Dodgy painful knees - podiatrist?

[zebedee]

I've had enough with my knee pain, which I only get when fell walking, and usually starts after 10 mins or so of descending and builds to a very painful stabbing sensation in the lower outside of my kneecaps where a muscle comes up from the lower leg and attaches in (usually right knee first, left shortly after). I reckon that I must descend slightly "bow-legged" and therefore put strain on the outside of my knees - as soon as it levels off or I climb again, or jump in the car at the end of the walk, there is no more pain. I tend to wear-out the soles of my shoes on the 3/4 point of my heel (to the outside) so clearly am not putting my foot down straight. I thought I might need surgery (I need to do something about it because I love fellwalking and it is very painful) but having noted wear my shoes are wearing, I assume I could have a footpad specially made to correct this. Has anyone had any similar experience of a succesful outcome with a podiatrist-made footpad relating to knee problems, rather than ankle problems?

[AdeTuono]

Judging by your user name, you need re-springing.

[Fleegle]

How bow legged are you?

Could you trap a pig in an alley?

[plg101]

zebedee said:

I've had enough with my knee pain, which I only get when fell walking, and usually starts after 10 mins or so of descending and builds to a very painful stabbing sensation in the lower outside of my kneecaps where a muscle comes up from the lower leg and attaches in (usually right knee first, left shortly after). I reckon that I must descend slightly "bow-legged" and therefore put strain on the outside of my knees - as soon as it levels off or I climb again, or jump in the car at the end of the walk, there is no more pain. I tend to wear-out the soles of my shoes on the 3/4 point of my heel (to the outside) so clearly am not putting my foot down straight. I thought I might need surgery (I need to do something about it because I love fellwalking and it is very painful) but having noted wear my shoes are wearing, I assume I could have a footpad specially made to correct this. Has anyone had any similar experience of a succesful outcome with a podiatrist-made footpad relating to knee problems, rather than ankle problems?

Doctor, refer to specialist.... get the root cause fixed... Maybe physio to strengthen the muscles around your knee to help it slide the right way.

I'm not an expert. In my case it helped doing both. I found that the muscles on the inside had wasted so that the knee wasn't sliding straight, but the root cause was debris inside the joint from an old injury.

If you can afford it and want to jump the queue, BUPA are quite good.

Mine went from being painful every walk (and very bad swelling on multi day walks) to being able to train well, ski, and planning a major alpine trek next year...

[zebedee]

very good with the zebedee thing, probably not far wrong!

Not that bow-legged, though I haven't attempted said porcine entrapment activity, it would be marginal, but enough clearly to put strain where the joint/muscles can't cope with it.

[zebedee]

plg101 said:

zebedee said:

I've had enough with my knee pain, which I only get when fell walking, and usually starts after 10 mins or so of descending and builds to a very painful stabbing sensation in the lower outside of my kneecaps where a muscle comes up from the lower leg and attaches in (usually right knee first, left shortly after). I reckon that I must descend slightly "bow-legged" and therefore put strain on the outside of my knees - as soon as it levels off or I climb again, or jump in the car at the end of the walk, there is no more pain. I tend to wear-out the soles of my shoes on the 3/4 point of my heel (to the outside) so clearly am not putting my foot down straight. I thought I might need surgery (I need to do something about it because I love fellwalking and it is very painful) but having noted wear my shoes are wearing, I assume I could have a footpad specially made to correct this. Has anyone had any similar experience of a succesful outcome with a podiatrist-made footpad relating to knee problems, rather than ankle problems?

Doctor, refer to specialist.... get the root cause fixed... Maybe physio to strengthen the muscles around your knee to help it slide the right way.

I'm not an expert. In my case it helped doing both. I found that the muscles on the inside had wasted so that the knee wasn't sliding straight, but the root cause was debris inside the joint from an old injury.

If you can afford it and want to jump the queue, BUPA are quite good.

Mine went from being painful every walk (and very bad swelling on multi day walks) to being able to train well, ski, and planning a major alpine trek next year...

When you say both - do you mean insert and physio or physio and medical advice? I'm just thinking the podiatrist is pretty specialist themselves, so should give me some good pointers and a fair chance of a cure, all within the cost of BUPA 'investigations'?

[henrycrun]

Not answering your question, but would using walking poles help to remove some of the load ?

