It is Not Your Knees Fault!


No matter the duration of knee pain nor the diagnosis you have dictates your ability to overcome! Here are 5 reasons why your knees hurt and tips for what you can do about it.

Written on
June 2, 2022
Dr. Don C. Dequine Jr. PT, DPT, CSCS

I recently learned in a book from John Mark Comer, that there is a difference between guilt and shame. Guilt is the understanding of doing wrong, making a bad choice. Shame is believing that we are what's wrong! Guilt says “I should not have done that”. Shame say’s “I am unable to be loved, accepted, or overcome”. It seems, culturally, that guilt is becoming obsolete while shame is reigning supreme! Guilt is good. Shame is bad. It is that simple. Likewise, pain is good. Like guilt, pain spurs us to make a change. Overtime, if we ignore the pain signals long enough, injury may ensue. As you continue reading, please understand that you were designed to overcome! Whether you are currently living in shame or have been diagnosed with damaged knees: “Osteoarthritis”, “torn meniscus”, “bone on bone”, “no more cartilage”, “No ACL”, “Old sports injury”, “Old age”, whatever it may be, you are alive! Growth, habit change, and healing is possible. So, here are 5 reasons your knees hurt, no matter your diagnosis:

1. Rapid change in weight: Whether it is due to weight gain or a rapid increase in lifting load. Every action has an equal and opposite reaction. When we hit the ground with a certain amount of force, the ground hits us right back with that same amount of force. If we have excessive weight, our brains will be more likely to use passive structures (bones, ligaments, joints) to absorb that force as the load is too much for our muscles to be able to withstand. 

  • Tip for success - Be aware, address the stress, find a guide for help, know that it is going to be ok! 

2. “Protecting” your knees: It has been drilled in our heads to not let our knees go over our toes as it can cause front of the knee pain (Patella Tendonitis), so we are encouraged to push our hips back. Unfortunately, we tend to overcompensate and by doing so, cause Pes Anserine pain. That is where the hamstrings attach. By pushing our hips back and reducing the bend in the knee, we can pull on the insertion of the hamstring on the front of the Tibia (Pes Anserine). This can cause sharp pain on the inside of the knee just below the knee cap. 

  • Tip for success - Bend your knees and your hips! 

3. “Protecting” your spine: Another mechanical cue which has been heavily enforced is to “keep your back straight and lift from your legs, not your back.” If you think about the cue to keep your back straight, what does that look like to you? I would assume, like many, it means to keep the spine straight up and down to the vertical. When we do this, we don’t “lift with our legs”, we lift with just our knees. Our low backs curve, our chest sticks out, and our hips lock into place. When we do not hinge from our hips, our knees are left to do all of the lifting. 

  • Tip for success - By bracing stomach muscles and leaning forward from the hips, you are still able to “keep your spine straight”. No need to keep your head and back vertical in order to keep your spine straight.  

4. Hips are weak: The Gluteus Maximus muscle is responsible for rotating the Femur bone out (Limits valgus) as well as keeping it from moving closer to the other knee (limits adduction). When this muscle does not work, the Femur will roll inward and towards the other knee. Pain on the inside of the kneecap is mostly experienced with this, however can lead to further knee pathologies. To compensate, it can also go the other way (varus) excessively by using other muscles or strategies which over time can lead to medial knee osteoarthritis.  

  • Tip for success - Find your Glute muscles with isometric banded holds: Clams, Hydrants, and Straight Leg Raises to the side. Once you can hold for 60 seconds, start doing reps - 3 x 10.  When able to do heavier lifts, use this cue: “Spread the band and the floor”. This will fully engage the Glute muscles. 

5. Ankle instability: An ankle sprain really hurts and can limit function for weeks, however, it heels rather quickly and seemingly limits little to no performance. Unfortunately, if your balance (proprioceptive cells) are damaged or impaired, they really should be rehabbed. By rehabbing, even though it seems slightly unnecessary, you are able to restore those cells, restore the ability to balance, and reduce future ankle or knee pain/pathologies. If the ankle is weak/unstable, similar outcomes can happen at the knee as weak hips. 

  • Tip for success - (Progress to next once able to achieve 30 seconds without wavering) Tandem stance with eyes open, tandem stance with eyes closed, single Leg balance with eyes open, single leg balance with eyes closed, single leg stance on unstable surface, single leg stance on unstable surface with ball toss against the wall.  

It is rarely ever the knees fault. The hip above and the ankle below are multi axle joints. 

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