The Center for Podiatric Care and Sports Medicine

Hip, Knee, and Foot Pain: How Foot Issues Can Lead to Other Lower Body Injuries

Posted by on Monday, November 13th, 2017


Researchers at the Hospital for Special Surgery and Harvard Medical School recently took another look at the results of the Framingham Foot Study to see if there was a correlation between foot, knee, and hip pain. Their paper appeared in the Journal of the American Podiatric Medical Association to provide practitioners with evidence-based guidelines for treating their patients. Not surprisingly, the study found what we have noticed in our NYC foot and ankle sports medicine clinic for years: there IS a significant association between foot pain and pain in the knees and hips.

The foot is the foundation of the kinetic chain.
The foot is the foundation of the kinetic chain, according to researchers and sports medicine doctors in NYC. Image Source: Unsplash user Lucas Sankey.

Foot Health and the Kinetic Chain

The foot is the foundation of the body—the very beginning of the kinetic chain. As the foot makes contact with the ground, it absorbs the shock before it can be transferred to the knees or hips. If this capacity is altered in some way, other parts of the body suffer. Patients forced to alter their gait to compensate for foot pain often end up with multi-joint arthritis, cartilage degeneration, joint abnormalities, or overuse injuries.

Though our experts are foot and ankle specialists, we routinely ask patients how their hips, knees, backs, and legs feel since hearing the firsthand experience is helpful when making a diagnosis. The physical examination allows us to put together a comprehensive picture of a patient’s health and where excessive pressure may be throwing off the kinetic chain. Our gait analysis center uses computers to show how much force the feet are absorbing and any corrections we can make with orthotic insoles, padding, surgery, or corrective footwear to reduce pressure and prevent injuries elsewhere in the body.

How Are Foot and Knee Pain Connected?

Of the 2,181 people who participated in the Framingham Foot Study from 2002-2008:

  • 16% of participants had bilateral foot pain, 6% had right foot pain, and 5% had left foot pain.
  • Men with right foot pain were 5-7 times more likely to have pain in that same knee or in both knees.

How Are Foot and Hip Pain Connected?

  • Foot pain was also linked with same-side hip pain in men.
  • Bilateral foot pain was associated with hip pain on both sides, on the same side, or on the opposite side in women.

Conclusions From the Study

“The study shows that a physician evaluating a patient for foot pain should also ask about possible hip or knee pain, and vice versa, so we can address all of a patient’s issues,” said study co-author Brian Halpern, MD. “In medicine, many times it comes down to ‘what does your MRI look like or what does your X-ray look like?’ But it’s really important to conduct a thorough medical history and physical exam. A comprehensive orthopedic evaluation may prompt a broader treatment strategy and possibly a referral to another specialist.”

It’s important to remember that pain in one area doesn’t mean other parts of your body may not be affected. Don’t brush off any pain as unimportant; instead, seek comprehensive professional care from experts who will consider every part of the kinetic chain.

Seeking Professional Care For Foot Pain

Most people make an appointment with a General Practitioner to explore their aches and pains, but a GP’s primary function is to mitigate acute symptoms. Though a sports medicine center may not be the first place you’d consider for hip, knee, or foot pain, our comprehensive approach of diagnosing and treating the root cause of suffering, rather than just focusing on the immediate symptoms, is a huge service to patients looking for long-term health and fitness.

Here at the Center For Podiatric Care and Sports Medicine, we work with Olympians, competitive runners, professional sports teams, high school athletes, active children, and active adults alike. We believe in using all the latest tools to help patients feel better and recover faster, including platelet-rich plasma injections, pain laser and ultrasound therapies, and implants. Plus, you don’t need to get a referral from a GP to be seen by our sports medicine doctors in New York City. Contact us for prompt assistance if you have any concerns about how your feet may be affecting other parts of your body.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.