Karl Johansson
Background
Karl, an experienced fell runner, began experiencing sharp anterior knee pain, particularly during downhill sections of her runs. Initially intermittent, the discomfort became more frequent, affecting both her training routine and race performance.
She reported:
- Pain around and beneath the kneecap (patellofemoral area)
- Instability and occasional clicking during descents
- Swelling after longer runs or steep trails
Sarah tried rest, foam rolling, and knee braces, but the issue returned whenever she resumed hill work.
Assessment
A full gait and biomechanical analysis revealed:
- Excessive pronation, especially on her left foot
- Uneven loading through the medial (inner) knee compartment
- Weak alignment during mid-stance and propulsion phases of gait
- Overactive quadriceps compensation, increasing patellofemoral load
Orthotic Intervention
Karl was prescribed custom full-length sport orthotics designed to:
- Control overpronation and enhance foot alignment
- Redistribute pressure evenly through the knee joint
- Improve lower limb tracking during technical terrain descents
- Reduce shock loading on knees by optimizing foot strike and push-off mechanics
Results (After 5 Weeks)
- Significant reduction (90%) in knee pain, especially during downhill running
- Improved stride symmetry and smoother transitions on uneven surfaces
- No post-run swelling or clicking reported after long trail sessions
- Increased training volume without flare-ups
Sarah also noted improved confidence on descents, where she had previously been holding back due to pain and instability.
Conclusion
This case highlights the importance of foot and ankle stability in knee function, particularly in demanding off-road environments. Through biomechanically tailored orthotics, Sarah was able to overcome chronic knee pain, regain full training capacity, and prepare for upcoming competitive events.
Custom orthotics offer a proactive solution for athletes in high-impact sports—bridging injury prevention with peak performance.
Foot Factor provides Expert Podiatry Treatment Tailored to You.
At Foot Factor, our podiatrists specialize in diagnosing and treating foot pain with precision and expertise. With advanced gait analysis, custom orthotics, and sports-focused podiatry care, we don’t just identify the problem—we provide a targeted solution to get you back to moving pain-free. Book a consultation today and take the first step toward lasting relief.
Services Used
Sports Podiatry Consultation
Our expert-led consultations dive into your movement history, pain points, and performance goals. Whether you're injured or seeking preventative care, we tailor each session to get you back on track—stronger, faster, and with a plan built around your lifestyle.
Gait & Biomechanical Analysis
We combine pressure plate data, high-speed video, and postural analysis to understand how your body moves—step by step. This advanced insight helps us detect imbalances and inefficiencies that could be causing pain or limiting performance.
Same-Day Bespoke Orthotics (Trail Running Adaptation)
Crafted in-clinic within 90 minutes, our custom orthotics are designed specifically for the demands of fell and trail running. Lightweight, durable, and precisely moulded to your feet, they provide targeted support exactly where you need it—on and off the hills.
Injury Prevention Plan
Preventing injury is as important as treating one. Our prevention plans blend rehab exercises, footwear guidance, and performance strategies to keep you active and resilient—so you can train hard without setbacks.
Foot Factor didn’t just get me back on the hills—they helped me run smarter. I’m climbing harder and recovering quicker. Game changer.
Karl Johansson
Fell Runner