Walk long enough on flat shoes, and you will probably experience knee pain!
But before you drop those flat shoes in the trash, read the “fix my flat shoes” section below, where I will show you how to improve them for your knee pain.
Can shoes cause knee pain?
Flat shoes cause knee pain because your tibia (shin bone) will tend to rotate inward, which puts stress on your meniscus (cartilage in your knee) and patella ligaments.
Over time, this torsion causes pain and inflammation, especially in those with dropped arches or “flat feet”.
Because of your body’s bio-mechanical chains, you could also end up with hip pain and lower back pain from the wrong kind of shoes.
So, what’s the connection between your foot and knee?
The connection between your foot and your knee are the bones, muscles, and ligaments. Your tibia (shin bone) forms the lower knee, and your calf muscles attach your foot all the way up to your femur, so it bridges the back of your knee.
Additionally, your fibula (outer leg bone) extends from your ankle, up to your knee. It’s not weight-bearing, but can suffer torsion and strain from a dodgy foot issue, and cause pain at your knee cap.
- When you walk, run, or jump, the force of impact is transferred from your foot up through your tibia to the knee meniscus, then through your hip joint and spine.
- The bones, muscles, and ligaments in your feet and legs act as shock absorbers, absorbing some of the impact and protecting your joints.
- The tendons in your feet and legs also play an important role in absorbing impact. The Achilles tendon, for example, is the largest tendon in your body. It’s a key structure with pain from wearing flat shoes.
How shoes affect our knees
Shoes are an important consideration in the health of your body.
They protect our feet from the elements, but shoes can also have a negative impact on your health, especially if they are ill-suited to your:
– foot shape
– previous injuries
It all starts at the calcaneus – your heel bone.
When we walk, the heel hits the ground first. As you can see in the above picture, the calcaneus is rather pointed. It really digs in to any footwear you have on.
The Calcaneus drop – why do my legs hurt when I wear flat shoes?
With flat shoes, that calcaneus is going to push in, dropping your heel area, putting excess tension on your achilles tendon and tibialis posterior tendon. You may suffer Posterior tibial tendon dysfunction (PTTD), an often-overlooked issue.
How to fix my flat shoes
If you have a firm, stable heel on the shoes you’re wearing, your calcaneus cannot dig so deep. This alleviates tension pain problems in your foot and knee. In lieu of supportive shoes like running shoes, for my patients I recommend inserting a firm wedge or chip into their flat shoes.
If you experience knee pain or don’t have the proper support from your flat shoes, try this easy fix for your flats.
With this approach you can avoid issues like:
- achilles tendonitis
- plantar fasciitis
- chronic foot pain and knee pain
- future knee arthritis
What are the worst shoes for knee pain?
- high heels
- thin, flat shoes
- floppy or overly flexible sneakers
High-heeled shoes might seem like they have a lot of support – but wearing them for a long time shortens the tendons in your legs and feet! The result? Possible chronic knee problems.
Why are flip-flops terrible for knee pain sufferers?
When you are walking on hard surfaces, your heel (calcaneus) will press down too far, placing tension on the arches of your feet, causing plantar fasciitis, and calf and knee problems.
This is because to keep them on your feet, you have to scrunch your toes every time you take a step!
The best shoes for knee pain
The right shoes will depend on your foot shape, but in general you should pick shoes with at least 1.5cm of firm heel, so your foot and knees are not stressed by the achilles and other tendons stretching too much.
Athletic shoes and quality boots are a good place to start. If you need specialized help, get custom orthotics from your healthcare provider.
How to choose shoes for knee pain – a chiropractic perspective
The best shoes for knee pain are ones that provide
- good arch support for your foot shape
- a firm heel
- a cushioned sole
Motion control shoes are a good choice for those with knee pain from overpronation, as they stabilize the foot.
Additionally, it is important to make sure that your shoes fit properly. Shoes that are too tight or too loose can cause problems, so it is important to get your feet measured and to try on shoes before you buy them.
Finally, keep in mind that different activities will require different types of shoes – keep separate your shoes for walking, running, and hiking.
Remember that shoes have a lifespan and the material in them decays over time, so throw out those 5 year-old tennis shoes because they could injure you!
Flat foot FAQ
What are fallen arches?
Fallen arches, or flat feet, is a condition where the arch of your foot sits lower than ideal, stressing bones and tendons in the foot. This can happen due to weakness in foot and leg muscles, injury, pregnancy, or obesity. When the arch falls, it can lead to pain not just in the lower leg, but the hips, knees and spine as well.
Do I have flat feet?
Look at your feet while you stand. Keeping the exact same position, carefully reach down and you should be able to run your finger under your arch. If not, you likely have fallen arches.
Another way to tell is by taking a wet footprint test – wet your feet and stand on a piece of paper or pavement, and if you can see the entire outline of your foot, you have flat feet. You should visit a podiatrist, chiropractor or physical therapist to get a professional opinion.
Are flat shoes better for knee pain for some people?
For people with strong, well-trained foot muscles and calves, flat shoes may be suitable for knee pain because they can allow for more natural movement and spread of the toes, and plantar fascia (underside tissue in the foot).
This does not apply to the majority of us though, because the modern lifestyle tends to be sedentary, leading to weak feet and legs. So it’s best to have the support.
Why do soft shoes cause knee pain?
Wearing soft shoes means you often have very little support, which can lead to foot, ankle and knee problems. Second, they tend to be very flexible, applying extra stress on the Achilles tendon and calf muscles.
Your heel bone will be unstable, rocking all over the place – not ideal if you want to keep leg issues away.
An example of this is the Nike free’s from a few years ago. They were popular, but far too soft for most people with foot and knee weakness.
Thankfully, Nike have come a long way in improving their running and training shoes, and now offer great options for stability shoes.
What are some good shoe brands for knee pain?
Some tried-and-tested brands for knee pain include New Balance, Asics, Brooks and Saucony.
They offer a variety of stability shoes to support your feet and ankles, helping to prevent or alleviate knee pain. They seem to invest and innovate the most, for those who are serious about keeping their body stable and pain-free when exercising.
How heavy shoes or boots cause knee pain
- if they are too heavy, your joints and tendons suffer more load, making a sprain/strain injury more likely on a hike or long walk
- Because of the extra force needed to lift your foot up, your hip flexors can get injured or tight which affects the other attachment point – at your kneecap.
Can chiropractors help flat feet?
Chiropractic adjustments improve the function of your foot, relieving pain associated with flat feet, by mobilising your navicular, calcaneus, and other foot bones, and ankle and knee joint.
Furthermore, chiropractors assess and improve your spine, posture, and movement, for overall health. They can usually recommend the right type of shoe for you.
So if you’re experiencing knee pain, consider ditching those flat, soft or overly-heavy shoes! With improper shoes you are at higher risk of bad knees.
If you have knee pain from flat shoes, appropriate footwear is important, but other factors like proper alignment of your body, strength, and weight loss, should be discussed with your physio, chiro, or podiatrist along with knee pain treatment options.
I hope you have found this post helpful. If you have any questions, leave me a comment below and I will get back to you as soon as I can.
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- Posterior Tibial Tendon Dysfunction (PTTD) https://www.foothealthfacts.org/