Knee and foot function

Knee pain and foot function: we assess loading, gait and footwear

Not every knee pain comes from the foot. In some cases, loading, gait or footwear may form part of the wider context and are worth assessing cautiously.

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Relationship between knee alignment, leg movement, loading and gait

MEDIPIE approach

The knee is not assessed in isolation from movement

Knee pain may appear when walking, running, climbing stairs, standing for long periods at work or after changing footwear. Foot function does not explain a painful knee by itself, but support, gait and stability may form part of the functional pattern.

At MEDIPIE we observe how the foot behaves under load, how it relates to the ankle, knee and hip, and what role footwear, activity and previous treatment may have. The aim is to decide whether an orthotic adaptation may make sense in the individual case.

What we assess

When symptoms appear and which activities change them.
Foot support, functional alignment and behaviour during gait.
Usual, sports or work footwear.
Ankle, foot and knee mobility and tolerance to load.
Previous treatments and the response to them.

How orthotic care may help

When indicated, an orthosis or adaptation may form part of the approach by modifying a variable of loading, support or tolerance identified during assessment. The decision is not based on a footprint alone, and response needs to be checked through real use and follow-up.

If signs suggest a medical, traumatic or joint-related cause requiring another assessment, we explain that rather than oversimplifying the problem.

Frequently asked questions

Common questions

Can foot function influence the knee?

Foot loading and movement can relate to variables in leg and knee loading in some cases, but that association does not prove they are the cause of pain. It is interpreted alongside knee examination, gait, strength, activity, footwear and symptom progression.

How might an orthosis help with knee pain?

For selected indications, an orthosis may modify variables of support or load during gait and form part of a broader approach. It does not permanently realign the knee and is not a universal treatment for knee pain; usefulness depends on the specific problem, tolerance and clinical response.

Another question before you book?

See information about assessment, orthoses, footwear, first visits and follow-up.

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Appointments by phone

We relate knee symptoms to activity and movement

Tell us when it hurts, which sport or work you do and which previous tests you have. The assessment helps decide whether foot loading is relevant in your case.

Clinical content reviewed by Juan Bautista Calero Márquez, podiatrist registered no. 115 in the Region of Murcia. Last clinical review: 21 August 2026.

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Clinical evidence and limits

Evidence for knee orthoses depends on the diagnosis

For patellofemoral pain, a JOSPT/APTA clinical practice guideline includes short-term use of prefabricated foot orthoses in people with greater-than-normal pronation, alongside exercise. The guideline also states that there is insufficient evidence to say that custom orthoses are superior to prefabricated orthoses in that context.

This recommendation is specific to patellofemoral pain and should not be extrapolated to every knee pain. At MEDIPIE foot support is assessed as one variable among several, not as an automatic cause.

Clinical source: JOSPT/APTA · Patellofemoral Pain Clinical Practice Guideline