Could your feet be contributing to knee pain?
The short answer is, yes. Our feet are our foundation and they directly affect our gait (the way we walk or run). As such, our feet can impact symptoms experienced further up the kinetic chain at our knees, hips and back.
Patellofemoral Pain Syndrome (PFPS) produces pain around the knee cap (patella) where it forms a joint with the thigh bone (femur). PFPS is one of the most common knee conditions (may account for as much as 10%-25% of all knee injuries) and the incidence is higher in females than in males. It can be aggravated by activities that load the patellofemoral joint such as: ascending/descending stairs, squatting, running and even prolonged sitting.
When our foot hits the ground the body’s response is for the foot to absorb impact and slowly roll inwards, flatten and to distribute forces heading up the leg. This is known as pronation. In some cases, foot structure can result in excessive pronation which can lead to misalignment of the lower extremities, knees and produce symptoms of patellofemoral pain.
On the flip side of the coin, a foot that doesn’t pronate enough, or supinates, can lead to problems. Pronation is the main way that our foot and lower extremities absorb shock and a foot that doesn’t pronate enough, or supinates, will provide less cushioning for the leg when it strikes the ground. This can result in more stress being placed on the knee.
In either case above, the kneecap is not tracking properly which can result in pain. Custom foot orthotics may be of benefit in order to offload irritated structures, promote better alignment and mitigate gait pathologies that may be contributing to symptoms. A biomechanical assessment and gait analysis are ways to determine if your feet are part of the problem and how to go about fixing it.
Patellofemoral pain can also be rooted in hip and quadricep muscle weakness (abductors, external rotators and Vastus Medialis). If these muscles aren’t working properly they may contribute to misalignment of the lower extremities and symptoms of patellofemoral pain.
Whether your knee pain is as a result of top down weakness or bottom up foot mechanics, proper assessment is key to appropriate treatment. A Canadian Certified Pedorthist can help you to determine whether your knee pain is related to poor foot function, structure or biomechanics and whether or not you’re a good candidate for custom foot orthotics.