Foot, Ankle, Shin, Knee or Hip Pain? Check Your Posture.

By: Dr. Peggy Malone


I see athletes in my practice everyday who have painful shin splints, plantar fasciitis, morton’s neuroma, Achilles tendinitis, knee pain, iliotibial band syndrome, strained hamstrings, hip pain, back pain or some combination of these.


Most athletes who are injured spend a lot of time addressing the injured area, and thinking about how they can make changes in their training to change up what may be the aggravating cause of the injury.  


Very few athletes think to up their awareness level about what they are doing in life when they are not competing in their sport.


I have noticed through the years of helping athletes that there are two common postures that almost every single one of these injured athletes does in their everyday lives that are almost certainly contributing to their pain and injuries.


If you have been suffering with shin splints or one of the other injuries that I mentioned above, you may get some benefit and some relief just by making some simple changes in the way you hold your body.


100% of the athletes that I see in my office who are suffering with shin splints, (and many with other leg injuries) have a tendency to stand with knees that are extended too much, or hyperextended.  While they are standing relaxed, they push their knees backwards and hang on the knee joints without activating any musculature in the legs.


This causes the hips to rock forward and the belly to protrude out, which ends up causing pinch to the joints of the low back.

If you look at a 2 year old stand, this is what they look like.  The reason that they look like this is because they haven’t yet developed the muscle strength and function to support themselves in a better posture.  As adults, we should have this figured out….but instead of using our muscles to support and stabilize our bodies…we hang on the joints which can, in many cases, lead to injury.


This hyperextended knee posture is detrimental in several ways.  


First, by hanging on the knee joint capsule and ligaments instead of supporting the joint with muscle activation, you are putting the knee at risk of injury as well as future degeneration.


Second, this posture creates a situation where the feet are more likely to roll in or pronate which puts a lot of pressure on the anterior (front) and medial (inside) muscles of the lower leg.  These are the muscles that, when they get angry,  are responsible for much of the pain of Shin Splints.


Third and most importantly, as I mentioned above, I see most people hanging on their hip and pelvic joints which creates a situation where their belly protrudes out and the lumbar lordosis (curvature) at their low back is amplified creating risk for back pain.  


This will create a situation of deactivation of the musculature that is supportive and offers stabilization to the pelvis, and ultimately to all the musculature below the pelvis (all the way down to the feet). This muscles are primarily the gluteal musculature.


If someone has a habit of standing this way all the time while they are relaxed, their bodies become accustomed to not having to use the stabilization muscles of the pelvis that are so important during running and other sports.


Then, when they go to run or do their sport, each step will not be supported in the way that it should be, making all the muscles from the floor to the core work harder each step.


The end result, if this is done repetitively (as running tends to be) is Shin Splints.  Or foot pain, or Achille’s tendinitis, or Iliotibial band syndrome, or hamstring strain or hip pain…etc.


Ok, so that’s the bad news.  There is good news.


I tell all of the athletes in my office that they have this bad habit of standing with their knees hyperextended and I tell them that it’s time to create a new habit.



All you have to do is check in with yourself occasionally and see what you are doing.  If you catch yourself in the bad posture, make a correction by softening your knees.  At first this will feel like you are doing a squat because your body is so used to being in the extended position and the muscles of your legs are not used to doing the work of supporting you while standing.


It will start to get easier the more you stick with it.


You can find someone in your life that is around you often and ask them to check on you and remind you to soften your knees or set an alarm on your watch for every 30 min or every hour to check in and see what your posture is.


The second posture that I commonly see that contributes to many running injuries is similar to the hyperextended knee posture but, the athlete tends to rest in one hip or the other when standing relaxed.



They tend to lean toward one hip putting most of their weight in that side and the knee under that hip is hyperextended.


This posture is common when the athlete has the symptom more strongly in one side than the other.  This posture creates similar stresses on the knees and pelvis but particularly on the side of the lean.


As a result, the deactivation of the musculature on that side leads to the injury showing up somewhere from the floor to the core on that same side.


Other common life postures that may lead to repetitive running/sports injuries because of how your body adapts to them are sitting with one leg crossed over the other.  Most people prefer one side over the other and often have an injury from the hip down somewhere on that side.


Spending a lot of time driving in the car with the right leg forward on the gas and switching to the break will also create problems in many cases on the right side of the body.


So, now that you have a new awareness that your injury may have started long before you laced up your running shoes…


… try these postures that we have discussed today.  See if you are guilty of them and then see if you can correlate them to some running injuries that you have been struggling with.


Next, break yourself of these habits and really take notice of how you spend your relaxed standing and sitting time when you are not doing your sport.


Your shins, feet, ankles, knees, legs, hips…..will thank you 


Until next time,


Live Well,





Dr. Peggy Malone is a Chiropractor and an Athlete who helps other athletes to overcome injury and get back to their sport. Her weekly Television Series 'Living Well" inspires people from all walks of life to take control of their health to be as happy and as healthy as they can be.

A former varsity Basketball and Rugby player, she has since entered the world of endurance athletics where she has completed 2 Ironman Triathlons, 3 Marathons, several Half Marathons and many other Triathlons, Road Races and Off-Road Adventure races of varying distances.

Her own athletic endeavors and injuries have given her valuable insight into working with athletes in her practice for both the care of injuries as well as for the improvement of athletic performance.