle activation.
Foot Orthotics No Good for Knee Pain Care in Runners
To strengthen a muscle, it needs to have higher levels of activation. Proprioception essentially turns on muscle activation, and heightened proprioception corresponds to barefoot or barefoot like conditions. Therefore, barefoot and ultra minimalist shod conditions is co-opted for improvements in neuromuscular strength and are fundamentally important to knee health in forefoot running.
In most cases, runners find knee pain relief when they switch from heel strike to forefoot strike running. However, thick cushioned running shoes may incite patellofemoral joints stress during forefoot running.
Orthotics are commonly prescribed for treatment in knee pain, however their efficacy is perpetually questioned because they alter biomechanics and joint loading patterns, leading to more knee pain.
For example, Neptune et al. (2000) compared the effects of vastus medialis oblique neuromuscular strengthening and orthotics on knee pain in runners and found that orthotics were ineffective at reducing patellofemoral joint stress as compared with neuromuscular strengthening.
Their results showed that medialis oblique strengthening was the only treatment to significantly reduce peak and average lateral constraint forces on the knee, suggesting that neuromuscular strengthening is more clinically relevant than orthotics.
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References:
Neptune et al. The influence of orthotic devices and vastus medialis strength and timing on patellofemoral loads during running. Clin Biomech, 2000; 15, 611-618.
Bretta Riches
BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
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