Wouldn’t it be great if the thing in your body that hurts was actually the thing that’s hurt? Wouldn’t it also be great to hit the Powerball?

Knee pain is super common, but unfortunately, the cause of it is not. In most cases, the pain you feel is being “referred” to your knee, but the real source of the issue lies somewhere else.

Unless you geek out on biomechanics like we do, most people don’t really consider the combination of muscles and joints that are involved in basic activities like walking, squatting, running or taking the stairs. But they’re pretty complex, and can place increased strain on the knee. When one of the structures involved gets thrown off — whether its a joint dysfunction or an angry muscle — your body will find a way to compensate to keep you moving. But eventually, the repetitive stress from that wonky compensation pattern will lead to pain.

That pain might feel dull, achy, sharp, stabbing, numb or radiating — and each type of pain can mean something different. Being able to differentiate which structures of the body are involved is the first step toward solving the real problem.

Let’s start with the hips and ankles. Ground reaction forces initiate at the foot and work their way up the leg to the hip and re-distribute back down. If either the ankle or hip is not working efficiently and lacks mobility, those two forces will meet in the middle. Meaning, your knee is toast.

Kneel down with one knee grounded and the other bent with your foot planted. Can you lean the bent knee over your toe? Does your heel pop up? If so, you’ve got ankle issues. Try Dr. James’s 90/90 rotation assessment and check out what’s happening with your hips. No bueno? That could be the source of your pain.

But the investigation doesn’t stop there. The lumbar spine can also refer pain from the back, down the leg and into the knee. This could happen because of a disc, pinched nerve or muscle issue. Along the lower extremity kinetic chain, forces are moving through lots of soft tissue structures that can be involved — the psoas, QL, TFL/ ITB, glutes, hamstrings, and the calf muscles. Did your head just explode? 

Bottom line, if you’re having recurring knee pain, pay attention to it. But your knee could just be the unfortunate soul stuck in the middle of a nasty cat fight between other structures of the body. Your knee pain could actually stem from issues in the:

• Hips

• Ankles

• Lumbar spine (disc, pinched nerve or muscle)

• Psoas / Hip Flexors

• Quadratus Lumborum (QL)

• Tensor Fascia Lata (TFL)

• Iliotibial Band (ITB)

• Glutes

• Hamstrings

• Calves

You may need a skilled practitioner to sort out what’s really going on. If you continue to only treat the symptom (pain), you won’t get to the root of the real issue. We’re here to help you fix it for good.

— Ray Delacruz, PT, MSPT, CSCS, CMTPT, FAAOMPT

BTW, not sure what’s an OK-ish pain and what should stop you in your tracks? Refer to our pain scale.