Should I worry about 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 as long as I don't wear my orthotics. 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.

[S. Kaul, MD]

Hi there!

It is very unlikely for the knee pain to be related to issues with ones feet. As far as the foot issues are concerned I would not be able to comment without an evaluation on if it is indeed the arch that is responsible for your symptoms or there are additional factors involved as well. Possibilities that would need to be ruled out are fractures, dislocations, tendonitis, arthritis, bursitis, fasciitis, degenerations, growths like spurs etc.
                   I would also suggest an evaluation for the knee pain by an orthopedician. A few possibilities to the knee pain include infections/ inflammations, tendon injuries, fractures, patellar dislocation, fractures, patellar dislocation, injuries to the internal knee ligaments/ menisci, arthritis, bursitis, tendonitis, cyst formation, iliotibial band syndrome, osgood-schlatter disease, bone growths/ tumours, nerve injuries etc; just to name a few. After a cause(s) to your symptoms is diagnosed, a management plan can be drafted accordingly. Meanwhile you may try resting the knee, application warm compresses and some OTC NSAIDS if the pain is severe.
Hope this is helpful.

Take care!