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Knee, Ankle and Foot

The Foot and Knee research group is focused on 4 keys areas:

  • Biomechanical function of the foot and knee during walking, running and various sports, 
  • How foot and knee structure and function are affected by disease (e.g. diabetes, obesity, osteoarthritis), injury (e.g. ACL tears, patellofemoral pain, lateral ankle sprain) and aging. 
  • Clinical and user (patient) research to investigate the real world consequences of poor foot and knee health for patients and athletes. 
  • Investigation of a wide range of physical therapy (e.g. exercise), device (e.g. orthoses) and health behaviour (e.g. compliance with devices or education programmes) interventions. 

One aspect of our research describes and explains how specific foot and knee structures (e.g. ligaments, bone structures, muscles and tendons) contribute to foot and knee function during walking, running and other important weight bearing tasks (e.g. sport). This includes how the size and form of foot and leg muscles relate to foot type, and how ACL injury relates to landing and jumping tasks. Other work has been concerned with mechanical properties of tendons and plantar fat pads. We are continuing work on how children’s feet develop.

How the foot and knee change their function due to disease, injury and aging is a prerequisite for the development and implementation of effective therapies. We have investigated changes in foot structure and function in people with diabetes, in stroke and in older people plus foot shape in those who are obese. We have also completed multiple studies evaluating the forces acting on the foot and knee in knee arthritis and patello femoral pain and how screening for certain biomechanical and clinical attributes could reduce injury and re-injury. A new focus is on the effect of lateral ankle sprains on ankle structures and function.

Developing and implementing quality interventions requires that we understand the mechanism of action of any intervention, so that its design and implementation is optimised. We have used biomechanical analysis to support improvements in footwear and foot orthotic design for people with diabetes, intermittent claudication, and general musculoskeletal disorders of the foot and knee (including in the workplace). In cases of knee arthritis work has focussed on evaluation of exercise, knee braces and foot orthoses, in terms of how these affect the joints, but also how patients’ lives are improved by the interventions (e.g. activity monitoring). 

Throughout all this research a growing theme is the voice of patients and application of qualitative methods to investigate health beliefs, behaviours and how interventions might better reflect patient perspectives. This includes work with patients on their understanding of foot health issues in specific diseases, their approach to use of footwear and orthoses, and how parents develop knowledge related to children’s foot health. We have worked directly with clinicians and the NHS to allow first hand insight to inform our research activities and the development of devices (such as orthoses). We are increasing looking at how digital technologies offer new opportunities for clinicians and services.

The research is supported by a wide range of NHS, clinical and industry partners. This includes East Lancashire NHS, Wrightington, Wigan and Leigh NHS, Salfordinsole Ltd, Toffeln Footwear Ltd, and FDM Digital Solutions Ltd.

Recently, the research has expanded out of the University to run projects within the National Institute for Health Research Clinical research Facility in Manchester and the new Manchester Institute of Health and Performance ( The MIHP is a strategic development alongside Manchester City Council, Sport England and Manchester City Football Group, and is being led by Professor Richard Jones.

The research is supported by active international collaborations including multiple partners across the EU, USA, Brazil and Australia.

Foot and Ankle research

  • How foot orthoses geometry affects plantar pressure, foot kinematics and muscle function.
  • Use of 4D foot scanning to understand foot function and orthotic design
  • Improving the design of work place footwear
  • Optimised design of foot orthoses and footwear for offloading in diabetes
  • Digital technologies for 3D printed foot orthoses
  • Development of the foot in infancy (part of SMALL STEPS project)
  • Health beliefs and behaviours in parents and professionals concerned with children’s foot health. (part of SMALL STEPS project)
  • National Foot Orthotic Survey

Knee research

  • Evaluating the responsiveness of treatments on clinical and biomechanical outcomes in knee osteoarthritis
  • The role of exercise and movement specificity on function and biomechanics in health and disease
  • Development of an athletic movement screening profile for risk factors for patellofemoral pain syndrome
  • The role of behavioural change in knee osteoarthritis when using interventions
  • Use of combined therapies in knee related disorders
  • Role of movement variability on injury risk

We have a large group of PhD students and are selective in who we would like to join or group. We are interested in those from a health professional, human movement and sports science background, who have an interest in the current project listed above. All PhD projects are jointly agreed with supervisors so that they can add value to and benefit from existing projects and collaborative working with other PhD students and our external partners.

Potential applicants should in the first instance contact one of the two programme leads who will assess the suitability of the application. A SKYPE (or similar) interview will be held to explore your background knowledge and research interests and the extent to which these match those in our team. If discussion progress well you may be asked to submit a Research Application for PhD. A conditional or un-conditional offer will be sent to you upon consideration from the programme team.

Visiting staff and Internships

There are also opportunities for visiting staff and short internships for a period of 1 month to 1 year in order to get some experience of working within the research programme. A bench fee may apply but this is an excellent opportunity to collaborate with us.

