Your Knee Pain Isn’t Coming From Your Knee

Four things to fix it:

More than just a part

Knee pain usually isn’t just a knee problem, because your knee mainly handles flexion and extension and relies on your feet, ankles, hips, and even glutes to control force, rotation, and alignment. So problems can come from all those places.

With that in mind, here are four things to identify and (as applicable) fix:

1. Foot arch collapse (overpronation)
   • What happens: when your arch drops, your foot rolls inward, your shin follows, and your knee tracks inward under load
   • Test for it: stand relaxed and see if your arches visibly collapse inward
   • Exercise to fix it: pull the ball of your foot toward your heel without curling your toes and hold briefly; repeat as necessary
2. Limited ankle dorsiflexion
   • What happens: if your ankle can’t move forwards, your knee compensates during walking, squatting, and stairs
   • Test for it: knee-to-wall test (10–12 cm distance, heel flat, knee touches wall)
   • Exercise to fix it: slow heel raises off a step to improve ankle mobility and control
3. Weak glutes (especially glute medius)
   • What happens: weak hip control lets your femur rotate inward, causing your knee to collapse inward under load
   • Test for it: single-leg squat—watch if your knee caves inward
   • Exercise to fix it: banded clamshells to strengthen hip stabilizers
4. Tight quads and hip flexors
   • What happens: tightness here alters how your kneecap tracks, increasing pressure and irritation
   • Test for it: simply watch for symptoms like pain going upstairs, stiffness after sitting, or a “gravelly” feeling
   • Exercise to fix it: couch stretch or standing quad stretch with your glute engaged

For more on all of this plus visual demonstrations, enjoy:

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Want to learn more?

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For a much deeper understanding of treating knee pain, here’s a great book that we reviewed a little while back:

Treat Your Own Knee – by Robin McKenzie ← he’s a physiotherapist and not a doctor, and/but with 40 years of practice to his name and 33 letters after his name (CNZM OBE FCSP (Hon) FNZSP (Hon) Dip MDT Dip MT), he seems to know his stuff. His work is very well-respected, and almost any English-speaking physiotherapist will have read his books.

Take care!