Why Is My Back Pain Causing My Knees To Be Sore?

Question: “I’ve got sore knees. Why is the pain in my knee/back caused by a problem in a different area of my body?”

Dharma Shay: Enter the “kinetic chain.” The kinetic chain is a mechanical engineering term which essentially describes the dynamics in which the segments of the body are connected by joints to create a system whereby movement is produced. The definition can get far more technical, though for now look at it as the governing factor to how joints, ligaments, tendons, muscles, fascia, and bones produce movement from one joint to another and affect another function.

When it comes to pain or being stiff in one region of the body to the next, physical therapist, chiropractors, massage therapist, or exercise physiologists tend to first look locally and then follow the kinetic chain. For example when a client tells me they have pain in or around their knee I almost immediately ask them to perform an air squat, identify the plane of dysfunction, identify which type of movement causes discomfort, isolate inflexible muscles related to knee movement, and likely send them to the podiatrist, especially if they are flat-footed. I have seen people turn their knee problems around purely by addressing their unknown feet problems.

This is a perfect example of how dysfunction in the kinetic chain works. Often, knee issues are more localized via the connecting muscles, tendons, ligaments, fascia, and bone. For example, if you have knee issues right now, consider improving ankle flexibility, quadriceps flexibility, lower limb flexors and extenders flexibility — because any of these muscles may be causing an imbalance in the knee — and start doing knee stability exercises right now. If a professional is able to isolate your current knee issue (this can be done over most modern video chatting services) you may come out with results such as medial or lateral meniscus rupture, ACL, MCL, PCL, or LCL tear, patella displacement, cartilage damage, or a sprain within the region. Knowing where the issue originates allows practitioners to utilize the appropriate exercises.

To get you on the right path, know what these terms mean when identifying where an issue may originate, lateral (outside of the joint along the lateral lines of the body), medial (along the center line of the body, so between the knees), anterior (the front of the body), and posterior (the back of the body).

The kinetic chain is highly effective and only makes sense because our bodies are highly adaptable. Once one link (joint) in the kinetic chain breaks, you will find the body instantly learns to compensate for the imbalance, though often causing other imbalances. A great example is when I ruptured my left Achilles I developed flexor and extender issues in my right knee and hip likely due having to base off of my right leg while using crutches. Developing some form of imbalance in parallel muscle groups is common in most athletes who favor one side (most athletes). Some sports scientists may argue that imbalance in the body muscle skeletal system caused by performing techniques to a point of expertise may benefit an athlete’s ability to perform.

The BJJ practitioner who always shoots from his right leg may find that he has more developed extenders in his right lower limbs. If you have been regularly training in MMA or BJJ for over a year you likely can stand up right now, have someone take a picture of you in a natural neutral stance, and a trained eye (and often an untrained eye) will be able to see apparent imbalances due to your favored fighting side.

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