Knee Pain From Foot Alignment | Workshop Live: Episode 13
, by Tony Chiappetta , 9 min reading time
Tony Chips walks through a six-month orthotic checkup for a customer experiencing persistent knee pain—not from the foot itself, but from underlying alignment issues.
Orthotics for Knee Pain Caused by Alignment Issues – Workshop Live
In this Workshop Live recap, Tony Chips walks through a six-month orthotic checkup for a customer experiencing persistent knee pain—not from the foot itself, but from underlying alignment issues.
This case highlights an important concept: even when your feet feel fine, improper alignment can travel up the chain and create discomfort in the knees, hips, and beyond.
Understanding the Root Cause: Alignment Over Foot Pain
Unlike many cases, this customer presented with minimal foot discomfort but ongoing knee irritation, especially on the right side.
Here’s what Tony identified:
- Genu valgum alignment (knees collapsing inward)
- Excessive pronation on the right foot
- Abduction during gait (foot splaying outward)
- Pain on both the inside and outside of the knee
Even though the left side appeared structurally “worse” from a medical standpoint, the right side was the one causing symptoms—showing how compensation patterns can drive pain.
As seen in other orthotic cases, issues higher up the body often originate from how the foot interacts with the ground.
What Had Already Been Working
The customer had been wearing orthotics successfully for about six months and staying consistent with physical therapy focused on:
- Core strength
- Quadriceps strengthening
- Mobility work
While this created a solid foundation, the recurring knee pain signaled that alignment still needed fine-tuning—not a complete overhaul.
The Workshop Approach: Small Adjustments, Big Impact
Rather than overcorrecting, Tony focused on targeted modifications to improve alignment and gait efficiency.
Step 1: Medial Support for Alignment Control
- Added a scaphoid pad to support the medial arch
- Built in a rearfoot medial wedge to reduce pronation
Step 2: Forefoot Wedge for Gait Correction
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Introduced a lateral forefoot wedge
This subtle addition helps guide weight distribution away from the big toe and encourages a more balanced stride.
Step 3: Balance the “Good” Side
- A longitudinal arch barfor light support
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This keeps both sides working together and prevents future compensation issues.
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This keeps both sides working together and prevents future compensation issues.
Why Less Is More with Alignment Fixes
One of the biggest takeaways from this Workshop Live is the importance of restraint.
Instead of aggressive corrections, Tony used a moderate, strategic approach:
- Small wedges instead of large structural changes
- Matching materials for a consistent feel
- Adjustments that support natural movement rather than fight it
This mirrors a key principle seen across orthotic success stories: thoughtful, minimal changes often outperform heavy-handed corrections.
Book Your FREE Appointment
If you’re ready to stop Googling and start solving, we’re ready.
We’ll assess your foot type using the Quadrastep Foot Typing System, evaluate your gait, and recommend the best path forward — whether that’s footwear, an OTC insert, or a true custom insole.
FAQ
Q: Why do orthotics sometimes cause more pain?
A: If they overcorrect, especially in flexible feet, they can irritate pressure points instead of relieving them.
Q: Should orthotics correct or accommodate feet?
A: Accommodation often works better, supporting natural movement without fighting it.
Q: Do orthotic materials matter?
A: Absolutely. Too stiff = uncomfortable, too soft = no support. The right balance is key.
Tony Chiappetta
Tony is a certified pedorthist and an owner of Chiappetta Shoes, a family-run business. With decades of experience, Tony specializes in crafting custom orthotics to alleviate foot pain. Through his hands-on approach, he empowers customers to achieve lasting comfort and mobility.
