We may think about our ankles and knees as separate joints but what happens at one is likely affecting the motion of the other. For this reason, if there is inadequate muscular support, excess forces can be placed through a joint. This can present as pain in one or both joints when tasked with more intense physical activity.
Ankle Pronation and Knee Valgus
If we think about a runner, each step requires the leg to support the weight of the body with the ankle, knee, and hip all working together. If there is an area of weakness, that can affect the leg’s ability to support this kind of loading. It is common to see that people will show dynamic pronation of the ankle during this type of exercise. This is an inward collapse of the ankle that occurs when weight is loaded through it. You can imagine that this alters the angle of the shin and lower leg, which then affects the orientation of the knee joint. So, ankle pronation can result in someone appearing more knock-kneed when trying to manage these higher forces. This is referred to as knee valgus and results in a greater amount of stress through the knee. Someone who demonstrates these attributes when running or performing other forms of exercise can commonly experience both ankle and knee pain.
How to Improve Pain and Tolerance to Exercise
To achieve long term relief, it is important to address the root of the issue. In many cases, there is weakness in the muscles of the leg that contribute to the faulty movement patterns discussed above. A physical therapist can help you identify these areas of weakness and prescribe exercises that target these muscles specifically to naturally remedy the problem over time. Additionally, shoe insoles that help provide arch support can reduce the instance of ankle pronation, help improve tolerance to recreational exercise, and generally reduce pain in these joints. Lastly, low impact exercise such as biking or using an elliptical may be a more tolerable alternative to higher impact exercises until the strength of the leg is enough to allow for return to these activities.
If you suffer from pain during exercise, when going up or down the stairs, or even walking, physical therapy can help. Call Respire Physical Therapy at 703-671-1871 or click here to request an initial evaluation with a physical therapist today to address your problem directly and get back to your favorite activities! 
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