The Ankle is the Foundation

If there is one part of our body we are most disconnected from, it is our feet.  Hidden in shoes, wrapped in socks, our feet are kept in solitary confinement for most of our lives.

Your feet are your foundations.  You can focus on knees or hips or backs all you like but if you don’t deal with what is supporting them from below, you may run into trouble.     A nice analogy would be renovating an old house.  You spare no expense; marble bathtub, beautiful wallpaper, the latest kitchen.  You spend all this time and money fixing this big beautiful house, but you totally forget to re-stump it.  Without good foundations, the cracks will soon appear again.

Ankle Joint Neutral Talo-Crural Neutral

The Ankle Joint is designed to sit in ‘neutral’.

When the arch of our foot collapses, we call this ‘ankle pronation’ (flat footed).

Ankle Pronation Flat Feet


The foot is the foundation of the knee.   If the foot collapses inwards, the knee falls inwards.

Pronated ankle internally rotated knee femur


Orthotics are a short term solution

This is where supportive shoes and ‘orthotics’ come in to play.  Shoes with arch support will prop your ankle up to help restore your knee alignment.  This is however a short term solution.

Functionality of the arch.

Osteitis Pubis Adductor Tib Post

Your Tibialis Posterior connects the arch of your foot to your pelvis via your adductor muscles (groin).

The arch of your foot is controlled by a muscular function (tibialis posterior).  When your Tibialis Posterior (Tib Post) contracts, your ankle is pulled out of ‘pronation’ and into ‘neutral’.

Without a neutral ankle, your foot has no stable connection to the rest of your body.

The role of feet.

Your feet are designed to communicate what’s happening on the ground to your hips, so that they can make decisions about how best to stabilise. Remember most of our running was cross country, on uneven surfaces, so our feet needed to relay a lot of information to keep us from falling over.

When we put our feet in shoes for years on end, we train our feet to become lazy, with causes the ankle to collapse.  Propping up the ankle is ok, but without activation of your Tib Post, you are still waking around without muscular/fascial support.

Whilst everything may be in line when you wear a supportive shoe, nothing is actually active, so you still lose the spring in your step.

Mountain Pose

In yoga, this relationship can be described by looking at the movement called Mountain Pose.   Mountain Pose looks at stability through the foot, which in turn supports the knee and the pelvis.  You must have at least a basic awareness of your ankle stability if you want to fix your knee pain.