• Sam Fischer

Knee hurts?! Look to the foot and hip!!!

Does your knee hurt? Did you fall and smash your knee on the ground? No. Was there a traumatic accident? No. Well then, the knee is probably not to blame.


It seems like the majority of people at one time or another will experience knee pain. Often the cause of the pain is simple, other times it is not. A physical therapist should be looking above and below for answers; at the foot and the hip.

While all joints in the body operate in three planes the knee is primarily a "hinge" joint; it flexes and extends. The foot not only moves in all three planes simultaneously it also has to accommodate to the shape of the ground, absorb forces, and transfer forces up the limb. Most of these forces are transmitted to the knee as a rotational force. But wait you might be thinking....the knee flexes and doesn't rotate. That rotational force continues up the femur to the hip. The hip also moves in all three planes extremely well, or at least it should. If motion is plentiful and muscular control adequate, the foot and hip work together and the knee is happy.

Lets look at a simple example and break down mechanics. You have knee pain that appeared out of nowhere. WHY? Your foot hits the ground and pronates (yeah....pronation is a good thing but everyone is terrified by it). This pronation creates an internal rotation force up the leg. Your hip is tight and doesn't have internal rotation. Your knee is getting torqued in relative different motions from the hip and foot. OUCH! So you develop knee pain, and it had zero to do with the knee. Stretch the hip and the knee pain "magically" goes away.

Often the knee is said to be a "dumb joint" simply doing whatever the hip and the foot tell it to do. I like to think of the knee as the middle child......trying its best to maintain communication between the older and younger sibling. Inevitably when the older and younger siblings aren't getting along....the middle child takes the brunt of the stress.

If you have knee pain that is not improving and your clinician hasn't looked at the hip and foot, it might be time.

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