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How the feet and the ankles relate to the knees?

This is an excerpt from BioMechanics Method for Corrective Exercise-2nd Edition, The by Justin Price.

The feet and ankles form the foundation of the human body. As with any structure, the integrity of the foundation affects everything above it, and the weight above has a direct impact on the foundation. Therefore, the condition of the feet and ankles influences the performance of all weight-bearing activities, such as standing, bending, reaching, squatting, walking, running, and lunging (Schamberger 2002).

When the foot overpronates, it causes the lower leg to roll inward and the heel bone to collapse toward the midline of the body. This collapsing inward of the foot, ankle, and lower leg results in a lack of dorsiflexion—that is, the foot, ankle, and lower leg do not come forward over the foot correctly. Simply put, if the foot and ankle collapse in too much, they cannot come forward enough. Since the soleus and gastrocnemius muscles are attached to the heel bone, this collapsing of the foot and ankle affects the function of these muscles and further limits dorsiflexion (Lowe 2009).

The internal movement of the lower leg caused by overpronation also affects the position of the knee since the bottom of the knee joint sits directly atop the tibia and fibula. Overpronation causes a valgus knee position, that is, an inward displacement of the knee (see figure 2.11) (Johnson and Pedowitz 2007). Excessive inward movement or displacement of the knee joint can result in tracking problems in which the kneecap does not glide smoothly over the femoral groove as it should (Johnson and Pedowitz 2007).

Figure 2.11 Valgus knee position.
Figure 2.11 Valgus knee position.

Lack of dorsiflexion in the ankle also directly affects the function of the knee when it is both bending (flexing) and straightening (extending). For example, many weight-bearing activities like squatting and lunging require the ankle to bend forward at the same time the knee is bending (figure 2.12).

Figure 2.12 Ankle in dorsiflexion when knee is bent.
Figure 2.12 Ankle in dorsiflexion when knee is bent.

Other weight-bearing activities like walking and running require the ankle to bend forward while the knee is straightening (figure 2.13). However, if the foot and ankle complex lacks dorsiflexion, the knee joint must compensate for this lack of movement in the ankle, and pain and injury can result (Cook 2010).

Figure 2.13 Ankle in dorsiflexion when knee is straight.
Figure 2.13 Ankle in dorsiflexion when knee is straight.

Assessment Checklist

Figure 2.14 Sample of completed foot and ankle assessment on Client Assessment Diagram.
Figure 2.14 Sample of completed foot and ankle assessment on Client Assessment Diagram.

More Excerpts From BioMechanics Method for Corrective Exercise-2nd Edition, The

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