Daily Mobility Exercises by Dr. Kelly Starrett Forums Knee Is poor core strength/slouching causing my knee pain?

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    • #70925
      AvatarJW Blish
      I think I may have come up with a theory as to why I have persistent pain in the side of my right knee. I’ve been diagnosed with IT band syndrome, but I’m not really much of an athlete – I used to do a bit of running and hiking but nothing major. And my symptoms have persisted despite me giving up both activities. 

      I’ve noticed that my lateral knee pain is a lot worse when I do a weekly voluntary job which involves a lot of standing up. I’ve realised I have a tendency to slouch in a way that my right knee rotates inwards and my right foot points out diagonally to the right (I’m a bit embarrassed typing this as it sounds awful). I’ve also realised that I tend to sit for hours at my desk job in this way. I told my husband who tried standing in the same position and said he immediately felt a pain on the side of his knee. Added to this, I know I have terrible core strength which I think is why I tend to slouch. It’s as though I don’t have sufficient strength to hold myself up. Does this make sense? Could this be the source of my knee pain?  

    • #74592
      AvatarNathan Richer

      The inability to stabilize the core is very central to many problems that can occur. Without the stability in the torso, your muscles will overwork and compensate to stabilize in its absence.  So yes, it could be a root problem which then extends to problems elsewhere.  Posture rehab/correction would be a good idea.  

      It sounds like you may have what is called valgus collapse of your knee. if you turn/angle/bend it inward, it will definitely cause problems. Core stability may not be the direct cause but it is definitely a contributor.  
      If you are in the UK, you may want to try Gokhale Method (http://gokhalemethod.com/) as i know there is at least one instructor operating there – scroll to the bottom of this page for UK: http://gokhalemethod.com/class-locations.
    • #74594

      Yes, you can see the impact of poor sitting position downstream at the knee.
      Everything starts with the spine.
      If the spine is in a poor position things are compromised at the big engines of the hip and shoulder.
      Your knee/leg issue could originate at the hip.
      There can be different causes of ITB. Sounds like you reached your body’s tolerance for the compromised position. Have you done anything to address your knee?
      Here are some to start with
      Pro Episode # 35 – MWod Pro-User Request Friday: The IT Band Primer
      Episode 361: Pathomechanics and IT Band Hell Part 1
      Episode 361: Pathomechanics and IT Band Hell Part 2
      Episode 361: Pathomechanics and IT Band Hell Part 3
      Episode 352: Dealing With Old Junky Tissue

      Episode 343: Stop Walking Like the Duck You Aren’t

      Sitting position
      Episode 276: MobilityWod Google Talk: Desk Bound

      Episode 88: Desk Athlete Hip Rescue
      Episode 15: You Must Defeat The Evil Chair Part 1
      Episode 15: You Must Defeat The Evil Chair Part 2

    • #74597
      AvatarJW Blish

      Hi Kaitlin. Thanks for these links – I will have a look through them all. I have seen three different physiotherapists who have all given me different exercises to do to strengthen my hips and glutes, but so far no improvement. This is why I’m thinking about core strength and whether that would help me. 

      Something else I have noticed is that I seem to have a big and very painful trigger point in my right thigh – I think it’s in the vastus lateralis? I am wondering whether this could be contributing to the pain? Whenever I go over it with a foam roller it’s excruciatingly painful to the point where I can’t really cope with it for very long. Does this mean that it needs more work or am I causing myself harm? I don’t really know what to think.   
    • #74598

      As others have noted – core strength can and does impact the entire body. Depending on your activities, your knee’s can easily take a considerable amount of damage.

      If you notice a trigger point on your quads – DEFINITELY hit those up. I suggest using a softball or lacrosse ball – not a foam roller.

      If you are able – I also suggest seeing a PT that is qualified in dry needling to hit up those trigger points. You’ll get tremendous bang for your buck if you go this route – but it won’t fix everything.

    • #74599
      AvatarJW Blish

      Thanks for your input Thor. I’ve tried going over this trigger point with a massage ball I’ve got – it’s pretty solid like a lacrosse ball – but it doesn’t really seem to do much, whereas the foam roller is AGONY. I’m not sure whether I’ve got the technique right. 

      The three different physiotherapists I’ve seen have all told me to foam roll. Out of interest, why do you not recommend a foam roller? 

      It’s interesting that you mentioned dry needling as I’ve been considering trying it. I think I’ll definitely look into this further.    
    • #74600

      Sometimes a foam roller is not hard enough other times its exactly right.
      Sometimes a lacrosse ball is too hard and the muscles don’t relax.
      It’s part of why there are several different tools out there, Find what works best for you and go from there.
      You may need to move to something different as things get worked out.

      It sounds like your hip are tight. You need to open them up first and improve range of motion any restrictions within the range of motion before you will see improvements with strengthening.
      The pain you experience in your thigh could be an impacting factor. It is pulling on your knee to create slack within the system for whatever is tight.
      Episode 245: Unglue Your Hips and Thighs
      Episode 228: PNF The Prime Movers of Your Hip
      Episode 138: Banded Squat Mobilizer and A Mid-Line Reminder

      When beginning to work on an area it may be tender. Do short doses that are repeated such as 4x :30 with :30 seconds between each work time.

    • #74602
      AvatarJW Blish
      So do you think the fact that I’m experiencing a shed load of pain with the foam roller means that it’s not right for me? I guess I’m not managing to get the muscles to relax because it’s so sore. Maybe I will get a lacrosse ball.
      I know my hips are tight as my last physiotherapist said so. Sounds like I really need to do some work on them to open them up.

      Thanks for these links – they all sound really relevant to me, so I will give them a try.

    • #74603
      AvatarDeven Williams

      Latest update for/from me is they feel some of my “knee problems” are coming from the lack of for/aft mobility in my hips and  the resulting tightness because of it which keep my hangstrings firing all the time. 

    • #74605
      AvatarDeven Williams

      And today further insight……

      Poor hip activation ability causing hamstrings to fire all the time resulting in their epic tightness.
      We’ll one big interconnected machine, one part locks up and the others suffer because of it.
      Talk about up/down stream!
    • #74608
      AvatarJW Blish

      Hmm that’s interesting. Sounds like you’re getting some good insights. I wish I could find a specialist that can determine that sort of thing.

    • #74609

      I feel that if you’re performing general maintenance – the foam roller does a good job.

      But if you have really bad trigger points in that area – you’ll get better quality work if you are a little more precise about it and use a lacrosse ball. The MOST precise would be dry needling – but that’s in the hands of a PT.

    • #74612
      AvatarJW Blish

      Just got back from seeing a chiropractor and she thinks I have a small piece of cartilage that has broken off. She thinks that would explain why I keep seeing improvements only for my problem to get worse again. I did notice a horrible grinding, popping sound when I was walking today. Who knows, maybe this could finally be my answer??

    • #74619

      I don’t think that’s the answer.

      The question that comes to mind is: why did that cartilage break off? There is likely a movement dysfunction associated with that – which could continue to cause further injury even if you get that cartilage tissue addressed/removed.

      Getting to the source of the problem is usually the ultimate goal. Unfortunately due to the complexity of the human body, the origin can be difficult to isolate and frequently takes time to address.

    • #74620
      AvatarJW Blish

      I think I forgot to mention that I fell over when I was hiking six months ago then had to climb down loads of wet, slippery stairs after. That’s when the pain first kicked in and it’s been with me ever since. 

      I do agree that there’s probably a movement problem involved too. I’m really concentrating on strengthening my hips and core now and doing stretches three times a day. 
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