[plg101]

zebedee said:

plg101 said:

zebedee said:

I've had enough with my knee pain, which I only get when fell walking, and usually starts after 10 mins or so of descending and builds to a very painful stabbing sensation in the lower outside of my kneecaps where a muscle comes up from the lower leg and attaches in (usually right knee first, left shortly after). I reckon that I must descend slightly "bow-legged" and therefore put strain on the outside of my knees - as soon as it levels off or I climb again, or jump in the car at the end of the walk, there is no more pain. I tend to wear-out the soles of my shoes on the 3/4 point of my heel (to the outside) so clearly am not putting my foot down straight. I thought I might need surgery (I need to do something about it because I love fellwalking and it is very painful) but having noted wear my shoes are wearing, I assume I could have a footpad specially made to correct this. Has anyone had any similar experience of a succesful outcome with a podiatrist-made footpad relating to knee problems, rather than ankle problems?

Doctor, refer to specialist.... get the root cause fixed... Maybe physio to strengthen the muscles around your knee to help it slide the right way.

I'm not an expert. In my case it helped doing both. I found that the muscles on the inside had wasted so that the knee wasn't sliding straight, but the root cause was debris inside the joint from an old injury.

If you can afford it and want to jump the queue, BUPA are quite good.

Mine went from being painful every walk (and very bad swelling on multi day walks) to being able to train well, ski, and planning a major alpine trek next year...

When you say both - do you mean insert and physio or physio and medical advice? I'm just thinking the podiatrist is pretty specialist themselves, so should give me some good pointers and a fair chance of a cure, all within the cost of BUPA 'investigations'?

I mean get referred by your GP to an NHS specialist either way - it doesn't cost and he will advise something... but may take some time. A good physio will give you a view on range of movement, strengthening exercises that will probably help and not risk making it worse. Go for BUPA if you have the funds and want a quick turnaround.

The insert feels like fixing an issue when you don't know the cause - it might help, it might make it worse - it might feel better in teh short term but cover up a bigger long term problem.

A bit like going for new shock absorbers to fix handling when it turns out to be a twisted chassis...

I'm just saying it worked for me, I make no guarantees - knees are complex things and the root cause can be unlinked to the knees (one friend who had bad knee problems - it turned out to be a back issue...)

Feel free to PM me.

[tegwin]

Sounds like osgood schlatters to me

[zebedee]

henrycrun said:

Not answering your question, but would using walking poles help to remove some of the load ?

Yes, it slows the onset of pain, presumably by taking some of the weight and limiting the twisting that my knee and muscles otherwise have to do. It still hurts eventually though.

I can't wait for NHS referrals I don't think, but I guess I could get the ball rolling at least. Doubt I could afford a course of BUPA investigation and treatment either. I understand a Podiatrist would see if they agreed any correction was necessary and if so, do me a custom insert for around £150-£200, and if it doesn't work, I've heard of people being refunded. I'm assuming BUPA would cost me more than that without arriving at a solution?

[Ayahuasca]

I have experienced the same on fell-walking descents. Uphill or level is fine; downhill, after a while, is murder. As someone said above, Leki poles help enormously.

[zebedee]

tegwin said:

Sounds like osgood schlatters to me

Looked at that on Wikipedia. Don't think so because 1) I'm a fair bit older than that! 2) No lump there 3) the pain is only during the activity of descending, it stops immediately that it levels out or I climb, there is a marginal bit of tenderness, but it wouldn't hurt especially to strike the area or prod it around even when it is at its worst. This is why I think it must be muscular strain,

[zebedee]

Ayahuasca said:

I have experienced the same on fell-walking descents. Uphill or level is fine; downhill, after a while, is murder. As someone said above, Leki poles help enormously.

Does it go from a few twinges quite quickly into a sharp stabbing pain like someone putting a hot sharp knife under your knee cap? If so, do you find that your shoes wear out to one side of the heel rather than level? I have one pole and have noticed a big improvement, two would undoubtedly help more when I get one, but I'd still rather correct the problem if possible.

