Knee Pain – Part 2: Is The Problem In Your Feet?

With chronic pain, there’s a deep desire to get to the root of the problem. Sometimes, the problem is at the root! We need a stable base in order for all the joints above to stack properly, and issues in the foot and ankle can cause chinks in the chain that affect us from toe to head.

Just as last week, we’d like to reiterate that the suggestions below are generalizations, and do not replace the diagnosis from a health care professional. If these situations sound like the pain you’re experiencing, please go get it checked out! These could be some additions to your homecare routine if your physiotherapist gives the “ok”.

Tension carried through the sole of the foot and in the calves can add to pressure at the knee joint, by impacting the joint alignment, or by forcing compensation when we lack adequate dorsiflexion (being able to pull your toes towards your shins).

How can you tell if your feet and calves are tight?

When you squat, do your arches start to fall in?
When sitting, can you pull your toes back towards your shins beyond 90 degrees?
When standing, does your weight mostly fall to one edge of the foot?
When standing, do you ever feel like your knees “lock” or hyperextend?

What areas should you focus on stretching/mobilizing?

Sole of the foot: The plantar fascia and the muscles that help to flex your foot can carry a lot of tension – especially considering how much time is spent with your feet crammed into shoes. This tension can impede them from moving properly, which can cause the “caving in” of your arches when walking or squatting. You can do some self-massage with a lacrosse ball, rolling along the ball of the foot and the arches, to relieve some of this tension.
Calves: Tension in your calves can limit movement at your ankle joint, changing your posture and gait, and impacting all the joints above. To help get things moving again, you can foam roll the calves, and then follow that up with some active ankle dorsiflexion (such as the knee tap to wall shown below) and passive calf stretches with both straight and bent knees.

What areas should you focus on strengthening?

Many people with caving arches make the assumption it’s weakness in their arches and jump right into orthotics. Although this can be the case, more commonly the caving is due to lack of mobility of the mid-foot (due to all the tension there, as discussed earlier). After working on mobility, the best thing you can do to build more stability through the foot is to spend more time “gripping” the ground from a tripod support – meaning that as you stand, your weight should be equally distributed between your heel, big toe, and pinky toe. Don’t be afraid to spend more time barefoot!