How to relieve knee and ankle pain: causes, connections, and exercises

Your knees and ankles are essential for your daily activities. “You use your ankles and knees for everything — walking, sitting, standing, climbing stairs, getting in and out of a car, and bending over to pick things up off the ground,” says Renee Bullis, PT, DPT, a physical therapist at Hinge Health. When your knees or ankles hurt, these activities become more challenging. Pain in both joints can make some tasks feel impossible.

A combination of knee and ankle pain in the same leg is common because of the relationship between your knee and ankle. But that doesn’t mean you have to grin and bear it or cut back on what you do. In fact, staying active is essential in managing and treating knee and ankle pain. 

Read on to learn how knee and ankle pain are connected, what causes pain to occur in both places together, and what you can do to treat and prevent it — especially with exercises recommended by Hinge Health physical therapists.

Why are knee and ankle pain connected?

“The knee and ankle joints are interconnected through what we call the kinetic chain,” says Dr. Bullis. Remember the song Dem Bones?

The ankle bone’s connected to the leg bone. 

The leg bone’s connected to the knee bone…

That’s the concept of the kinetic chain. “Your joints, muscles, tendons, ligaments, and other connective tissue interact with each other when you move,” says Dr. Bullis. When one part moves, it affects the other parts. 

“The knee and ankle joints are neighbors,” says Dr. Bullis. “If there’s an issue at one, such as a lack of mobility, weakness, or pain, it can affect the joint above or below.” For example, if you have poor ankle mobility or ankle pain, your knee could try to compensate and take on more stress. Similarly, knee pain or a knee injury can shift your gait when you’re walking, which can put more pressure on your ankle and lead to symptoms, such as pain and stiffness over time. 

The resulting pain can vary from a dull ache to sharp, shooting pain. It could be throbbing, constant, or intermittent. Sometimes it may feel more like discomfort or stiffness. And the pain may feel different in each joint. How your pain feels often just depends on what’s contributing to it.

Causes of knee and ankle pain 

Here are some common reasons you may experience knee and ankle pain.

• Pain or injury in one of the two joints. If you have tendinitis or a sprain, strain, or fracture in your knee or ankle, you’re more susceptible to pain or injury in the neighboring joint. Muscles, nerves, and other connective tissue run between these joints, making it easy to experience pain in another area. 

• Pain or injury in another area of your body. “Our bodies are smart,” says Dr. Bullis. “If you have pain, an injury, or weakness in one area, your body compensates.” For example, if you have pain in the bottom of your foot, you may shift the way you walk. While that’s helpful initially to relieve pain and keep you moving, it can put more stress on other parts of your body, like your ankle and knee. Over time, that stress can lead to pain or an injury in those areas, or even further up your body, like your hip or back.

• Increased activity. Activity is beneficial, but a sudden increase can cause knee and ankle pain if your body isn’t quite ready for it. “I see this a lot in the spring when people jump back into activities like tennis or pickleball after not playing them for much of the winter,” says Dr. Bullis. “The activity isn’t bad. It’s just a matter of easing into an increased activity level gradually.” 

• Ignoring an issue. Stiffness, soreness, or pain in either your ankle or knee, or other parts of your body, can lead to future problems in other joints if you don’t address the issue. 

• Chronic conditions. Arthritis is a common condition that can result in both knee and ankle pain. It may contribute to swelling in joints, which can limit range of motion and trigger other joints to compensate. There is even evidence that changes in how your ankle moves can contribute to the development of knee osteoarthritis. That’s another reason you don’t want to ignore pain.

These exercises recommended by Hinge Health physical therapists help to alleviate knee and ankle pain in multiple ways. They strengthen the muscles surrounding your knee and ankle joints to provide more support, which takes pressure off the joints. They improve mobility and flexibility for greater range of motion. They increase circulation to provide more nutrients and lubrication to joints. And they also help with balance and proprioception, or body awareness, which can protect you from injury.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for knee and ankle pain

Your ankles and knees are crucial for stability and mobility, so you want to take care of them to stay active and healthy. The sooner you address any pain issues, the quicker you can get back to your regular activities and prevent problems in other areas of your body. Most knee and ankle pain can be treated conservatively with options like these.

