Introduction

If you’ve clicked on this blog, you’re not alone in trying to figure out your knee pain. More than 654 million people over the age of 40 worldwide in 2020 were diagnosed or had previously been diagnosed with Osteoarthritis. A number that would be staggering enough if it were the only cause of knee pain when bending. 

‘Runners knee’, ‘ITB syndrome’, ‘Patellofemoral Pain Syndrome’; these are just a few of the diagnoses that people receive without any real long term solution.  Luckily for you, we at Functional Patterns see these issues on a very regular basis, and there’s almost always something that can be done to help diminish the negative effect it has on your life.

In this article we’re going to covering why you might feel knee pain when bending, what to avoid, what you can do to help, and how to get started.

Pain? No Gain

Let's get straight into it. If your knee hurts when you bend it (assuming it's not due to a traumatic event like an acute sports injury or car crash, in which case seek medical help) then you need to get to the bottom of why this is happening. You should definitely not ignore these warning signs and continue on with your gym routine, sports or hill sprints; this advice almost always leads to further issues down the line.  

 The Bodybuilder

At Functional Patterns, we generally see hip and knee pain split into a few different mechanisms.  The first type of body that exhibits knee pain when bending would be the bodybuilder.  The client that does regular squats, deadlifts, leg press and leg extensions followed up with hamstring curls and hip thrusts.  These exercises have very limited carryover to daily activities like walking and running, and while you may think there’s relevance to picking things up off the floor like groceries or pot plants, placing a barbell on your spine just doesn’t get close to the forces involved with these activities, while also compressing the spine, hip, knee and ankle joints unnecessarily. If you have pain in knee when bent and you perform these exercises you should definitely ask yourself “Shouldn’t these exercises be helping me instead of hurting me?”

The marathon runner

The next ‘stereotype’ we see with pain with bending knee would be the long distance athlete.  The weekend warrior who runs miles and miles in preparation for a half marathon in two months time. Although the dedication to a goal is admirable, most of their bodies are in no way ready for the rigors of the hundreds of thousands of repetitions of their knees and ankles hitting the concrete.  We specifically notice in this population that there are a lot of ‘knee valgus’, or ‘knock knees’ present when we watch them run or walk, dysfunctions that we have a very good track record of solving at Functional Patterns. 

Results by HBS Jen Calleja 

The Cyclist

The third population that we regularly see with pain when bending knee is the cyclist. Similar to the long distance athlete, these guys are committed to getting fit, and believe that a bike may be the best way to get rid of the supposed joint damage from running.  In fact, alot of cyclists have told us that they already had pain when they used to run and that cycling has been a natural progression/regression now that they’re unable to run anymore.  The problem with cycling as it is currently done is that we never really train the biggest muscle of our bodies, the gluteus maximus, through its full range of motion.  It’s equivalent to doing bicep curls but just dropping and lifting the weight 1 inch up and down.

  When we see elite level athletes with a functional gluteal muscle, we’re generally thinking about sprinters, basketball players, wrestlers and some martial artists. Cycling unfortunately doesn’t replicate these mechanics and in our experience actually diminishes the performance of our bodies when sprinting and doing other athletic activities.

Where to start

So now that we’ve explained who tends to experience hip and knee pain the most, we need to help decrease the pain itself.  Myofascial release (MFR) is something we recommend to virtually all of our new clients, and symptoms around the knee are often alleviated with release work.  MFR basically works like an eraser to your bodies’ movement dysfunctions throughout the day - it rehydrates tissue and gives you a window to better lengthen and contract muscles that might otherwise be ‘stuck’.  Something to keep in mind however is that erasers don’t stop you from writing on the page again, and if you don’t correct these faulty patterns, then they’ll continue to let you know about it with your pain with bending knee.

Something you can do at home

Next up, it's time to address the faulty movement patterns.  Try this at home to get a better understanding of your bodies’ compensations. Set your camera or phone up in a hallway about 20ft long, and make sure you’re wearing clothing that enables you to see your knees and ideally your lower spine. If you’re able to run, run, but if pain is a factor then walk towards and away from the camera with slow motion recording.  When you watch yourself, have a look at your knees; do they look symmetrical? Do they drive forward and back equally, and do they do so in a straight line, or are they touching each other?  Does your lower back jar on contact with the floor, and does it do so more on one side? 

Even if you have no formal training in health and fitness, you’ll be surprised as to how much information your eyes can pick up.  We notice our clients that get the best results in Functional Patterns take an active approach to understanding their dysfunctions, and this test can prove invaluable in your journey to pain free knee bending.

How to get to the root cause

Before we get into the details of how you can go about correcting the issues you’ve seen above, it’s very important to realize that symptoms of musculoskeletal pain can be very misleading.  The amount of clients that have come into our center limping and in agony with every step, only to show us their completely clear MRI’s and X Ray is astounding.  This isn’t to say that symptoms aren’t important; your body is definitely telling you that something is off; my point is just to stress that the body generally is telling you WHAT is hurting, but not WHY it's hurting.

Let's think about all the activities that happen throughout the day that involve the hip and knee. Squatting into the car, sitting on the toilet, sitting into bed, leaning over to pick something up, walking, running, standing; the list goes on.  With all of these movements our bodies have a tendency to follow a pattern that develops from when we are children.  If we aren’t either genetic freaks like Usain Bolt or Lebron James, or actively thinking about these patterns, they can develop into dysfunctions, asymmetries and imbalances, eventually resulting in the hip and knee pain you’re currently experiencing.

What Won’t Help

“So the easy solution is just do some leg exercises and stretching, right?” This is the type of question I always receive when I inform people of these imbalances.  Squats, leg presses, deadlifts, clamshells, these are the norm in the rehab and fitness industry - these exercises don’t change HOW you move, resulting in the same movement patterns that you were using before your knee pain occurred.  Sure, you may notice some general increase in the  strength of your legs, but more often than not you’re just doing a slightly different movement exactly the same way as you’ve always done. Stretching on the other hand, can also be very damaging, as it generally feels good initially.  However, just like a painkiller, the effect often wears off very quickly, resulting in a more intense stretch being needed the next time pain arrives.  This creates a vicious cycle where eventually we notice clients’ pain may spread to other joints or muscles in addition to the knee pain when bending they’re already experiencing.

What will definitely help

Over time we notice that there’s really only one solution to knee pain when bending, and that’s addressing the big 4 movements of standing, walking, running and throwing.  As human beings, we have evolved to perform these functions first and foremost, and the efficacy of these movements has a domino effect on every other movement we perform on a day to day basis.  We consistently help clients in both acute and chronic pain anywhere on the body by addressing the big 4, and we suggest that adopting these principles will help you overcome your hip and knee pain quicker and more effectively than any other method.

Now that you have a basic understanding of why you need to address the big 4, you’re armed with all the information needed to help your knee pain when bending.  If you’d like more specific help, feel free to reach out to a practitioner near you at https://functionalpatterns.com/pages/find-a-practitioner.