Knee pain can often be related to foot function, especially when excessive internal rotation of the Tibia and Fibula is due to foot function. Excessive pronation of the subtalar join between the Talus and Calcaneus, can lead to changes in the Q angle of the knee. Continuous repetitive changes to the alignment of the knee during gait, commonly leads to knee pain. Even when knee pain is due to other medical conditions or previous trauma or injury, excessive strain on the knee due to foot related biomechanics, can exacerbate the pain that is experienced in the knees. Careful and complete assessment of the contributing factors present in the knee lead to a treatment plan to address these factors. This may include stretching and strengthening exercises, foot orthotic therapy, or she wear recommendations.