Common Faulty Movement Patterns Involving the Knee
Everyone at some point in their life has had knee pain. Most commonly this pain is at the front of the knee and may hurt walking up and down stairs. Knee pain comes and goes but it is a huge sign that biomechanically something isn't right. The knee is considered a stable joint because its plane of motion is mostly in one direction. Muscles that surround “stable” joints have a unique ability to produce tremendous torque. Torque at a joint is simply movement in one direction in a period of time. The knee, for example, is able to extend very quickly and forcefully due to its “stable” joint position. Another way of saying this is that there is less variance of joint position so the muscles can fire maximally with one purpose. The only problem with this joint stability is that our muscles surrounding our knee are not very good at stabilizing joint position. This is usually because we are not often in “unstable” joint positions at the knee where the muscles are forced to stabilize.
The opposite is true at the hip and ankle. These joints have many planes of motion which force the muscles surrounding to stabilize at each joint position. The muscles surrounding these mobile joints are not as capable in providing torque, but rather are great at providing stiffness. This is because the muscles at these joints are forced to act as stabilizers more often on a daily basis. Stiffness is achieved when muscles from either the side of the joint (the antagonists) contract in synergy to provide less movement at the joint. Now don’t get confused, the muscles around the hip and ankle are not there to limit movement but rather stabilize the joint through a large range of motion. With this being said, there are many instances where different levels of torque and stiffness at each joint are needed simultaneously and independently. A problem occurs when range of motion or muscle control is lost. Let's say we have someone with anterior knee pain. Yes, most likely rectus femoris or your quad is tight. At this point you must ask, “Why is my quad tight?” This could be because of a lack of hip extension, a lack of dorsiflexion in the big toe (not kidding), or multiple other reasons. After this you must ask yourself, is this a joint problem or a motor control problem. Do you have the joint range of motion but not able to use the range of motion through a functional movement? Are you not able to get into glute extension because of a lack of a stable core and subsequent lumbar extension and anterior pelvic tilt? The point is that something simple such as knee pain cannot be simply looked at as overuse. Getting a massage, dry needling, stretching, or simple single joint exercises are not going to fix the cause of your problem. A biomechanical problem needs to be addressed by analyzing biomechanics, not chasing pain. The key to getting out of pain and staying out of pain is realizing the difference between the cause and source of pain. No one has to live with knee pain. Make sure you are getting the care you deserve and get back to doing the things you love to do.
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