2032 N. Broad Street,
Lansdale, PA 19446

(215) 368 - 5319

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 our 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 feet and legs putting stress on the ligaments and muscles that support the knee joint.  If you have swelling, clicking, popping or limitation within the knee joint, you may need an orthopedic evaluation.  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 impact shock on the knee.  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.  The knee joint is the largest in the body and functions best as a hinge with forward motion.  The knee is vulnerable to injury from side-to-side and rotational stresses.

If the excessive pronation of the foot and the abnormal movements of knee are diagnosed and the foot is properly balances with the use of an orthotic devise, we can effectively treat the knee pain and allow the athlete to continue.  A complete gait analysis will show how the foot is affecting the knee and be able to neutralize the problem with a custom Bio-mechanical orthotic.

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 to its maximum degree when the whole foot is on the ground.  During pronation, the structures of the foot are loose and able to adapt (compensate) to the supporting surface.  When pronated, the foot functions as a “loose bag on bones.” 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 contacts in weight bearing sports such as running, race 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” = chondromaiacia 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.”  Additional strain on the knee may cause inflammation and pain without tearing any of the structures and we can definitely say that the cause of the 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 an orthotic device, we can effectively treat the knee pain and allow the athlete to continue.  A complete gait analysis will show how the foot is affecting the knee and be able to neutralize the problem with a custom Bio-mechanical orthotic.