The knee does not work on its own. Between the ground and the hip there is a chain, and the foot is its first link: the way it lands and the way the ankle moves force the tibia to rotate, and that rotation reaches the knee with every step. That is why there are knee pains in which gait plays a part — particularly those that appear when walking a lot, running or going down stairs, and that did not follow a blow.
Playing a part is not the same as causing it, and that is worth saying plainly: there are knee pains that have nothing to do with the foot. A meniscus or ligament injury, advanced osteoarthritis, an inflammatory problem or pain that began after trauma are matters for a doctor, and the right thing from podiatry is to say so rather than delay the diagnosis. What can be assessed here is whether the way you load the foot is adding strain to that knee.
What is assessed from the foot
- How the foot lands and how the ankle behaves during walking.
- Whether there is a sustained rotation of the leg reaching the knee at every step.
- Differences between one side and the other, and whether the pain is always on the same one.
- Footwear, the usual surface, and what changed before the problem started.
- Where appropriate, insoles to change the loading and see whether the knee responds.
Does your knee hurt when walking or running and nobody has looked at your feet?
Book an appointmentFrequently asked questions
- How do I know whether my knee pain is related to my foot?
- There are three clues pointing that way, and none of them is proof: that the pain appears with activity — long walks, running, going down stairs — and did not follow an injury; that it is always in the same knee and the same spot; and that it started after a change of footwear, surface, weight or training load. If you also notice one foot loading differently or one shoe wearing very differently from the other, that is a further clue. What rules this route out is the opposite: pain that began after trauma, that locks the knee, swells it, or makes you feel it gives way. That belongs to a doctor, and from here it is said and referred.
- Will insoles take my knee pain away?
- That cannot be promised, and anyone who promises it is selling something. What an insole does is change how the foot loads, and with it the rotation reaching the knee at every step. If that rotation is part of what hurts you, changing it usually shows; if your pain has another cause, the insole does not touch it. That is why it is framed as a trial with review and not as a closed solution: you decide what to modify, wear it long enough to judge, and reassess. If at the reviews the knee is grateful, it is kept and adjusted; if nothing changes, that is useful information too, and it means the cause has to be looked for elsewhere.
