
Knee pain is a common issue in many athletes. It almost seems like people think it is a “right of passage” in order to be involved in any sport. It doesn’t have to be that way!
I don’t care what your physician, family, or friends tell you about the activities and sports you are involved in. Running is NOT bad for your knees! Neither is squatting! And most likely neither is anything else they have told you is bad for your knees.
What is bad for your knees? Any activity you do WITH BAD FORM!
Is that loud and clear enough for you?
Unless you had some sort of traumatic event – accidents still do happen after all – knee pain is often a symptom of something else not moving properly. Because of the anatomy and biomechanics of the foot, ankle, knee, and hip, if our bodies move in a manner that is not biomechanically correct or efficient, our knees tend to take the hit.
Starting with the foot since that is our foundation of our body: if the foundation isn’t strong, the body won’t be strong. As much as you might think you have good control over your foot, you don’t! Unless you spend a lot of time barefoot, make time to work on strength and control in the foot and lower leg, and make a point to do some training barefoot, I promise, you don’t have good control over your foot and are likely compensating much more than you think you are.
And then we compound that foot weakness with poor ankle mobility. Between the amount of sitting we do, the shoes that we wear, and the fact that most people don’t work on ankle mobility, most people don’t have enough mobility in their ankles to maintain good movement patterns with most movements and activities.
When the foot is weak and/or the ankle is stiff, our bodies compensate which creates increased force and torque on the knee. Those increased stresses on the tissues surrounding the knee can result in pain almost anywhere around the knee and contribute to meniscus tears and cartilage damage.
I do want to point out here that just because a scan shows meniscus tears and cartilage damage does not mean you need surgery or that you will be unable to continue participating in high level sports. Many people live with damage in those areas, myself included, and continue on to be highly competitive.
At the top of the leg is the hip, the other common culprit of knee issues. That knee collapse you see when you squat or run could be from poor foot control, but could also be from poor hip control. Certain hip muscles need to fire in order to keep our legs and knees in good alignment with all weight bearing activities. If you lack the strength in those areas or have never learned how to properly utilize them, which is more likely the case, the knees end up taking the hit again.
And then we come to movement faults. Movement/technique faults fall into two categories: 1) poor movement patterns from poor strength and/or mobility, or 2) you have good strength and mobility, but never learned how to move properly in the first place
When talking about poor movement patterns due to poor strength or mobility, this goes back to the previous two areas discussed. Your body can only do so much with what it has available at any given moment. If the demands you are placing on your body are greater than what your body’s strength and stability will allow, you will not be able to maintain good movement patterns. It’s as simple as that. For example, if you can’t support your body very well on a single leg because of weakness or lack of control, there is no way you will be able to maintain good control on a single leg when running, which is a huge requirement of running.
Some people have good strength and stability but simply don’t know how to move properly because they were never trained properly. If no one ever explained to you where the weight distribution should be on your foot with movements such as deadlifts or squats, then why would you know? If no one taught you how to hip hinge to initiate a squat and activate your hips in the bottom of a squat, then you won’t do it. And if you have never had a running analysis or worked with someone to address running technique, you don’t realize there is a more efficiently and economical way to run.
If you work with a coach, or have in the past, awesome! Coaches are essential to improving performance. Unfortunately, not all coaches are created equal. Many people I have worked with have worked with coaches in the past or were currently working with a coach and never learned the proper ways to move their body. Working with someone who understands the whole body well and can pinpoint movements faults is essential to longevity and resiliency as an athlete. If you are working with a coach and yet continuing to have consistent injuries and flare ups, it may be time to look for a new coach – someone who knows how to create resiliency, not just train for the next upcoming race or event.
Another great article to check out on this topic is How The “Knees Out” Cue Caused Your Knee Pain by Matt Zanis, PT, DPT
If you are interested in having your movement checked or looking into new virtual coaching options, email Brianne at brianne@getyourfixpt.com.
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