Is my knee pain connected to my feet?

I'm 16 and have had knee problems for about 3.5 years. I did pt 2 years ago. They said my feet pronated, were very flat and bunions had developed because of the way I walked. They thought that my feet were the cause my knee pain so they made me custom orthotics and we did loads of exercises. At the time you could see 3 of my toes from behind me. After about 3 months with no improvement I gave up and so did they. The latest diagnosis I had was bursitis but with something was going on too. They were supposed to be better by the time I was 16 which was last November. I wore my orthotics everyday up until the beginning of July. I was having foot pain so I stopped. The foot pain is minimal and doesn't effect me anymore. I have noticed that my feet are flattening out again. My knees are also getting worse but they have been progressively getting worse for about a year now. They are pronating worse and my balance is way off.  You can see all 5 toes from behind me. The docs don't think it is my feet causing my knee pain and I used to agree. Three physical therapists, karate instructor and now I think my feet could be causing my pain. Could my feet be to blame? How could I tell if they were? Should I push the issue at my next visit? Am I killing myself by wearing Converse with no orthotics? Sorry for the long post and abundance of questions.

[Michael L Gross, MD]

From what you are describing, you certainly do have pronated feet. The fact that you can see all your toes from behind may even indicate a tendon injury in your ankle. So, I would suggest the use of orthotic inserts in your shoes and sneakers. Excessive pronation is a wellrecognized cause of knee problems.