The Foot-Knee Connection: How Pain Travels Up (and Down) the Chain

If you've ever had nagging knee pain or foot discomfort, you might be surprised to learn the two are often closely linked. Why? Because your body doesn’t move in isolated pieces—it moves as a unit. Like links in a chain, each part affects the others.

So, how do your feet influence what’s happening at your knees? And can knee issues cause problems in the foot? Let’s dig into the connection.

It’s All Connected: The Kinetic Chain at Work

Think of your body as a kinetic chain—especially the lower body. The foot, ankle, knee, and hip all work together to help you walk, run, jump, squat, and move efficiently.

When one part of the chain is off, the others have to compensate. And over time, those compensations can lead to pain, strain, or even injury.

How Foot Mechanics Can Lead to Knee Pain

Your feet are your foundation—they’re the first part of your body to make contact with the ground. How your foot hits and moves directly influences what happens up the chain, especially at the knee.

Here’s how common foot issues can throw the knee out of alignment:

• Overpronation (foot rolls in too much)
  Causes the lower leg to rotate inward and puts the knee in a compromised position. Over time, this can lead to issues like patellofemoral pain or IT band syndrome.
  
  
• Oversupination (foot stays too rigid)
  When the foot can’t absorb shock, that stress travels upward—often landing at the knee, causing pain or irritation on the outer side.
  
  
• Flat Feet or Collapsed Arches
  A flattened arch means less support and stability, forcing the knee to pick up the slack—which can lead to discomfort or overuse injuries.
  
  
• High Arches
  Just like too little arch support is a problem, so is too much. High arches don’t adapt well to the ground and cause the knee to compensate, creating stress and imbalance.
  
  

Bottom line: If your feet aren’t doing their job properly, the knees often pay the price.

How Knee Pain Affects Your Feet

It works the other way too. When you’re dealing with knee pain—whether it’s from an old injury, arthritis, or overtraining—you naturally change how you move to protect it. But those compensations can shift the load to the foot and ankle.

Here’s what that can look like:

• Shifting Weight
  You may start avoiding pressure on the painful side, leaning more into the opposite leg or rolling your foot differently. This can lead to fatigue, plantar fasciitis, or collapsing arches.
  
  
• Altered Gait
  Pain may limit how much your knee bends, changing your stride. A stiff, guarded gait puts odd pressure on the feet and ankles.
  
  
• Weakened Muscles
  Knee pain can reduce quad and hamstring strength. When those key muscles aren't pulling their weight, the foot and ankle have to work overtime—often resulting in overuse injuries.
  
  

Real-World Example: When One Problem Creates Another

Let’s say someone has flat feet. Every step causes the arch to collapse and the foot to roll in, which makes the shin and thigh rotate inward. This inward twist pulls on the knee, stressing it in ways it wasn’t built to handle.

Now flip it. Someone with chronic knee pain starts favoring one side, putting more pressure on the outside of their foot. Over time, that compensation leads to arch pain, ankle issues, or even plantar fasciitis.

It’s not just one joint—it’s the entire system working (or not working) together.

What You Can Do About It

Understanding how the foot and knee are connected gives you a clear path forward—not just to get out of pain, but to move better long term.

Here’s what works:

• Treat the Whole Chain
  Don’t just focus on the painful area. Assess the hips, knees, ankles, and feet to find the real root of the problem.
  
  
• Build Smarter Strength
  Strong glutes and hips help control knee alignment. Strengthening the foot and ankle builds a stable foundation from the ground up.
  
  
• Rethink Your Footwear
  Shoes matter, but they’re not the whole solution. Custom orthotics or shoe tweaks can help—but they should support a bigger plan that includes strength and mobility work.
  
  
• Move Better
  Learning proper squat, walk, or run mechanics can make a huge difference. Small tweaks in how you move can take pressure off the knees and reduce wear and tear on the feet.
  
  

Final Thoughts: Don’t Chase Pain—Follow the Chain

Pain in one area is often just a signal that something else isn’t working right. Zoom out. Look at the whole picture.

Whether you’re a runner, lifter, weekend warrior, or just trying to stay active without setbacks—treating the whole chain is how you get lasting results.

Because your body doesn’t move in parts. It moves as one.

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Ready to get to the root cause of your pain?

If you’re ready to feel confident in your body again, let’s work together to get you back on your feet—and keep you there.

Reach out to i.Athlete Physio in Torrance, CA to schedule your evaluation. Your knees (and feet) will thank you.

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