Knee Pain Is Often Not the Knee

You may be saying, “What do you mean? My knee is killing me!” Often the knee is where we feel pain, but it’s not the culprit. Knee pain is frequently a symptom, not the root cause. When treating pain, it is important to look at the entire body. With knee pain, except for when there is a specific trauma to the knee itself, the cause is often the joint above (the hip) or below (the ankle).

While there are certainly instances where knee pain is caused by the knee itself, there can be many reasons for knee pain that are not directly caused by the knee. Let's look at some of the most common issues that can lead to persistent knee pain.

Hip Weakness or Instability

Weakness in the gluteus medius (one of your key hip stabilizers) can throw off the alignment of your pelvis and leg. When this muscle isn't doing its job, it often results in hip drop that can cause the knee to collapse inward (knee valgus). This misalignment places excessive stress on the knee joint and is a common contributor to pain, especially in runners and athletes.

To help with hip strengthening, you can incorporate targeted hip-strengthening exercises (like standing clamshells, lateral band walks, and side plank with hip abduction) along with improving pelvic control during dynamic movements.

Limited Ankle Mobility

The ankle’s ability to move into dorsiflexion (pulling the toes toward the shin) is critical for walking and running mechanics. When ankle mobility is restricted, your body compensates, often pushing the load up to the knee. This altered movement pattern increases joint stress and can lead to injury.

Stretching the calf muscles regularly, mobilizing the ankle joint, and incorporating movements that improve the range of motion of the ankle are key.

Core Weakness and Trunk Control

Your core is not just about the six-pack abs we hear so much about. It is the central stabilizer for your entire body. Core weakness can create excessive trunk movement, poor control during arm swing and rotation, and inefficient energy transfer during movement. All of this can impact your overall body mechanics and can increase strain on your knees. Building a strong foundation with core stability exercises like planks, bird dogs, and dead bugs is essential for good core control.

Poor Foot Mechanics

The feet are our foundation. You might have heard of the term overpronation (when the foot rolls too far inward). Overpronation can create rotational forces in the lower leg that ultimately affect knee alignment and its ability to take load appropriately. Many times there is tightness in the Achilles tendon, big toe, or plantar fascia. This can affect how your body is able to take the forces and transfer them up to the knee.

Working on foot and ankle mobility, as well as strengthening the foot, can help.

If you are dealing with knee pain, it is important to get assessed and treat the root cause of the pain, not just the symptom. Remember, often the poor knee just pays the price for an issue above or below!

Need more specialized help? Feel free to reach out to Bean at Brandon Stretch and Neuromuscular Therapy at 401-345-7464.