The way your foot hits the ground will have a profound impact on the rest of your leg joints. If your foot contacts the ground so that your ankle bone tilts too far inward -- called overpronation -- the angle of your knee changes, potentially leading to pain. Walking or running downhill can further aggravate your knee joint. Corrective shoes, orthotic inserts and leg-specific exercises can help alleviate pain and even out your gait.
Pronation
As your foot performs its normal movements while you walk, it will naturally pronate slightly to absorb impact, flattening your arch. Your lower leg, knee and thigh also rotate inward. Excessive pronation occurs when your arch is already flat -- hence the term "flat feet" -- and your ankle bows to the inside. If you overpronate, you are at risk for over-use injuries, particularly if you run or hike frequently. The normal inward rotation your leg experiences is exaggerated, placing additional strain on the muscles, tendons and ligaments of your lower leg. Shin splints, plantar fasciitis and patellofemoral pain syndrome, or PFPS, can result from overpronation.
Patellofemoral Pain Syndrome
PFPS is characterized by anterior, or front, knee pain that typically occurs with activity and worsens when you go down steps or hills. Overpronation is one of the biomechanical conditions that can lead to PFPS, as it causes your patella or kneecap to track incorrectly. Repeated, weight-bearing impact -- like that experienced while hiking downhill -- when your kneecap is misaligned can damage tendons, ligaments and the cartilage that cushions your knee joint.
Shoe Solutions
One way to improve your overpronation is to buy the right footwear or see a specialist for orthotic inserts. Since overpronation angles your leg and ankle inward, more support is needed in the medial or inner arch. If you are an active hiker, select shoes with harder material in the medial insole to ensure the shoe supports your arch even after repeated compression. Orthotics and heel cups -- both custom-made and over-the-counter types -- are also effective; you can place them in almost any shoe to help even out your gait.
Physical Therapy
Increasing the strength, endurance and flexibility in your leg muscles will also help alleviate pain and potentially prevent further injury. Weak quadriceps -- your front thigh muscles -- will cause improper tracking of your kneecap. Overpronation can actually be caused by weak or tight external hip rotators; stretching and strengthening these muscles is recommended. Tight hamstrings -- your back thigh muscles -- will also impact the stress on your knee joint, as it leads to more pressure between your patella and thigh bone. Talk to your doctor or a certified personal trainer to develop a program to strengthen and stretch your leg muscles. Your pain may lessen and your hiking endurance may improve.
