Expert answers by Alex Pool, Orthotist
Published: 12 August 2026
Can Orthotics Help Knee Pain?
Knee pain is one of the most common issues we treat in the clinic, but the cause is not always the knee itself.
Your feet are the foundation for the rest of your body, so when foot alignment is off, the effects can travel upward through the knees, hips, and lower back. If one part of the body starts compensating for another, it can create extra strain and contribute to pain over time.
In this Ask an Orthotist article, we meet Alex Pool, an Orthotist born and trained in South Africa, with a Bachelor of Health Sciences in Medical Orthotics and Prosthetics from Durban University of Technology.
Alex answers some of the most common questions he hears about knee pain and explains how improving the body’s foundation from the ground up can have a flow-on effect through the knees, hips, and back.
Can orthotics help knee pain?
Yes, they definitely can, especially if the knee pain is coming from how your feet are moving. If your feet roll in (also sometimes referred to as overpronation) or even outwards (supination), it can throw the whole leg alignment off a bit and put extra stress through the knee joint.
Orthotics basically help guide your foot into a better position (think of it as wheel alignment for your body). By changing the angle, it can reduce some of that load off the knee, specifically when we are experiencing unilateral knee pain.
Pain is usually a mix of things. But when foot mechanics are part of the problem, they can make a
noticeable difference (think of the foundation of a house; a good strong foundation
that is level will result in a sturdier house)
Can foot alignment affect knee or hip pain?
Yes, foot alignment can affect knee and hip pain – very much so. Your feet are like the foundation for everything above, so if they’re a bit off, it can travel up the chain.
For example, if your feet collapse inwards, your knees tend to follow, and that can start irritating the knee or even the hip over time. The same goes the other way: if things aren’t absorbing load properly, something higher up usually accommodates it.
Orthotics can help by improving that alignment and giving you a more stable base. Not always the only issue going on, but often it’s a missing piece people don’t realise is there.
Can orthotics help with lower back pain?
They can, but it depends on what’s causing the back pain in the first place. If your feet aren’t giving you a stable base, it can affect how your whole posture lines up: ankles, knees, hips, then your lower back ends up compensating. Over time, that can lead to a bit of strain or fatigue back there.
Orthotics can help even things out a bit and reduce that chain of compensation. But yes, back pain is rarely just one thing. A good example and common issue that we treat is leg length discrepancies (when one leg is shorter than the other). Common issues include one side taking more impact as more weight is passed through the longer limb; patients often complain of hip and lower back pain often. This usually goes unnoticed for several years, sometimes even decades. Usually, a simple fix such as a shoe raise or wedge we place in your shoes is all it takes to reduce symptoms considerably and load pressure more evenly across the body.
What causes knee pain when running?
Simple question with no so simple answer. It’s usually not just one thing.
Most of the time it’s a combination of training load (doing too much too quickly), muscle imbalances (hips are a big one), and sometimes footwear not really suiting you. Running form plays into it as well.
Foot mechanics can definitely contribute. If your feet are rolling a lot or not absorbing impact well, that force can end up irritating the knee, especially with things like runner’s knee.
Usually, we look at the whole picture rather than just blaming the knee itself.
Can orthotics help with shin splints?
Yep, quite often they do, especially when shin splints are linked to how the foot’s moving.
If you’re overpronating or not absorbing load well, the muscles along the shin must work harder to control things, which is where that pain starts creeping in.
Orthotics help take some of that strain away by improving how the foot handles load. That said, you still want to look at things like training volume, shoes, and a bit of strength work too; otherwise, it can just keep coming back. So yes, helpful tool, but not the only piece.
How do orthotics improve posture?
Basically, it starts from the ground up. If your feet are more stable, everything above has a better chance of lining up properly.
When your feet collapse or don’t support you well, your body naturally compensates, knees, hips, even your back shift a bit to deal with it. Over time that can turn into a posture that’s not very efficient
Orthotics help guide things back toward a more natural position. It’s not like you suddenly stand perfect overnight, but it can reduce strain and make things feel a bit more balanced, when posture is more localised to the upper body we can target those areas with a posture support brace, which is able to give you a gentle reminder to position your shoulders a bit more back and keep your head and neck in good alignment. These are just basic examples; every patient is unique in how we approach the solution or improve areas that they are struggling with.
