knee pain

Causes of Knee Pain

When we experience knee pain, is it the knee the issue is stemming from?

Several studies have been written stating a link with knee pain to problems with the lower back, hips, ankles, and feet. Because we walk on two legs, everything from the ground up affects the rest of the body. The first “link” in this “kinetic chain” is our feet, and the last link is the head.

If any of the lower links are affected this has a ripple effect up through the rest of the body and in most instances, having a negative effect. For example, a “knocked knee” can be a cause of a flat foot or pronated ankle whereby the foot rolls in the way. If you look around you when you are in town or in the supermarket you will see how people walk on their insteps.

You will see this in particular on holiday amongst those wearing shorts and flip flops. It is estimated that the vast majority of us are over-pronating by the age of 30. Many of us are born with flat feet and as a result can be suffering from this from the minute we start to walk.

There are several tissues in the knee that can produce pain. In the over-pronation situation, the knee is overloaded so the medial, or inside compartment, of the knee is opening up excessively whilst the lateral, or outer compartment, over-compresses or jams together. We often find medial and/or lateral compartment pain in the over-pronated ankle/knocked-knee side.

The front section of the knee houses the kneecap that slides in a groove, and the knocked-knee results in overloading on the outside of the knee cap/groove creating a condition called lateral patellofemoral pressure syndrome and/or chondromalacia patella.

When you present for an Osteopathic evaluation, your Osteopath will pay attention to your gait or walking rhythm and look for over-pronation. You can correct the pronation effect with an orthotic foot wedge, which would hopefully prevent any conditions from arising in the future, such as arthritis.

Exercise is key as it is so important to keep the muscles around the knee stretched and strong. There is one muscle in particular, the vastus medialis oblique or VMO that connects our upper/inner kneecap to the medial/inside leg. It is the muscle that counteracts the outward pull by the other quadriceps muscles that attach to the kneecap. Your Osteopath can show you how to specifically exercise and isolate the VMO, if necessary. Book online now at

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