• Exercise and physical therapy. Strengthening and stretching the muscles surrounding your knees and ankles provides support and reduces stress on those joints. If you don’t get relief from the exercises above, a physical therapist (PT) can design a program to address your specific needs. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• P.E.A.C.E and L.O.V.E. protocol. This new self-care model is more comprehensive than the R.I.C.E. (rest, ice, compression, elevation) approach for knee and ankle pain and injuries. It prioritizes movement and exercise over rest, encouraging active recovery to promote faster healing and long-term resilience.

• Ice and heat. Icing can help reduce swelling and pain immediately following a knee or ankle injury. Heating increases blood flow and can reduce stiffness. You can apply ice or heat as needed for 10 to 20 minutes at a time, but avoid using heat to treat a new injury, which may delay healing. 

• Activity modification. Movement is medicine, so you don’t want to remain or become sedentary. However, sometimes you need to modify how much or what you’re doing to stay active without aggravating your pain. For example, if walking is too painful, try low-impact activities like biking or swimming. “This takes some of the stress off your joints, and you’re working through a gentle range of motion,” says Dr. Bullis. 

• New shoes. Shoes play an important role in protecting your joints from impact. If you’ve had your shoes for six months or longer and you’re noticing pain, it might be a signal that you need new shoes. 

• Massage gun. This handheld device helps to reduce muscle tension, increase circulation, and improve range of motion. For knee and ankle pain, Dr. Bullis recommends working on the front and back of your thighs and your calves with the massage gun. Make sure to use the massage gun over your sore muscles and avoid bony areas. 

How to prevent knee and ankle pain

There are numerous steps you can take to protect yourself from knee and ankle pain. Here’s how.

• Stay active. “Do a little bit of activity every day to work on your mobility, strength, and balance,” says Dr. Bullis. “It doesn’t have to take a lot of time, but doing it consistently can really help prevent knee and ankle pain.”

• Start slow. “When starting a new program, ease into it,” says Dr. Bullis. “Be mindful of how your body’s responding so you don’t overdo it.” Going too hard or too long when your body isn’t used to an activity can set you up for pain or an injury. And don’t forget to warm up before any activity.

• Take movement breaks. If you’re sitting for long periods of time, get up and move around every hour or so. “Moving your body increases blood flow and lubricates your joints so you’ll be less likely to develop stiffness,” says Dr. Bullis. The increased circulation also brings more nutrients to muscles and joints to keep them healthy.

• Invest in good shoes. “Your shoes can impact your ankles, knees, back, and hips,” says Dr. Bullis. So it’s important to find the right pair for you. It’s generally best to avoid wearing high heels or thin, flimsy shoes regularly, since these can put more stress on your lower leg.

• Replace shoes regularly. Worn-out shoes don’t provide enough support, especially for activities like walking or running. A lack of support can increase your risk of knee and ankle pain. Shoes that you wear regularly usually need to be replaced every six to 12 months.

• Act fast. “When you start to feel aches and pains creep up, and they linger, it is best to address them sooner rather than later,” says Bullis. Taking quick action can help prevent minor discomfort from turning into a more serious issue, making recovery easier and faster in the long run.

PT tip: Meet yourself where you’re at

It can be frustrating when pain slows you down, especially if you have a very active lifestyle. But pushing through pain could result in ‌longer downtime, more problems, and more frustration. “Don't compare your capabilities now to what you were previously able to do without pain,” says Dr. Bullis. “Instead, take note of where you're at and set a goal of moving forward. Then ease into exercise, taking consistent, small steps to improve mobility and strength.” As you progress, listen to your body and adjust accordingly so you don’t aggravate the problem. “Be mindful of your movement sweet spot as you work your way back to what you used to do.”

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Perry, T. A., Segal, N. A., Bowen, C., Gates, L., Arden, N., & Nevitt, M. C. (2021). Foot and Ankle Pain and Risk of Incident Knee Osteoarthritis and Knee Pain: data from the Multicentre Osteoarthritis Study. Osteoarthritis and Cartilage Open, 3(4), 100210. doi:10.1016/j.ocarto.2021.100210

2. Corrigan, P., Felson, D., Neogi, T., Lewis, C., Torner, J., Nevitt, M., Lewis, C., & Stefanik, J.. (2021). Relation of Foot and Ankle Pain to Worsening Knee Pain: The MOST Study [abstract]. Arthritis Rheumatology, 7(9).