Runners Knee: Why The Cause Is Rarely At The Knee!

Many people have knee pain and they're many common solutions for this Secondary Condition/symptom. For example...

Many people have knee pain and they're many common solutions for this Secondary Condition/symptom. For example, many use exercise for strengthening the muscles around the knee, stretching the muscles around the knee (hamstrings, quads, etc.), trigger point therapy (stubborn knots in the muscles), massage, ice, heat, NSAIDS, special tape, special compression sleeves/clothing or a combination of all of the above (the "throw the kitchen sink and see what works approach").

The above is called "soft tissue" work and I have no doubt that soft tissue work helps.

What I have seen is Structural deficiencies in the foot and ankle that lead to Structural Shifts in the pelvis and finally the lower back region (the old song," foot bone is connected to the leg bone").  This is what I describe as Hard Tissue (bone alignment) problems.

Here is the thing - you cannot separate Hard Tissue and Soft Tissue problems - they are occurring in the patient at the same time. The question is what is the sequence of care or to put in other terms, "which came first the chicken or the egg"?

Normal structural alignment - now no one has perfect alignment, but there is a normal range. When alignment is outside the normal range Secondary Conditions start to gradually show up, for example: Plantar fascitis, Runners Knee, Shin Splints, Arch Problems, Over Pronation, etc...

These I call Secondary Conditions because, as you might of guessed is a result of a Primary Structural Problem that must be addressed. Once the Primary Structural problem is addressed - THEN soft tissue work becomes more effective.

The most common primary structural problems I look for are: over pronated foot, faulty knee extension (can't get the knee entirely straight) and over rotated tibia and under rotated fibula (twisted knee alignment), foot arch issues, and under looked issue of anatomical short leg syndrome.

Once the sequence or the Primary Structural issue is found, then it is easier to get ahead of chronic, nagging knee, hip, ankle problems.

The result of not getting the primary structural problem addressed are: chronic pain, trigger points, degenerative joint disease, plantar fascitis, SI joint dysfunction and iliotibial band syndrome.


Some of the corrections for Primary Structural problems are simple, once you determine the sequence of the condition.

Have a GREAT Day!

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