Flat feet, pronated feet (collapsed arches), high arches and leg length discrepancy are some biomechanical factors that can contribute to pain in the knees and legs. When the feet are not centred and weight is borne unevenly, forces are concentrated on focal areas. Sudden increases in activity, weight gain and overuse from doing too much too soon will produce pain in these areas. Poor foot mechanics also leads to inefficient walking and running patterns, and poor shock absorption. This can be corrected with orthotics (shoe inserts) and suitable footwear.


Calf strain refers to a tear of some fibres in the calf muscles, namely the gastrocnemius or soleus muscles. Calf muscles that are tight, weak or attempting to compensate for another weak area, such as ankle instability, will be prone. Common sites of injury are the central and inner aspect of the mid calf where the achilles tendon meets the fleshy gastrocnemius muscle. If there is pain on walking, a heel raise in the shoe will take some of the strain off. Physiotherapy, using ultrasound, therapeutic massage, progressive calf stretching and strengthening, will help optimize recovery.


Achilles tendonitis is the inflammation and degeneration of the Achilles tendon that connects the calf muscles to the back of the heel. Tight calf muscles, hard running surfaces, overuse and poor footwear superimposed on poor foot biomechanics is a recipe for injury. Due to the tendon’s poor blood supply, it has a very slow healing process and easily develops into a chronic condition if not properly treated. If there is pain on walking, a heel raise in the shoe will take some of the strain off. Initial management involves rest from aggravating activities and ice. Long-term management requires the correction of foot and leg alignment issues, attention to training factors and footwear, deep tissue massage of the tendon, calf stretching and strengthening.


Shin splints are often caused by inflammation where the calf muscles insert into the tibia on the inner aspect of the leg. It is an overuse injury from running on hard surfaces or up hill, and sudden increases in activity. Poor footwear, tight calf muscles, flat or high arches of the feet are contributing factors. Treatment involves rest from aggravating activities, ice and physiotherapy to release the injured and tight muscles. Orthotics (shoe inserts) and proper footwear help dissipate shock waves from the ground. There should be a graded and gradual increase in training, keeping within pain-free limits.