A connection exists between having high arches and experiencing knee pain. This relationship is not a direct cause-and-effect, but a structural issue in the foot that alters the walking and running mechanism, placing stress on the knee joint. The foot influences the alignment of the leg, and when this foundation is exaggerated, forces are transmitted differently up the body. Understanding this biomechanical pathway is the first step toward managing the resulting discomfort.
Defining the High Arch (Pes Cavus)
The medical term for a high arch is pes cavus, which translates literally to “hollow foot.” This foot structure is characterized by an exaggerated arch that remains elevated even when the foot bears weight. Individuals with this condition often concentrate their weight on the heel and the ball of the foot, leaving the midfoot unsupported.
The high-arched foot is typically rigid, meaning it has limited flexibility and movement through the midfoot joints. This rigidity is significant because a healthy foot requires flexibility to adapt to surfaces and absorb impact shock. This structural variation can range from a mild form to a severe deformity, sometimes linked to underlying neurological conditions.
The Biomechanical Pathway to Knee Stress
The primary function of a healthy foot is to absorb impact forces and distribute them evenly, relying on the arch’s ability to slightly collapse and spring back. A rigid, high arch compromises this function, leading to reduced natural shock absorption. When the foot strikes the ground, impact forces are transmitted more directly up the leg, affecting the ankle, knee, and hip.
High arches cause the foot to roll outward, a motion known as supination, throughout the gait cycle. This outward rolling means the foot is less able to absorb rotational forces, forcing the leg above to compensate. This compensation often leads to an outward rotation of the tibia, which alters the mechanics of the knee joint.
The change in lower leg alignment can lead to abnormal tracking of the kneecap (patella) as the knee bends and straightens. The increased force transmission, combined with the altered alignment, places uneven stress on the knee’s soft tissues and cartilage. This mechanical inefficiency is why a foot issue can manifest as pain higher up the kinetic chain.
Common Knee Conditions Linked to High Arches
The abnormal forces and altered alignment caused by pes cavus often result in specific knee injuries. One frequent diagnosis is Patellofemoral Pain Syndrome (PFPS), sometimes called “runner’s knee,” characterized by a dull, aching pain around or under the kneecap. This condition is related to the poor tracking of the patella over the femur due to the foot’s supinated position.
Another condition associated with high arches is Iliotibial Band (IT Band) Syndrome. The IT band is a thick band of tissue running down the outside of the thigh from the hip to the shin. The constant supination and external rotation of the lower leg increase tension on this band, causing friction and pain on the outside of the knee.
These conditions are overuse injuries resulting from repetitive impact and strain placed on the knee structure. The pain often develops gradually, worsening with activities like running or climbing stairs. The underlying foot structure creates a chronic mechanical disadvantage that predisposes the knee to these issues.
Strategies for Pain Relief and Support
Addressing knee pain caused by high arches begins with improving the foot’s ability to manage impact and alignment. One effective intervention is the use of foot orthotics, which are inserts designed to redistribute pressure and provide support. Custom orthotics are beneficial because they are molded to the individual foot, supporting the arch and helping to control excessive supination.
Proper footwear is also a significant factor, and people with high arches generally benefit from neutral or cushioned shoes. The cushioning helps replace the natural shock absorption the rigid arch lacks, reducing the force transmitted to the knee. Avoiding shoes that promote excessive outward rolling is important to prevent exacerbating supination.
Physical therapy plays an important role by focusing on strengthening the muscles above the ankle. Strengthening the hip and core muscles improves stability throughout the kinetic chain, reducing the need for the knee to compensate. Exercises that promote flexibility in the calf muscles can also help alleviate the tension contributing to the foot’s rigidity.