[sawman]

zebedee said:

I've had enough with my knee pain, which I only get when fell walking, and usually starts after 10 mins or so of descending and builds to a very painful stabbing sensation in the lower outside of my kneecaps where a muscle comes up from the lower leg and attaches in (usually right knee first, left shortly after). I reckon that I must descend slightly "bow-legged" and therefore put strain on the outside of my knees - as soon as it levels off or I climb again, or jump in the car at the end of the walk, there is no more pain. I tend to wear-out the soles of my shoes on the 3/4 point of my heel (to the outside) so clearly am not putting my foot down straight. I thought I might need surgery (I need to do something about it because I love fellwalking and it is very painful) but having noted wear my shoes are wearing, I assume I could have a footpad specially made to correct this. Has anyone had any similar experience of a succesful outcome with a podiatrist-made footpad relating to knee problems, rather than ankle problems?

It might be worth having your gait evaluated and a Podiatrist may be the best person to do this, however evaluation in a clinic may have limited value as you do not get the pain when walking normally, but they may be able to make some predictions of how your legs behave when decending.

Based on their exam, your may be recomended orthotics of some description, additional or alternatively they may suggest some footwear changes - you should take your fell boots with you when you attend.

Orthotics can be helpful for knee issues but not always.

[996 sps]

See a sports physio or sports therapist hard one to answer over the net. ITB syndrome is popular one for the area you describe.

[Ayahuasca]

zebedee said:

Ayahuasca said:

I have experienced the same on fell-walking descents. Uphill or level is fine; downhill, after a while, is murder. As someone said above, Leki poles help enormously.

Does it go from a few twinges quite quickly into a sharp stabbing pain like someone putting a hot sharp knife under your knee cap? If so, do you find that your shoes wear out to one side of the heel rather than level? I have one pole and have noticed a big improvement, two would undoubtedly help more when I get one, but I'd still rather correct the problem if possible.

Not as bad as knives, but definitely painful! IIRC, correct heel wear is on the outer edge. Normal foot strike is outer edge of heel, then roll onto ball, then push off with big toe. I overpronate, so rolls inwards too much.

[zebedee]

sawman said:

zebedee said:

I've had enough with my knee pain, which I only get when fell walking, and usually starts after 10 mins or so of descending and builds to a very painful stabbing sensation in the lower outside of my kneecaps where a muscle comes up from the lower leg and attaches in (usually right knee first, left shortly after). I reckon that I must descend slightly "bow-legged" and therefore put strain on the outside of my knees - as soon as it levels off or I climb again, or jump in the car at the end of the walk, there is no more pain. I tend to wear-out the soles of my shoes on the 3/4 point of my heel (to the outside) so clearly am not putting my foot down straight. I thought I might need surgery (I need to do something about it because I love fellwalking and it is very painful) but having noted wear my shoes are wearing, I assume I could have a footpad specially made to correct this. Has anyone had any similar experience of a succesful outcome with a podiatrist-made footpad relating to knee problems, rather than ankle problems?

It might be worth having your gait evaluated and a Podiatrist may be the best person to do this, however evaluation in a clinic may have limited value as you do not get the pain when walking normally, but they may be able to make some predictions of how your legs behave when decending.

Based on their exam, your may be recomended orthotics of some description, additional or alternatively they may suggest some footwear changes - you should take your fell boots with you when you attend.

Orthotics can be helpful for knee issues but not always.

I intend to take my boots, though they are not the root cause as it did with 2 older pairs too, will also take my very worn shoes which demonstrate very clearly where my heel strike is! Good point re replicating a descent, might be worth enquring if they have the facilities to do that - they might have an elevated treadmill or something

[996 sps]

See a sports physio first.

[jules_s]

996 sps said:

See a sports physio or sports therapist hard one to answer over the net. ITB syndrome is popular one for the area you describe.

I get the same symptoms as the OP and it's ITB related.

I'm currently doing hydrotherapy as part of my AS managment, but essentially the object is to get the muscles in my back/bum built up and balanced...which should (has) helped the ITB/glute issues I had.

[996 sps]

jules_s said:

996 sps said:

See a sports physio or sports therapist hard one to answer over the net. ITB syndrome is popular one for the area you describe.

I get the same symptoms as the OP and it's ITB related.

I'm currently doing hydrotherapy as part of my AS managment, but essentially the object is to get the muscles in my back/bum built up and balanced...which should (has) helped the ITB/glute issues I had.

yep it is quite common and my concern for the OP is I have seen some awful insoles for shoes/trainers made by cowboys out in the podiatrist world, sometimes waste of money and effort.