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Orthotics and Lateral Knee Compartment: A Response to a Reader's Question

Recently, one of our readers reached out with a great question: 

Reader's Question

"I have a 36 year old female marathon runner who has a pronated forefoot on the left.  She has had ACL reconstruction surgery on the left 15 years ago.  She recently had a lateral meniscal tear and arthroscopic surgery for debridement.  In the surgery the doctor found significant lateral femoral cartilage changes.  She wants to continue to run.  I feel an orthotic will help control her pronation and decrease her knee stress.  The podiatrist  wants to post the lateral side of the orthotic to help offload the lateral compartment of the knee.  Is this correct thinking or should she just have the arch supported to correct the forefoot?  Thanks for your help with my questions."


Our Response

Thanks for reaching out and great questions!  First off... a lateral wedge will offload the medial knee and is counter productive if you are issuing medial longitudinal arch support. By a pronatory forefoot I am assuming they mean forefoot Varus.  I think an “ arch” support can assist in limiting pronation (thus off loading the lateral knee). A medial wedge can also assist in this capacity. 
Shoes and gait modifications can also be of value. Would need to know more on that front. 
Don't forget how much running gait adjustments may be able to reduce compressive loads on the lateral compartment.  If she's a collapser, changing this could pay great dividends for her!
Thanks for reaching out!
The Certified Gait Analyst Team
If you have a question that you would like us to help with, feel free to reach out at [email protected].  We'll get to as many of them as we can!

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