How do knee pain and a misaligned pelvis relate to one another?

Knee pain is a very common complaint that I see in the clinic. But did you ever consider that the knee pain could actually be due to your misaligned pelvis?

The younger patients tend to experience knee pain after activities such as running, soccer, tennis, or working out at the gym, etc. This also applies to children and teenagers. Often, they tell me that they think it is normal to have knee pain after these activities, and I have to tell them “NO”.

The older patients usually have had knee pain for several years and some of them need to use assistive devices such as a cane. Some of these patients’ legs have started to bend in either an “O” or “L” shape. They tell me about their friends who have undergone knee replacement surgery. Often these patients were told by other practitioners that their knee joints are degenerating and that nothing can be done. Again, I have to tell them “NO”. 

If the pelvis was in alignment, it would be unlikely that this type of knee pain would have happened in these cases, and it is unlikely that the degeneration would have shown up so early. In our current sedentary lifestyle, we generally do not experience so much wear and tear on the knee joints in our daily lives that our knee joints would be “naturally” degenerating so much in our 50s or 60s. The reason for the early wear and tear on the knee joints is mostly likely the misaligned pelvis. In fact, when I do treatment on these patients and focus on re-aligning their pelvis, the knee pain goes away and their legs straighten. So, I know that in these types of patients, the knee is not the main problem, the real culprit is the pelvis. 

There are two common pelvis misalignment-related problems that lead to knee pain:

1. Pelvis misalignment

In my clinic, the most common reason for knee pain is because the pelvis and sacrum are not in the right position. If you have been told or if you have noticed that you have one leg that is shorter than the other, it is most likely due to the malposition of the sacrum and pelvis. As the body does not like this imbalance, it tries to compensate, leading to increased pressure at the knee joint, leading to knee pain. Usually, the forces going through our bodies when standing or walking are absorbed by the pelvis and the spinal discs, but if the pelvis is misaligned, the forces need to go elsewhere, and in these cases, a lot of the force is absorbed by the knee joints. The problem is that if the pelvis is not aligned, the knees are likely not in an optimal position, and this leads to damage and deterioration of the knee joint. Over time, this will cause significant damage and pain.

Some people even notice that one or both of their legs change shape and start to bow. This is because the forces on the body are not going straight through the joints and bones, as the joints of the pelvis and knee are misaligned. If the forces run through the knee joint and leg bones at an angle, over time, the legs start to change shape. To get rid of the knee pain and fix any bowing of the legs, we need to fix the actual problem and realign the pelvis and sacrum.

The pelvis can become imbalanced for many reasons: falls, accidents, poor sitting or standing posture, sitting on your wallet, one-sided sports such as golf, and poor sleeping posture, etc.

2. Anterior Pelvic Tilt

The pelvis is shaped like a bowl, and the spine and thighbones attach to it. Muscles also attach to the pelvis in different directions. These muscles can directly affect the position of the pelvis. If the surrounding muscles are tight or weak, then it may negatively influence the position of the pelvis. One of the poor pelvis positions is called anterior pelvic tilt.

Anterior pelvic tilt is very common in athletes, officer workers, and people who sit for prolonged periods of time. When sitting for a long time, the hip flexors become shortened, and this will pull on one end of the pelvis and thighbones. This will appear as a very curved lower back. This leads the thighbones and the legs to rotate internally, which puts excess stress on the knees due to a knock-kneed position. So, anterior pelvic tilt can lead to lower back pain, hip pain, knee pain, and flat feet. It also leads to a bigger curve in the thoracic spine, leading to a hunched back, which puts you at risk for neck pain, shoulder pain, headaches, etc.

To deal with this problem, we need to re-align the pelvis and retrain the proper position of the spine and pelvis as well as the hip musculature so that the anterior pelvic tilt is corrected. 

Take-home Message

It is important to find out the real cause of your knee pain. I have had many patients who have had lots of other therapy focusing locally on the knees, but that only brings them temporary relief. Once the pelvis is re-aligned, the knee pain goes away, and the knee joints can function smoothly again. If the pelvis is not corrected, then over time, the knee pain will get worse. Then, you may experience pain and early degeneration of the knee joints, leading to the need for an assistive device such as a cane or walker, or you might even require surgery when the pain and degeneration become too severe.

So, the next time you or your friends have knee pain, consider that the pelvis might be the main issue.