Runners: Why Your Knee Pain Might Not Be Coming from Your Knee

Written by
Dr. Arthur Lee
Published on
July 17, 2024

Here's what you need to know: Your knee pain probably isn't coming from your knee! If you experience knee pain, it's likely that the issue lies elsewhere. Even in cases of traumatic knee injuries, such as ACL tears, research has uncovered risk factors that come from above and below the knee.

Risk Factors for Knee Pain

Collapsing Mechanics refers to the posture characterized by pronation at the foot (collapsed arch), internal rotation of the leg, and a drop of the opposite hip. This phenomenon can occur during squatting, jumping, or running, and several movement limitations can contribute to it.

Limited Ankle Mobility – When the knee cannot move straight over the center of the foot due to insufficient ankle dorsiflexion, the leg may rotate in or out to compensate. Typically, pronation of the foot and internal rotation of the leg occur as compensations for limited ankle mobility, placing additional strain on the knee.

Core, Pelvic, Hip, and Foot Weakness – Weakness in various areas can contribute to collapsing mechanics. Commonly, weaknesses in the hips and pelvis impair the ability to control the hip and leg during squats or while absorbing shock from running or jumping.

Quadriceps Weakness – Weak quadriceps are a risk factor for knee injuries, particularly in runners and field athletes, and can predict ACL injuries. Strong quadriceps are crucial for shock absorption during the landing phase of running and jumping.

Running Mechanics – Despite strengthening and mobilization efforts, reverting to the same movement or gait pattern during running is possible. Improving running mechanics can help decrease pain, reduce injury risk, and enhance performance.

Knee Pain from Osteoarthritis Can Improve As Well!

Although the physical changes caused by knee osteoarthritis can't be reversed, you can manage the pain and enhance your knee's function.

Quad Strength – Increasing quadriceps strength enhances your ability to absorb force during activities like running and jumping. The more force your muscles absorb, the less stress is placed on your joints.

Hip Mobilization and Strength – Limited hip mobility can lead to increased strain on the back and knees. Improving hip mobility can be transformative for those suffering from knee osteoarthritis.

Ankle Mobilization – Proper ankle mobility is essential for optimal running mechanics and correct alignment throughout the gait cycle. It also aids in shock absorption during the landing phase.

How to Identify What to Work On for Knee Pain

The best way to determine what you need to work on is to get evaluated by a movement professional. As mentioned, many causes of knee pain originate outside the knee. If standard knee pain exercises aren't providing relief, it's time to seek professional help.

For long-lasting results, it's essential to look beyond the immediate area of pain. If you need help with your knee pain, give us a call or set up a free consultation.

Ready to move better and train smarter?

Book a discovery call and let's talk about what's keeping you from your sport and how we can help you get back to it.