Recent visitors include:

Luis Fernando Selistre – Universidade Federal de São Carlos, Sao Paulo, Brazil
Dongyun Gu – Biomedical Engineer, Jiao Tong University, Shanghai
Wang Fang – Orthopaedic surgeon 1st People’s Hospital, Shanghai
Dr Karen Mickle, University of Wollongong, Australia
Salih Angin, Dokuz Eylül University, Turkey
Dr Annamaria Guiotto, University of Padova, Italy

Surname First name Supervisor
NEWTON Veronica Andrew Findlow
HALL Natalie Anita Williams
ATKINSON Lewis Christopher Nester
EVANGELOPOULOU Eftychia Christopher Nester
REEVES Joanna Christopher Nester
SWEENEY Declan Christopher Nester
ABDEEN Rawan Gillian Crofts
WILLIAMS James Gillian Crofts
ALAHMARI Ahmed Lee Herrington
ALARIFI Saud Lee Herrington
ALZHRANI Msaad  Lee Herrington 
GHULAM Hussain Lee Herrington 
NEAMATALLAH Ziyad Lee Herrington
WATERMAN Rosemary Lee Herrington
ZADEGAN Mehrzad Lee Herrington 
ALHAMMAD Ayman Richard Jones 
ALHARBI Sultan Richard Jones
ALJOHANI Ahmed Richard Jones 
ALRAYANI Hasan Richard Jones 
ALTHEBAITY Yasser Richard Jones 
ALTHOMALI Omar Richard Jones
ELZEIN Ihab Richard Jones
GREUEL Henrike Richard Jones
JOYCE Victoria Richard Jones 
SHANIB Yousef Richard Jones
SILK Edward Richard Jones 
ALYAMI Abdullah  Richard Jones 
Molyneux Jimmy Richard Jones
ALGARNI Ali Steve Preece
BRAMAH Christopher Steve Preece
HARPUR Barry Steve Preece
ELSAIS Walaa Steve Preece

1.Arnold JB, Wong DX, Jones RK, Hill CL, Thewlis D. (2015) Lateral wedge insoles for reducing biomechanical risk factors for medial knee osteoarthritis progression: A systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2015 Nov 25. doi: 10.1002/acr.22797.

2.Jones PA, Herrington LC, Munro AG, Graham-Smith P. (2014) Is there a relationship between landing, cutting, and pivoting tasks in terms of the characteristics of dynamic valgus?Am J Sports Med. 2014 Sep;42(9):2095-102. doi: 10.1177/0363546514539446. 

3.Jones RK, Chapman GJ, Parkes MJ, Forsythe L, Felson DT. (2015) The effect of different types of insoles or shoe modifications on medial loading of the knee in persons with medial knee osteoarthritis: a randomised trial. J Orthop Res. 2015 Nov;33(11):1646-54. doi: 10.1002/jor.22947. 

4.Chapman GJ, Parkes MJ, Forsythe L, Felson DT, Jones RK. (2015) Ankle motion influences the external knee adduction moment and may predict who will respond to lateral wedge insoles?: an ancillary analysis from the SILK trial. Osteoarthritis Cartilage. 2015 Aug;23(8):1316-22. doi: 10.1016/j.joca.2015.02.164. 

5.Herrington, L., Munro, A., Comfort, P. (2015) The effect of jumping –landing training and strengthtraining on frontal plane projection angle Manual Therapy (in press) doi: 10.1016/j.math.2015.04.00914;188-198

6: Sweeney D, Nester C, Preece S, Mickle K. Effect of antipronation foot orthosis geometry on compression of heel and arch soft tissues. J Rehabil Res Dev. 2015;52(5):543-51. doi: 10.1682/JRRD.2014.12.0306. PubMed PMID: 26465089.

7: Harrison-Blount M, Cullen M, Nester CJ, Williams AE. An action research approach to facilitating the adoption of a foot health assessment tool in India. J Foot Ankle Res. 2015 Sep 16;8:52. doi: 10.1186/s13047-015-0108-3. Collection 2015. PubMed PMID: 26388945; PubMed Central PMCID: PMC4574208.

8: Hashmi F, Nester C, Wright C, Newton V, Lam S. Characterising the biophysical  properties of normal and hyperkeratotic foot skin. J Foot Ankle Res. 2015 Aug 12;8:35. doi: 10.1186/s13047-015-0092-7. eCollection 2015. PubMed PMID: 26269720; PubMed Central PMCID: PMC4533794.

9: Nester CJ, Jarvis HL, Jones RK, Bowden PD, Liu A. Movement of the human foot in 100 pain free individuals aged 18-45: implications for understanding normal foot function. J Foot Ankle Res. 2014 Nov 28;7(1):51. doi: 10.1186/s13047-014-0051-8. eCollection 2014. PubMed PMID: 25493100; PubMed Central PMCID: PMC4260241.

10: Angin S, Crofts G, Mickle KJ, Nester CJ. Ultrasound evaluation of foot muscles and plantar fascia in pes planus. Gait Posture. 2014;40(1):48-52. doi: 10.1016/j.gaitpost.2014.02.008. Epub 2014 Feb 26. PubMed PMID: 24630465.

11: Graham AS, Williams AE. Foot Health Education for People with Rheumatoid Arthritis: '…. A Game of Chance…' - A Survey of Patients' Experiences. Musculoskeletal Care. 2015 Jun 15. doi: 10.1002/msc.1111. [Epub ahead of print] PubMed PMID: 26076891.

For queries related to the foot and ankle please contact Professor Chris Nester:

For queries related to the knee please contact Professor Richard Jones:

The team

Prof Richard Jones

Lead for Knee research; Clinical Biomechanics

Prof Chris Nester

Lead for Foot and Ankle research

Dr Gillian Crofts

Dr Andrew Findlow

Ms Andrea Graham

Prof Malcolm Granat

Measurement of Physical Behaviour

Mr Michael Harrison-Blount

Dr Farina Hashmi

Podiatric Dermatology

Dr lee Herrington


Dr Kristen Hollands

Neuro rehabilitation

Prof David Howard

Dr Stephen Hutchins

Mr Paul Jones

Dr Anmin Liu

Dr Jane McAdam

Dr Allan Munro

Mrs Veronica Newton


Dr Daniel Parker


Dr Stephen Pearson

Dr Jill Phethean


Dr Stephen Preece

Knee, ankle and foot

Dr Anita Williams

Qualitative; user evaluation of interventions/pespectives on LTC