There are a variety of different types and causes of knee pain, and your treatment will vary depending on the cause. In some cases, knee pain can be exacerbated by poor foot biomechanics, most commonly over pronation (flat feet).
How do flat feet affect the knee?
Over pronation can cause the following:
- Inward rotation of the leg bones (tibia and fibula) causing malalignment of the tibia and femur (bones of the knee joint)
- Maltracking of the patellar (knee cap) tendon (patellofemoral dysfunction) resulting from internal leg rotation
- Stretching of the structures on the inner (medial) side of the knee
- Compression of the structures on the outer (lateral) side of the knee
All of these effects on the knee can result in pain and injury as the knee components are moved out of their optimal functioning position
Treating knee pain
If you are suffering from knee pain and you also have flat feet (over pronate), it may be worth seeing a podiatrist to assess whether you may benefit from orthotic therapy to control your pronation. Controlling pronation can remove stress from the knee and aid recovery.
Consultation with other healthcare professionals is recommended to make a thorough assessment of your condition and it’s causes. In some cases x-rays, MRIs or ultrasounds may be used to help make a diagnosis. Stretching and strengthening exercises may be prescribed along with other therapeutic treatments.
Hip and lower back pain
There are many and varied causes for hip and lower back pain and as with knee pain, the hip and lower back can also be affected by poor foot biomechanics, and over pronation in particular.
The hip joint is where the head of the femur (thigh bone) connects with the pelvis bone in a cosy ‘ball in cup’ type arrangement. The ‘ball in cup’ joint allows for the large range of movement the hip has.
The lower back usually refers to the lumbar and sacral vertebrae in the spine. This area of the spine attaches to the pelvis. The way the lower back is positioned and moves can be connected to the positioning of the pelvis.
How do flat feet affect the hip and lower back?
The way that the movement of the foot can alter the movement of other bones and joints further up the leg and body is referred to as the ‘kinetic chain’. In the case of over pronation, the kinetic chain works something like this:
- Over pronation at the sub-talar joint (joint beneath the ankle)
- Internal rotation of the tibia (leg bone)
- Internal rotation of the femur (thigh bone)
- Increased anterior tilt of the pelvis (hip bone)
- Increased curvature of the lumbar spine (lower back)
When the positioning of any joint or structure in the body is put out of it’s normal alignment it can result in pain, discomfort or injury. Whilst you will likely need to seek trained advice from a therapist to assess and treat your hip or lower back pain, it is worth being aware that your foot biomechanics may be playing a part in your condition, and treating any abnormal biomechanics may assist in your recovery.