Middle Child

Do you know anyone who is a middle child? I do. I know a bunch. They are easy to come by when you have a large family. Some of the closest people to me are middle children. 2 of those being my sister and my cousin Jaison. They have a lot in common. 

When we were younger they would tend to get blamed for all of the noise coming from the childrens play area during family parties. They are more willing to take risks and explore compared to their older and younger siblings. 

As a younger sibling, I usually took a more calculated risk after assessing the consequences received by everyone older than me. 

You see, I brought up a middle child because they have a lot in common with a knee joint. (Strange analogy, I know). But much like a middle child, the knee tends to take the blame of everyone surrounding them. It will oftentime take on the load of what may be missing from the ankle and the hip. 

In clinical practice, it is common to deal with knee pain. Unless there is direct trauma, you can almost always trace the roots of knee pain to something happening (or not happening) at the ankle or the hip. 

Calf game weak? It is going to be tough to push off when running, the knee might think it is a good time to hyper-extend a little bit to make up for that lack of ankle push. You end up blaming the knee when in reality it is working harder than it needs to and compensating for the ankle!

Tight hips? That squat depth might take a hit. Sounds like a good time for the knees to get a little loose to provide extra space for the incoming load! To produce force when we go into a loading pattern such as a squat or a deadlift, our body needs to be able to internally rotate at the hip. If we are limited in hip internal rotation, the body may compensate by increasing internal rotation demands at the knee!

Oftentimes, people end up going to a provider and they do a hell of a job strengthening the knee and getting it to work better. But here is the issue with that…the knee is already doing too much! The true root cause can be higher or lower down the chain. 

If you are focused on getting your knees stronger. It will be just as important to address your ankles and your hips. Throw in some calf raises (double leg, single leg), hip planks (targeting abductors and adductors) and see how much better your knees begin to feel!

When you play the long game, taking care of your hips and your ankles when dealing with knee pain will pay dividends for your rehab. Does that mean we should neglect the knee? No! Working the knee is just as important. Schedule a call with us if you are struggling with knee pain and we will get you started on a customized program to help you!