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. Being proactive about looking after your knees has rewards that you will feel for the rest of your life.

The knee joint is like any other joint in the body in that once it begins to degenerate then the onset of osteoarthritis is inevitable. This highlights the importance of looking after your body with regular, well-directed exercise.

When it comes to knee pain the first thing that should be considered is the mechanics of the knee joint and surrounding muscles. The mechanics of the knee joint will highlight the way that force is passing through the joint, and what parts of the joint complex are dealing with more load than they are designed to bear. Most knee problems (that have not been the result of direct sudden trauma) are the result of poor alignment, and thus mechanics, of the joint itself. This in turn is a result of poor balance of the muscles that cross the knee. In other words, the muscles on the outside of the thigh are tighter and stronger than the muscles on the inside of the thigh. This leads to the knee and knee cap being pulled to one side instead of having even force acting on them.

Initially this may not sound like a major problem. However if you are to consider the amount of times you flex and extend your knee each and every day then you can begin to appreciate the effects on the joint surfaces that this may have. This irritation to the joints is often felt after walking or running for a period of time, or even in the hours or days following exercise. Basically it leads to premature wearing out of the smooth coating of the joints. If left untreated then the knees will continue to wear, eventually leading to complete degeneration of the joint, possibly requiring partial or complete joint replacement.

Knees are designed to work in a certain way, with muscles and ligaments offering support and movement. Because we are relatively sedentary compared to our ancestors we tend to loose muscle strength and muscle control. As discussed in previous articles we tend to roll forward with our pelvis as a result in poor core strength. This leads to us becoming slightly ‘knock-kneed’. This also can lead to us becoming flat footed. Alternatively it may occur in the reverse order; we develop flat feet which make us become ‘knock-kneed’, which makes us roll our pelvis forward. Either way, the muscles on the inside of your thigh tend to switch off and become weak, and the muscles on the outsides of our thighs become tight.

It is therefore very important to exercise the muscles of the inside of the knee to build up strength in them so the knee cap is held in the correct position. Also, the muscles along the outside of the thigh, and the gluteal muscles, need to be loosened so that the tension is removed from the lateral side on the joint. But this is not all that needs to be done. Any pronation of the feet (flat feet) needs to be corrected by using appropriate footwear, or by using orthotics. Finally, the correction of an abnormal pelvic tilt should be addressed. As long as the pelvis is tilted forward then the knee alignment will be incorrect (see previous articles for discussion on this topic).

Prevention of knee degeneration is extremely important. If you have knee pain then seek professional advice regarding biomechanical correction of your walk or run through education and appropriate exercise prescription. You then stand the best chance of eliminating pain and ensuring that you will have knees that allow you to live an active life well into the future.

Next time, we discuss foot pain…


Stuart Hicks
Myotherapist (Adv. Dip. of Myotherapy)
stuie_1@hotmail.com