Knee pain associated with footwear change? Orthotics - Barefooting

[Bryan Stell]

I have been dealing with some knee issues recently. Patellar Tendonitis first, which has been resolved, then more recently provoked by running Ilio-tibial band syndrome. Also, during high rep squats I get a searing pain on the medial aspect of the knee by the vastus medialis insertion. The Iliotibial band pain and medial knee pain during high rep squats are always enough to stop my workouts in the the tracks. I first attributed the knee pain in my RIGHT KNEE only to doing too much too fast as I had just recently recovered from herniated discs in my back. Now I feel thats not the case anymore and that it could be caused by my switch in footwear, from orthotics to barefooting shoes (Vibram Five Fingers).

I have a hypermobile metatarsal joint which makes my medial longitudinal arch unsupportive. So the arch compresses under force and makes my 2nd metatarsal head bear weight; hypertrophying the 2nd metatarsal head but also causing pain. So to deal with this, i got orthotics.(2 years ago) I hate relying on some unnatural support. I was becoming so reliant that any shoes without significant support would almost immediately cause pain at the 2nd metatarsal. So this summer I decided to try and fix the foot pain by going at the cause. Weak ligaments at the foot bones (cuneiform) and such. I ordered Vibram Five Fingers which I love and have been using quite regularly.

Very rarely do I wear shoes now, and when I do I have less problems with the metatarsal pain. However, I believe this is now the issue causing most of the knee pain. (Iliotibial pain, and more recently pain I notice on the medial aspect of the knee around the attachment of the vastus medialis. (really comes out doing tabata squats or any high rep squats.) The knee pain is not so bad when walking, but squatting, running, going down stairs or hills it is noticeable and crippling to my workouts.

I have been stretching the quads and IT band, (moreso on my right leg with the affected knee and bad foot). Also, I have been foam rolling religiously for about a week now. My form on all exercises (maybe not running) is good. I am going to make a conscious effort to get ice on after provoking it. I take no NSAIDS. Diet is clean, mostly paleo, zone esque without weighing portions, fish oil is there.

So I am at a crossroads, give up my Vibram Five Fingers and go back to the orthotics? Or try and correct my biomechanics somehow and continue wearing the barefooting shoes. Any thoughts? I was thinking prolotherapy at the weakened foot bones could help. I just really don't want to go back to orthotics.

[Steven Low]

I posted in your other thread

wfs
http://www.board.crossfit.com/showthread.php?t=48889

Also, it may be a good idea to try to find a PT/doc who doesnt prescribe orthotics like they're candy and see if they can help you out as well