“The Thigh Bones Connected to the...”
Neal Blakely, PT, Apex Physical Therapy

One of the magnificent qualities of the body is its ability to compensate.  The body functions as a complex system with many dependent and interconnected parts.  Problems in the knee provide a common example.  Many types of knee pain can originate from biomechanical dysfunctions involving the hip and/or foot.  We know excessive pronation (flattening) of the foot rotates the tibia which affects the knee. Weakness in the hip muscles can allow excessive or poorly controlled rotation of the femur altering knee biomechanics from above.
   
We can even move up from there and include the core (abdominal, low back and pelvic muscles) and recognize their role in stabilization and good lower extremity biomechanics.  If the knee’s ability to compensate for biomechanical problems in these areas is overwhelmed, pain and dysfunction can result.
   
If an athlete is receiving treatment for knee pain, it is not uncommon for the physical therapist to start with an evaluation of the original area of injury and move on to the hip, foot and core.  Strengthening the hip and core and improving hip flexibility may be recommended in addition to treatment of the knee directly.  The search for dysfunctional compensation patterns may also include assessment of the opposite leg.  Asymmetrical range of motion and strength may contribute to additional biomechanical problems.  This is especially true in athletes who are involved in activities demanding high speeds, power and repetitive movements.
   
It is crucial to recognize the original area of pain is not necessarily the only area to be addressed for a full recovery.  It is all connected and these other areas may hold part of the key to long term success.