The knee or not the knee – that is the question

If you’ve been reading this blog for a while you’ll know that I’ve had a bit of a reoccurring problem with my right knee. It started at the end of last year, I was never quite sure what caused it but thought the likely culprits were lots of very deep squatting and too much plyometric work.

I had quite a few weeks of treatment with my osteo who eventually referred me for an MRI scan as it didn’t seem to be healing. He thought that I might have torn my anterior cruciate ligament but was also concerned about my medial collateral ligament. The MRI showed that both were normal. There was some wear and tear to my cartilage but nothing to be concerned about. I was relieved. Gradually my knee recovered.

20160405_174338But then the same thing happened again, and just a few weeks before my competition. The feeling is difficult to explain but there was a lot of swelling around the kneecap and it became difficult to bend it backwards because of that swelling. So I found myself back at my osteopath who noticed that my right foot appeared to be quite flat with very little arch at all. Excuse the feet photo but you can see it clearly here.

One of the first things my osteo prescribed for me over 4 years ago when I first started seeing him was a pair of orthotic insoles for exactly the same problem. I wore them for a while and then ditched them when I taught myself to run in minimal footwear as I thought I’d done enough to strengthen my feet. But of course I’m not running anymore and what I am doing instead is lugging around lots of heavy weight. My flat feet aren’t doing what they are supposed to, effectively collapsing under the strain and as a result my knee is taking that additional load. I started wearing my orthotics straight away.

I also booked a sports injury rehab session with Rob Blair, the owner of The Commando Temple in Deptford who I had met a few weeks earlier when I went there to try out the Atlas stones. Rob describes himself as bridging the gap between physiotherapy and the strength and conditioning world – I’d been impressed with his no-nonsense approach and the fact that he works specifically with strength athletes.

So a few Fridays ago I found myself at the temple with Rob watching my every move for about 90 minutes. It was a hugely enlightening session. I had no idea that I lift my toes when I squat, that I’m unable to lunge without leaning my body forward, that my ankle mobility is pretty poor, or that I have completely different ranges of motion in my left and right hip – I just thought they were both tight!

Rob concluded that I favour internal rotation though my right femur, tibia, fibia and ankle. The cause of this appears to be a very tight hip flexor and a lack of ankle mobility. The effect is that my poor old knee is being inwardly rotated far more than it ought to be and is protesting as a result. This video of me jumping shows what’s going on.

I now have a lot of rehab work to do. Exercises to improve my hip and ankle mobility which I need to do regularly if I’m going to see a difference. I’m scheduling them into my workouts as either part of the warm up or cool down and I think I am starting to see some very small improvements with my hips. He’s also given me some cool strength moves to do  as well some of which I was already familiar with but some of which are brand new. Rob has warned me that it’s going to take months to see a significant improvement but now that I know what the issue is I know that I’ll be diligent and carry on doing what he’s advised.

So as it turns out, and as is often the case with the weird and wonderful human body, my knee is not actually the problem at all. I’m really glad that I got it all checked out -at least I know what I’m dealing with and can take steps to improve the situation. Thankfully my knee currently feels a lot better – hopefully it will remain that way!


4 thoughts

  1. Very interesting diagnosis. I have heard that weaknesses or tightness in hip flexor muscles can cause our legs to twist in unnatural ways. This in turn puts additional stress on our joints, muscles and tendons.
    When we see people running and their feet and lower legs are flailing all over the place, sometimes this is the result of weakness or tightness in other muscle areas.
    PTs address these imbalances by giving us stretching and strengthening exercises. We essentially heal our selves. A surgeon would probably want to cut us open and do some procedure!

  2. Spot on diagnosis 🙂 usually if the knee is painful the problem lies in the hip, ankle or both. Regaining mobility should solve your problem 🙂 Good luck !

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