What to expect from custom orthotics for patellofemoral pain syndrome

Patellofemoral pain syndrome commonly causes pain around or behind the kneecap, especially with stairs, squatting, running, or prolonged sitting. For some people, the way the foot rolls and the leg turns during weight-bearing influences knee loading. An orthotic can guide that movement and may make activity more comfortable.

The insert is one part of care, not a replacement for strengthening or movement retraining. A clinician considers your walking pattern, footwear, hip and knee control, and the activity that brings on pain before deciding whether an orthotic is appropriate.

Begin with brief wear in supportive shoes, then increase time as tolerated. Keep track of pain during stairs, sitting, and exercise rather than judging the device after a single walk. Continue the prescribed exercises unless your clinician changes them, and reduce activities that sharply aggravate the knee while it settles.

Bring your main activity shoes to the fitting. A review may address the device, your exercise technique, or the amount of activity. A comfortable fit should not create new pressure at the arch, heel, or toes.

Ask for a review if knee pain worsens, the orthotic causes foot or ankle discomfort, or you cannot wear it in your usual shoes. Seek prompt care after a twisting injury with major swelling, a locked knee, inability to bear weight, or new weakness.

Ask what movement the orthotic is intended to change, how it fits with your strengthening plan, which activities to modify, and when improvement should be assessed. Ask what to do if pain remains during stairs or sitting despite a good fit.