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Knee Pain: Where to Start?

This is not medical advice. If you’ve recently had an accident, go see a doctor.

To evaluate your knee pain, we want to look at ankle and hip mobility followed by strength and stability. When we have joint pain it’s important we look above and below the chain because the source of knee pain is rarely the knee itself!

Ankle mobility

Try the 5 inch ankle mobility test against a wall. If you have 5 inches of ankle dorsiflexion then your ankles are probably mobile enough. It’s important to note if there’s any difference from side to side, and if so, this imbalance can be a potential cause for faulty movement patterns.

Try sitting on your ankles, is there a significant difference from side to side? Again, fixing this imbalance will likely help to alleviate your pain.

Hip Mobility

Check your hip internal and external rotation by getting into a 90-90 stretch. Are you able to lift your back foot off the ground? Does the stretch feel the same on both sides? These are clues to see if you have a mobility imbalance.

You can also have a physical therapist or coach test your hip internal and external rotation as you lay on your back.

Finally, try the couch stretch, are you able to touch your knee, foot, and hip to the wall? The quadriceps muscles are antagonistic to the glute muscles, so if your quads are overly tight this can cause movement dysfunctions that lead to pain over time.

The hip airplane exercise is fantastic for improving both hip mobility and control.


Strength & Stability

Perform a single leg squat to test if there’s a strength or stability issue. Is it more difficult to perform on the painful side? This is a sign that stability and strength are going to be key to overcoming your pain.

The most common technique issue I see with people who suffer knee pain is their knees track slightly inwards. This can be because of excessive foot pronation i.e. a weak foot and flexor hallucis longus muscle, or from weak lateral hip muscles, mainly the gluteus medius muscle.

The short foot exercise is great for strengthening our feet and the single leg glute bridge exercise is great for training glute coordination and strength.

If you find you have a strength or stability problem, focus on your foot and glute strength!

If there’s significant swelling, tingling, numbness, or throbbing at the back of your knee, it’s best to see a medical professional as that indicates a more significant problem.

Your specific solution for knee pain is going to be unique, so it’s important to view your body from a global perspective, not just by looking at your knees. If you’d like to work with me to overcome your chronic knee pain, schedule a consultation here!

Hope this helps! - Tom


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