Knee Pain
Knee pain can feel debilitating and knowing what’s the best thing to combat it can feel confusing so that we end up doing nothing about it rather than doing something to improve things.
Knee pain in fact can resonate from our ankles, hips or IT bands, – what does that mean and how do I know what to do>?
Tight ankles, or ankles lacking in mobility, particularly dorsi flexion ( this is to point the toe to the floor or keep your heels down when squatting) can be a factor that contributes to knee, hip and lower back pain, so its important to not just label knee pain as being just that.
Tight ankles can resonate in the soft tissues, muscles and fascia or it can affect the joint itself and this can come from an old injury eg a sprained ankle, poor footwear, are you someone that wears ill fitting shoes or high heels? sedentary lifestyles, or poor gait, over pronating for example.
However they can be prominent in those with a active lifestyle, especially runners or those people doing lots of repetitive high impact exercise.
Tight ankles can therefore cause a knee valgus
This is where the knees are drawn into each other and this can put strain on to the other joints but particularly the knee.
There are different reasons why a valgus position occurs but restrictions through the ankle is certainly one of them.
Having this restriction can then create tight lower leg musculature (Gastrocnemius, soleus and Tibialis anterior.)
Not having adequate dorsi flexion and tight lower leg muscles can cause the knee to migrate forwards which fthen forces the tibia (lower leg bone) to internally rotate which then affects the hip as it leads to internal hip rotation and hip adduction which pulls the knees inwards.
This can cause knee pain, (patellofemoral) ACL tears and illotibial band syndrome.
You might have a PT with me or I ask you to submit photos where I ask you see you from all angles or to squat – one of the things I do is looking at the way your limbs move, looking for tight ankles or tight hips can help me understand what my clients needs would be as well as their likes.
One drill for you to check your ankle mobility is to bring your toe a fist and a thumb away from a wall and push your knee towards the wall (not having the back leg too far away) if your heel lifts then you lack in dorsi flexion then we would benefit by increasing it.
Muscular Imbalaces
Impaired hamstring function
The medial hamstrings -( these are called the semimembranosus and semitendinosus) and they stabilise the knee by flexing the knee and extending the hip and a lack of strength can cause some knee displacement medially and will be felt at the back of the thigh and behind the knee.
Impaired Quad function
Inadequate VMO strength – this is the quad muscle known as vestus medialis ) this also stabilises the knee and will cause the knee to track inwards
If you have joined the program and felt knee relief we are likely to have improved some of these factors!
WEAK HIPS
Inadequate gluteal strength – GLUTE MAX, MINIMUS AND MIDIUS and hip external rotaters)
couples with possible tight or overactive adductors prevents the stabilisation of the main bone in the thigh known as the femur. This causes the hip to move into adduction (inwards) and the femur to internally rotate, by strengthening your glutes and hips youll not only strengthen your muscles but improve the skeletal position of your body, so there’s less stress on the joints and the tendons and ligaments attached.
In short – modify, you dont have to do high impact movements, start at bodyweight and slowly add more time under tension, range of movement and resisitance and keep to a healthy BMI to make a positive difference to knee pain.
Long term pain can be extremely hard going, but also it takes a long time to retrain the body and central nervous system particularly to pain receptors,
Go slowly and steadily and you should feel a diffenece,
Im not a doctor or a physio so please if you have any concerns please do a self referral for Physio or see your gp.
Bethan xxx