Is Your Knee Pain Really Just a Pain in the Foot?

with Dr. Heather Whiting

It’s very common, especially as the weather is getting better, that people start to get knee pain. People are running outside, going on walks, biking and generally getting back into an active lifestyle. Patients come in complaining of knee pain and wonder why we, as manual physical therapists, start looking at your feet. Often times there is a foot component that is the main driver of the knee pain.

If you are experiencing pain in the knee, there is most likely dysfunction there in the form of soft tissue restrictions and joint misalignment, but these can be a result of foot dysfunctions. These knee dysfunctions need to be addressed and you might start to notice improvement in your pain but if the reason for these dysfunctions are not addressed then the pain will return.

How can you determine if your foot is a driver for the knee pain? During a squat, in the efficient state, your knees should track over your 2nd toe. This test can help to lead to further exploration of foot alignment. If you do not have an efficient squat there can be break down in the knee. A manual physical therapist can also evaluate your standing posture and torsions created at the knee from the alignment of the femur and tibia. If there is a discrepancy then the foot can be held into subtalar neutral and look for improvement of knee alignment. The foot wants to make full contact with the ground and will create compensations to ensure this happens but this can lead to the torsions seen in static standing. These examinations help the therapist to make a clinical decision on whether or not your foot needs to be addressed.

Manual therapists have different techniques to adjust the alignment of the feet and improve the torsions on the knee. When necessary, the patient may need to be fitted for orthotics to help with the alignment of the leg. If you have recurrent knee pain, it is worth to get evaluated by a manual physical therapist to find if your knee pain is really a pain in the foot.

Dr. Heather Whiting joined the EHS team of physical therapists through the post graduate program started by the Institute of Physical Art (IPA). Heather graduated from Northeastern University with her Doctorate in Physical Therapy and a minor in Spanish. In addition to her academic pursuits at Northeastern, she was also a member of the women’s varsity swim team earning All-CAA Conference honors and was voted team captain. During her NCAA Division I swimming career she was a valued member of multiple record breaking relay teams.


Elite Health Services, located in Old Greenwich, (and now Westport!) CT is a world-class provider of certified functional manual physical therapy, personal fitness, golf & triathlon performance training, massage therapy and wellness related services. Our team of highly skilled and dedicated professionals take a no-excuses approach to providing exceptional care and delivering exceptional results. To learn more visit www.EliteHealthServices.

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