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No Knee-d to Feel Pain

By Paul Folan Adappt Co Owner and Sports Therapist

Written March 2011

Knee pain is a common complaint and can be caused by a number of factors.  Lifestyle, lack of mobility, lack of training and bad shoes can all play a part!


A pain in the knee may also be a symptom of a muscle imbalance or of a joint not working correctly.  As a result, your trainer will go through a series of assessments and tests to see what is causing your pain.

The two most common areas where pain can occur are:



A sports therapist and/or physio are good specialists to consult when you are looking at the cause of your pain.  By working with your personal trainer, your specialist’s exercises can be included in your training schedule to ensure that your problem is sorted out quickly.


Your hip and your ankle joints work in many directions (planes).  You knee joint, however, only works in one plane….it bends backwards and then it straightens.  As a result, it can be put under severe pressure if it’s being asked to do more than it is capable of or if it’s not working in a straight line.


Twisting and turning injuries can cause massive trauma to the knee…as any skier or footballer can tell you.  Everyone knows someone who has damaged – or ruptured – the ACL (anterior cruciate ligament).  If severely torn or ruptured, only surgery can rebuild an ACL.  Regular physio visits and rehabilitation is needed to ensure that the knee can be used properly in the future.

Tight hamstrings and tight calf muscles also impact on the knee – especially the back of the knee.  If you sit down a lot then your hamstrings will tighten.  This is also a major cause of back pain – but lets not go there!  Specific stretching will help alleviate this problem.


Tight calf muscles – especially for women who are in heels all the time – also have a major impact on the knee.  Calf stretching is vital as this can also impact on the foot.  Tight calf muscles are a major factor in Planter Fasciitis (which we will look at in future issues).


Finally, how you walk or run has a massive impact on your knee.  If your foot rolls in (pronation) or rolls out (supination) when you land, the stress and strains on your ankle are transferred to your knee. Correct foot wear, running shoes and orthotics (implants/insoles for your shoes) can correct these conditions.  


Before you start any exercise regime, get your foot strike analysed and get the right footwear for your sport.  


There are many factors which can cause knee pain: it may be a symptom of problems elsewhere in your body.  However, you just feel pain in the knee!  Rest, Ice, Compression and Elevation (RICE) can help alleviate the symptoms – as can anti-inflamatories/painkillers - but they don’t solve the problem.


The sooner you sort the problem out, the less damage you are doing to the knee or to other parts of the leg and back.  


By working with your trainer you can sort these issues out quickly, start enjoying exercising again and achieve the results you want to achieve.


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Muscle imbalances, however, can be resolved and, with time and effort, the pain will completely disappear.


Starting at the butt, muscular imbalances in the lower back and hip affect the femur – the biggest bone in the leg.  This, in turn, puts strain on the knee, By releasing the muscles (if tight) using sports therapy techniques or strengthening a weak muscle, your trainer will help you resolve the pain.


On the outside of the thigh, the iliotibial band (ITB) is a thick piece of connective tissue linking the hip and the knee.  It plays a fundamental part in knee stability.


If the ITB is tight, it pulls the knee out of line and causes pain slightly below the knee and on the medial (inside) side of the leg. This is a common injury for runners who don’t stretch – hence the term ‘runners knee’.


Deep tissue massage from your trainer (or using the ‘foam rollers’) helps relieve this condition.  A range of stretches target this area and symptoms can be relieved very quickly – if the condition is caught early.