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shoes that relieve heel pain
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knee pain & foot pronation
iliotibial band syndrome

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Health & Prevention
heel pain in youngsters
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orthotic foot supports

Knee Pain & Foot Pronation

The unbalanced foot maybe causing that knee pain. When considering the possibility that your knee pain might be coming from a foot imbalance, it is important to know more about the biomechanics of the foot and leg in motion.

More than 30% of the athletes treated in my practice have knee pain, and the majority of those pains can be treated with non-invasive biomechanical therapy.

Knee problems can be caused by internal joint derangements or imbalance of the body above or from the feet and legs putting stress on the ligaments and muscles that support the knee joint. If you have swelling, clicking, popping or limited motion within the knee joint, you may need an orthopedic evaluation.

The knee joint is the largest in the body and functions best as a hinge with forward motion of waking and running. The knee is vulnerable to injury from side-to-side and rotational stresses. If you have pain that changes with activity, and there is no swelling, then you probably have an overuse injury caused by biomechanical imbalance. This imbalance produces excessive motion (hypermobility) and an impact shock on the knee joint. Upon contact of the foot with the ground during sports, the foot and leg should be stable. Structural problems such as limb length differences, bowed legs, knock-knees, and flat feet produce functional problems during walking, running and sports performance.

"Runner's Knee" is likely to develop as a result of the pronated foot.

In the weight-bearing sequence known as “gait,” it is important to know the terms “pronation” and “supination” and the effects they have on the knee and leg. Pronation is a complex motion but in simplified terms is a flattening of the foot and arch that occurs when the whole foot contacts the ground. During pronation, the structures of the foot are loose and able to adapt (compensate) to the supporting surface. Supination is also a complex motion and the opposite of pronation. During the walking gait cycle, supination begins after completion of pronation, as the heel is rising and the forefoot is bearing the most body weight. When supinated, the foot works as a “rigid lever,” to propel the body forward.

As these motions occur, the knee and lower leg are also undergoing motion. When the foot pronates and flattens, the knee and leg twist inward. If there is excessive pronation, then there is an additional amount of knee or leg motion. If we multiply this excessive motion by the number of foot contact s in weightbearing sports such as running, race walking, fitness walking, hiking, basketball or tennis, there is a much greater chance of injury. In addition to injuries at the foot level, knee injuries are common (“Runner’s Knee” = chondromalacia patella; “Jumper’s Knee” – a patellar tendonitis; “Cyclist’s Knee” = patello-femoral syndrome). Multiple small injuries accumulate producing stress and strain on tissues and may ultimately produce the “overuse syndrome,” and we can say that the cause of the knee injury is the abnormal foot motion.

If the excessive pronation of the foot and the abnormal movements of knee are diagnosed and the foot is properly balanced with the use of supportive motion control shoes and/or arch support or an orthotic device, we can relieve the knee pain and allow the athlete to continue. Proper foot balance with an appropriate custom made orthotic device will solve the cause of the problem and enable you to return to your sport.