Joe Nimble

Is 10,000 steps per day a pain in the …. knees?

Regular physical activity has many health benefits (Blair, 2009), and public health campaigns recommending 10,000 steps per day are based on undisputed physiological principles and large-scale medical research (Wattanapisit and Thanamee, 2017). The benefits of physical activity are largest for those moving from sedentary to active (Lee et al., 2014), unfortunately, knee pain is the largest barrier to sedentary people becoming active or engaging in regular physical activity (Hootman et al., 2001) affecting 25-37% of over 50s (Nguyen et al., 2011).

Dysfunctional feet and knee pain

Around 60% of adults have structurally compromised feet (Dunn et al., 2004). Toe deformity, leading to an unstable foot, is the most prevalent problem afflicting 23% of 18-65 year olds and over 36% of over 65s (Nix et al., 2010). Compromised big toe position leads to excessive pronation and inward collapse at the knee in walking (Plank, 1995). Walking 10,000 steps per day equates to 3,650,000 steps per year, each step loading the supporting leg and foot with up to 125% of bodyweight. For an 80kg person, that’s a cumulative load of 10,000,000 Newtons per day or 365,000,000,000 Newtons per year! Is it any wonder that a dysfunctional, unstable foot is a major factor in movement-related pain?

Restoring foot function and stability

To restore foot stability, the natural spread of the toes must be restored. Fortunately, the plasticity that permitted development of compromised feet in response to narrow, shoe-shaped shoes (Munteanu et al., 2017), also permits restoration of foot structure and therefore foot function (Knowles, 1953).The solution is:

  1. Wear foot-shaped (functional) shoes with space for the toes to spread and the foot to widen and flatten and;
  2. Load the feet with bodyweight creating the force to stimulate restoration of foot shape and function.

In functional shoes, 10,000 steps a day can become the cure for your pain, instead of the cause!


  • Blair SN. Physical inactivity: the biggest public health problem 21st century. British Journal of Sports Medicine (2009)
  • Dunn, JE et al. Prevalence of foot and ankle conditions in a multi-ethnic community sample of older adults. American Journal of Epidemiology (2004)
  • Hootman, JN et al. Epidemiology of musculoskeletal injuries among sedentary and physically active adults. Medicine & Science in Sports and Exercise (2001)
  • Knowles, FW. Effects of shoes on foot form: An anatomical experiment. Medical Journal of Australia (1953)
  • Lee, D-C et al. Leisure-Time Running Reduces All-Cause and Cardiovascular Mortality Risk. Journal of the American College of Cardiology (2014)
  • Munteanu, SE et al. Hallux valgus, by nature or nurture? A twin study. Arthritis Care & Research (2017)
  • Nguyen UDT et al. Increasing Prevalence of Knee Pain and Symptomatic Knee Osteoarthritis. Annals of Internal Medicine (2011)
  • Plank, M. The pattern of forefoot pressure distribution in hallux valgus. The Foot. (1995)
  • Wattanapisit, A and Thanamee, S. Evidence behind 10,000 steps walking. Journal of Health Research (2017)

Article picture: © naturwohl-gesundheit –

Tags: activity, knee, foot function, science, mobility, foot