On2 Physical Therapy

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Knee Pain - Where are you coming from?

Knee pain is tricky.

Before I delve into why, I need you to understand what bones make up the knee. The knee is a joint that is mainly made up by the bottom end of the thigh bone (femur) and the top end of the lower leg bone (tibia). The knee cap (patella) and second lower leg bone (fibula) are important to but won’t be discussed here.  

When a client comes in with knee pain, I usually go hunting for the source of the problem elsewhere because the cause of the issue is usually not at the knee. 

So where do I go? 

First, I check the hip and thigh muscles. Many of the muscles that support the knee originate at the hip. For example, 1 out of 4 quads muscles, all the hamstring muscles, and glut max (aka the butt) start at the hip and cross the knee (and this is by no means a comprehensive list). Even the muscles that start at the hip but don’t cross the knee still AFFECT the knee because they connect to the thigh bone femur).

How???

Well, the top of the thigh bone connects to the hip and the bottom of the thigh bone makes up the top part of the knee, any muscle that connects to the thigh bone can affect the knee. This includes all your hip external rotators, internal rotators, your inner thigh muscles, and the outer thigh muscles. So while a good portion of the hip muscles are no where near close to the knee, they are super important for maintaining your knees pain free and healthy.

Once I’ve looked at the hip and thigh muscles, I go hunting in the lower leg muscles. In particular, I want to make sure that the calves (gastroc + soleus) are strong because one directly crosses the knee (gastroc), and the other (soleus) crosses the bottom of the lower leg bone (the tibia). Similar to the muscles of the hip that don’t cross the hip, the soleus affects how the bottom of the bone moves which in turn affects the top of the bone… which is your knee. Does that make sense? So, if either of these are weak, then you can have knee pain (typically back of the knee or bottom of the foot…helloooooooo plantar fasciitis) while wearing high heels, squatting down, going down the stairs, or jumping. 

As you can see, knee pain can be quite tricky because the source of the problem can be coming from any of the muscles being weak. Usually, it’s not just one muscle but a combination of muscles that need to be strengthen depending on many individual factor, from what you do for a living, to your hobbies, to the types of shoes you wear…etc.

If you find yourself not knowing where to start with your knee pain, strengthening your hip muscles is good place. However, if you’ve tried that and you’re not getting better, or maybe even worse, (yikes!) it may be time to have a professional (like me!) look at you and determine the root cause of your pain. You can always contact me and book a free consultation to see if I can help with absolutely no obligation.