Could foot problems be the reason for my knee pain?

You've tried ice, rest, and over-the-counter pain relievers. Your knees still hurt when you walk, climb stairs, or stand for too long. You assumed the problem was in your knees—but what if it actually started in your feet?  

When your feet don't function properly, the ripple effect travels upward through your entire body, and your knees often take the brunt of it. At Massapequa Podiatry Associates, our podiatrists frequently help patients just like you see the alignment connection between foot problems and knee pain. Understanding how your feet influence your knees changes everything. Instead of treating symptoms that keep coming back, you can address what's actually causing the discomfort—and that often means starting from the ground up. 

How Do Your Feet Control What Happens to Your Knees?

Biomechanics sounds technical, but the concept is straightforward: it's the study of how your body moves. Every time you take a step, your feet absorb shock, maintain balance, and propel you forward. They act as the foundation for everything above them—ankles, knees, hips, and even your spine.

When your feet work correctly, they distribute pressure evenly across joints and muscles. Your knees track in proper alignment, and movement feels natural. But when something goes wrong with your foot structure or function, the kinetic chain reaction begins immediately. Your body compensates by shifting weight differently, altering your gait, and forcing other joints—especially your knees—to work harder than they should.

What’s the Domino Effect of Poor Foot Mechanics?

Think of your feet as the base of a tower. If the foundation tilts even slightly, every level above it shifts to stay balanced. Your knees don't just bend and straighten—they also stabilize and absorb impact with every step.

Healthy feet keep your knees aligned during all these movements. Problematic feet throw everything off course. Here's what happens when foot mechanics fail:

• Altered leg angles stress knee joints. Flat feet, high arches, overpronation, and other structural misalignments change the angle at which your legs move. Your knees compensate by rotating inward or outward, placing abnormal stress on ligaments and cartilage that weren't designed to handle those forces.
• Repetitive strain creates inflammation. Every misaligned step compounds the problem. What starts as minor compensation becomes chronic stress on specific parts of your knee—the inner edge, outer edge, or under the kneecap—leading to persistent inflammation and discomfort.
• Long-term damage develops gradually. Over months and years of improper alignment, cartilage wears unevenly, ligaments stretch beyond their normal range, and joint structures break down. This progression happens so slowly, you might not connect today's knee pain to foot problems that started years ago.

What Foot Problems Commonly Trigger Knee Pain?

Recognizing these connections helps explain why your knee pain hasn't responded to treatments focused solely on the knee itself.

Flat Feet and Overpronation

Flat feet lack the natural arch that helps absorb shock and maintain balance. When your arches collapse, your feet roll inward excessively with each step—a movement called overpronation. This inward rolling forces your lower leg to rotate internally, pulling your kneecap out of its ideal alignment.

The result? Your knee tracks incorrectly during walking and running, creating friction between the kneecap and the thighbone. This misalignment leads to conditions such as patellofemoral pain syndrome, in which the front of your knee aches during activity. You might notice the pain worsens when climbing stairs, squatting, or sitting with your knees bent for extended periods.

High Arches and Supination

High arches create the opposite problem. Instead of rolling inward, your feet tend to roll outward—a pattern called supination. This reduces your foot's ability to absorb shock, sending more impact directly up through your ankles and into your knees.

Without adequate shock absorption, your knees experience increased stress with every footfall. Cartilage wears down faster, and the surrounding muscles work overtime to stabilize joints that should receive better support from below. Knee pain from high arches often feels like a dull ache on the outside of the joint.

Plantar Fasciitis and Altered Gait

Plantar fasciitis causes sharp heel pain that makes normal walking difficult. When your heel hurts, you instinctively change how you walk—you might shorten your stride, shift weight to the outside of your foot, or favor the unaffected side. These compensations seem minor, but they dramatically alter your biomechanics.

Your knees respond to these gait changes by adjusting their movement patterns. One knee might bear more weight than the other, or both knees might track incorrectly to accommodate your modified stride. What started as heel pain quickly became knee pain because your entire lower body adjusted to protect the original injury.

Bunions, Hammer Toes, and Other Structural Deformities

Visible foot deformities don't just affect appearance—they change how your foot contacts the ground and distributes weight. For example, bunions push your big toe out of alignment, affecting push-off during walking. Hammer toes curl under, creating pressure points that make you adjust your step.

Each structural adjustment to avoid pain ripples upward. Your ankle compensates, your knee adjusts to the ankle's new position, and before long, you're dealing with knee pain that seems unrelated to your foot deformity. The connection exists whether you recognize it or not.

How Do Our Massapequa Podiatrists Identify the Foot-Knee Link?

First, Dr. Corey Fox and Dr. Justin LoBello start with a thorough evaluation. We examine more than just where it hurts—we also analyze how you move, where pressure concentrates, and how your feet function during normal activities. Here’s the solution-oriented approach you can expect to assess knee pain related to foot problems: 

• Gait analysis. Watching you walk reveals compensatory patterns you don't even realize you've developed. Our podiatrists observe foot strike, weight distribution, and joint alignment throughout your stride. Video analysis captures subtle movements that explain why your knees hurt.
• Structural assessment. Your foot structure—arch height, ankle flexibility, toe alignment—determines how forces travel through your legs. Measuring these elements reveals specific biomechanical issues contributing to knee stress.
• Pressure mapping. Advanced technology shows exactly where your feet bear weight during standing and walking. Uneven pressure distribution highlights problems that alter your gait and affect your knees.
• Range of motion testing. Stiff ankles, tight calf muscles, and limited foot flexibility all impact how your knees move. Testing these factors sheds light on the restrictions that force your knees to compensate.

Trust Our Progressive Treatment to Address the Root Cause

Once the connection between your foot problem and knee pain becomes clear, Dr. Fox and Dr. LoBello focus on restoring proper biomechanics from the ground up. Your individualized treatment plan may include:

• Custom orthotics. Prescription medical orthotics support proper foot alignment based on detailed measurements of your feet. They redistribute pressure, control excessive motion, and help your feet function as they should—many of our patients notice significant knee pain reduction within weeks.
• Physical therapy. Targeted exercises strengthen your feet, ankles, and lower legs while stretching tight muscles that restrict normal movement. This combination improves stability and reduces compensatory stress on your knees.
• Footwear recommendations. Sometimes, solving knee pain is as simple as replacing shoes that sabotage your foot function. Shoes with adequate support and cushioning work with orthotics to maintain alignment throughout your day. 
• Treating underlying conditions. When plantar fasciitis, bunions, or other foot conditions drive your foot problems and alter movement patterns, addressing these directly through conservative care or surgical correction restores proper function and eliminates discomfort.

Your knees hurt because they're working too hard to compensate for what your feet can't do properly. Let us help fix the foundation, and the pain above it often resolves. This isn’t a coincidence—it’s biomechanics in action.