Those who experience pain in their backs, hips or knees while walking, running, working or exercising may find that the source of their discomfort resides much lower in their bodies – perhaps in their feet, said Seattle physical therapist Izette Swan.

Made up of 26 bones, 33 joints and more than 100 muscles, tendons and ligaments, the feet are complex structures designed for shock absorption and propulsion. Any functional deficiencies within the feet can negatively affect muscles and joints up through the legs and into the back.

“Pain in the spine, hips and knees may be caused by an abnormality in the feet or gait,” said Swan, owner of Real Rehab Sports + Physical Therapy in Seattle.

“When dealing with such issues, you have to take into consideration the entire kinetic chain, from the feet up through the body,” Swan added. “Assessing how your body moves globally, starting with the feet, is often key in identifying the underlying causes of pain and dysfunction in other parts of the body.”

Such assessments may find your feet to be the cause of these dysfunctions, or they may determine your feet are innocent bystanders (so to speak) in a more complex chain of movement-related deficiencies.

For instance, an improper step brought on by issues in strength, stability, balance, mobility and/or flexibility of any part of the lower extremity along with improper footwear, Swan said, can lead to painful foot conditions such as plantar fasciitis, Achilles tendonitis and bunions, to name just a few. Such conditions, along with the issues that caused them, can not only be the source of problems for your knees, hips and back but can also create problems for these areas.

“It’s common to take our feet for granted – that is, until they start to hurt,” Swan said. “It’s at this point when the rest of our bodies are most susceptible to injury because, to compensate for the pain and possibly a lack of flexibility or proper movement, more of the impact and stress normally absorbed by the feet is transferred up through our muscles and joints.”

Swan suggests stopping such potential chain reactions in their tracks. Physical therapists are able to analyze a person’s foot type and gait, then suggest footwear specifically designed for the shape of his or her feet.

Physical therapists are also trained to identify deficiencies in strength, stability, mobility, flexibility, balance and musculoskeletal makeup that may affect the feet and the rest of the lower quadrant.

“By achieving the right balance between flexibility and strength, mobility and stability plus wearing shoes that are appropriate for your foot type, your feet should feel great,” Swan said. “And of course, the rest of your body will benefit, as well.”