Even though the pain you are experiencing is in your knee and the images of your knee show arthritis, cartilage damage, meniscus tears, inflammation, etc., that does not mean your knee pain is due to your knee. Yes, the symptoms are there, and I completely understand that, but the actual cause is from something else.
Because of the anatomy of the knee, the chronic ‘wear and tear’ issues that occur at the knee are caused by mechanical faults in another areas of your body. Meaning, your movement patterns are off which is causing your knee to take the hit. Or put another way, you are creating compensation injuries in your knee because of how your body is moving.
There are three specific areas I want to dive into when talking about causes of your knee pain.
Foot and Ankle
The foot and ankle have big jobs to do. The foot creates a stable base for you to be able to walk, run, and jump on, among other tasks on your feet. The ankle is a mobile joint that needs a good amount of mobility to allow you to be able to function in the ways you want to when doing things such as squatting, running, walking, and pivoting.
When the foot is lacking stability and control, it often causes the arch to collapse when performing tasks on your feet. When that happens, the only thing for the knee to do is to fall inward as well. It is impossible to keep the knee in a good position when the foot collapses. What happens instead is you roll to the outside of your foot, which places abnormal stress on the knee. Regardless of which happens, the knee falling in or the foot rolling out, the mechanics of the knee are impacted.
When looking at the ankle, it is not uncommon for people to lack ankle dorsiflexion, that motion of your forefoot and toes coming up towards you. That is the motion that is needed for you to be able to perform a good squat. If you are lacking dorsiflexion, the body finds ways to rotate or move around it. That compensation that occurs often places torsional forces on the knee, which can create soft tissue (cartilage and meniscus) issues over time.
The hip is a mobile joint that also requires good control and stability. Lacking both or either can place abnormal stress and strain on the knee.
When you lack mobility in the hip and desire to do an activity that requires that motion, the knee may take on more motion than ideal. For example, if you are attempting to squat but have tight hips, the knee may shift in a way to allow the body to move where you want it to. That ultimately places more forces on the knee.
When lacking stability and control, all sorts of things can happen in the knee including increased rotation of the leg and tissues surrounding the knee or the knee falling inward placing strain on the inside of the knee. You can work to calm down and strengthen the knee all you want, but unless you improve the control at the hip, the knee pain is not going to go away.
Sometimes your mobility, strength, stability, control, etc. is great, but you simply do not know how to move well. Poor mechanics with squats, lunges, running, and jumping can place increased stress on the knee. In situations like these, it is not a matter of getting an area working better, but rather teaching your body to move in more ideal patterns that place less stress on the knee. While this can be a frustrating process that requires a significant amount of patience, the more you work on it, the happier your knees will be.
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