Knee Pain and 2 Reasons it’s Never Going Away

Knee pain is very prevalent across the world. But before you run to the Doctor (within reason) to get an extremely expensive scan or inquire about surgery, please give these 2 fixes a try and you might be surprised by the results.

When do you experience pain?

Today’s discussion is more relevant on a bio-mechanical point of view, meaning- what is happening to your body while movement is required from it.

Your knee pain could originate from running, squatting, lunging, jumping, twisting or even sitting down on the toilet, bending to pick something up or walking up and down stairs.

Here are 2 reasons your knee is always in pain. Keep in mind that the knee is one of the most dependent joints in the body, it can only do what the ankle allows and the hips can control.

2 Reasons You Have Knee Pain

Reason 1 

Image result for bad dorsiflexion

Source: T-Nation

Inadequate dorsiflexion of the ankle joint.

Dorsiflexion is the ability to bring the top of the foot closer to the shin bone.

This is very important for good body positioning and the efficient production and application of force.

There is a number of ways your body compensates for inadequate ankle dorsiflexion. Here is what it looks like when trying to do squats. (Keep in mind that some images might be a bit exaggerated to make the discussion easy to follow)

Yhea! All this weird stuff can happen just because you don’t have enough dorsiflexion.

Now, image 1 & 3 is more relevant to knee pain.

If you look like image 2 and you have been experiencing some back related pain when doing squats, it’s your lucky day, because you can start by treating it the same way. Probably need to work on them hips as well 🙂

Image 1, 2 and 3 can be the same problem, it only looks different as your body tries to adapt to the situation differently.

In image 1 you will notice the dorsiflexion restriction when someone tends to shift their weight to their toes, as it is difficult for them to keep their heels on the ground.

This places a lot of strain on the knees.

In image 3 the ankle/foot is collapsing inwards thus creating a way for the knee to access more forward travel/ROM (range of motion). But this is not a good thing – when your ankles collapse inwards, you lose stability in your ankles and hips and wallah, your knees are collapsing inward and again you have a lot of strain on the knee joint.

Do you have this problem?

FullSizeRender-7

Source: Squat-University

Quick test:

  1. Put your foot (big toe) 12 cm away from a wall.
  2. Put your knee against the wall while keeping your heel flat.
  3. If you can do this while the knee is inline with the foot you are AWESOME.
  4. If you can touch the wall but the knee is on the inside of the foot  you need to work on your dorsiflexion.
  5. If you can’t touch the wall with your knee or your heel is lifting from the ground, you really need to work on your dorsiflexion.

Depending on where you feel the restriction you may need to work on the flexibility of your calf muscles (gastrocnemius and/or soleus),  Calcaneal tendon (Achilles) or the mobility of your ankle joint.

Click here if you need help improving dorsiflexion.

Reason 2 

Image result for bad squat on toes

Source: Scott Hermann

Weak glutes – or more specifically, the gluteus medius. The gluteus medius is an important muscle if your looking at improving the stability of your hip and thus improving the control of your knee.

So what does poor glute control look like?

Again looking at the squat as an example, this is what it would look like.

It looks very similar to some of the pictures in reason 1. And that is why a lack of control in the glutes paired with inadequate ROM in the ankles can be detrimental to the knees.

When the knees cave inwards we call it valgus knees (knock knees). One of the many factors playing into knock knees is usually a weak glute medius.

Do you have this problem?

Image result for trendelenburg

Source: Precision Movement

Quick test:

  1. Stand in front of a mirror and draw a hypothetical line between your left and right ASIS (2 pointy hip bones at the front of your pelvis)
  2. Keeping the line in mind, stand one one leg in front of the mirror and see if the opposite hip remains inline with the standing legs hip or if it drops below the line. Retest other side.
  3. If it drops you need to work on your hip stability.
  4. Also do some functional movements like a squat and a lunge. Look if the hips remain in an even line but also look at the knee. Does it cave in when you lunge or squat? If it does, then that can also be a sign that your hip stability needs more work.

 

And there you go, addressing these 2 problems areas alone can make a huge difference in the way you move and how your knees feel.

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