Are you suffering from knee pain? Have you seen someone about it? If you have, chances are they told you it was a sprain, or possibly a tear of a ligament or meniscus, and maybe recommended some medication. If you have a hammer, everything looks like a nail:
The odds are the pain is something far less ominous, and likely a result of some mobility restriction or a really overworking muscle that changes the mechanics of the knee, resulting in pain. Pain is a warning signal you should pay attention to, not ignore or turn off with pain meds.
Are there really 13 possible causes for my knee pain?
No, there are more. I said 13 because there are usually 13 muscles that cross the knee, occasionally a person might have only 12. Here are the muscles:
- 4 x Quadriceps
- 4 x Hamstrings
- Plantaris (some people don’t have this muscle)
Each of these muscles contributes to knee stability, so each could contribute to knee pain. It’s also possible that restrictions in the ankle mobility and hip mobility can contribute to strain on the knee. The body generally alternates in areas of mobility and stability, and while this is somewhat of an oversimplification – we can use it to see where we need to address mobility issues:
If the hip is lacking mobility, something above or below will likely pay the price – your back or knee. If the ankle is lacking mobility, your knee might get trashed or you might start developing foot symptoms like plantar fasciitis.
There is no cookie-cutter approach that works every time, but there are some problematic patterns that I see more often than others. Here are three places to start:
1. Address the Popliteus
An extremely important muscle for “unlocking” the knee. In full knee extension, the popliteus contracts first to unlock and allow knee flexion. An overactive popliteus will prevent full knee extension, which is a guarantee of eventual knee problems. Aside from generalized work with a lacrosse ball or alpha ball in that area, Kelley Starrett has a video for regaining full extension of the knee utilizing the voodoo floss band and some distraction bands.
2. Treat locally
Start off with some general voodoo floss banding in the areas directly around the knee. You’ll notice I rely heavily on the floss band – because it’s super effective when done correctly. Other methods to employ would be the calf smashing with a barbell and foam rolling in the quadriceps & hamstrings.
3. Treat globally – the Hips & Ankles & Feet
If the first two steps don’t get your knee feeling better, or make it feel better temporarily, the chances are high the issue is in the hips or ankles. If you’ve been putting in lots of time working on your hips and your problem persists, then the root cause is probably in your foot & ankle mechanics. There are 26 bones in the foot, 33 joints, and over 100 ligaments and tendons – it is extremely complex and creates the foundation for the entire kinetic chain. If you’ve ever had pain in your foot, sprained your ankle, been told you have flat feet, or cannot perform basic intrinsic foot strength exercises like in this video – then your knee issues probably stem from the foot. Start by exploring exploring different mobilization techniques for the foot and ankle here (mobilitywod subscription is required for some of these videos).
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About the author: Julian Corwin is an NSCA Certified Strength and Conditioning Specialist and Active Release Techniques ART® provider. His passion is restoring pain-free movement and educating people about their body