T Nation

Anterior Knee Pain and Hip Catching/Clicking


tl;dr: read the topic title. my pelvis seems misaligned causing knee pain, and my hip has a slightly limited ROM at a certain point which I've been able to overcome by pushing/stretching through it. but how do I fix my misalignment?

I was in a bike accident at the end of last April. Didn't seem very serious, got up and walked immediately, some bruising on my left hip area. After a couple days I started training again, and had been focusing on my hip abductors at the time before the accident, so did that again. Ended up with excruciating pain and it completely disabled me from walking for a good three months until I figured out what was causing the problem - massive trigger points in my left leg, completely inactive gluteal muscles, calf muscles, and thigh muscles. I saw a chiropractor who readjusted my leg lengths (which got messed up in the injury somehow) and readjusted either my pelvis or my hip, not sure which, and that helped massively and allowed my glutes to fire again. After a month or so of SMR I had reactived all the muscles in my left leg.

I think complications arose when my muscles were in that state of atrophy. My left knee started hurting really bad, and the range of motion of my left hip was limited. I am able to move through certain degrees of certain movements with some clicks, and I was thinking if I kept moving through the clicks they would go away and free up the hip. That actually helped a little bit, as I've regained most of my hip's ROM. But not all of it. My knee has also gotten a lot better as I took time off my sport and weight training, and now that I've been rehabbing with deep squats, deadlifts, and single leg lunges, I've regained a lot of strength (though not nearly where I was before) and my knee hurts slightly less.

However, trigger points keep coming back, and my TFL is still highly overactive. (note: it was not overactive before the accident) I believe something in this accident caused my hip or pelvis to become misaligned and is causing certain muscles to tense up and overwork others, and causing my knee pain. Because when I foam roll my IT band and quads, and tennis ball roll my hip abductors, the pain in my knee completely vanishes. And then like three hours later it comes back.

It's almost been a year now. I feel like I'm almost out of this slump, but I need to realign my pelvis or hip or something for the final piece. I have no health insurance and I'm not sure how much I trust chiropractors in my current area, and the PTs at my university are garbage.

how can I overcome this last hill? I'm pretty damn sure my leg lengths are the same, and the chiro who I saw a couple months ago agrees.

here's a couple pics that show an odd difference in my mechanics that was never there before the injury. I added the box so you aren't distracted by my shlong :wink:

my left knee is lower (in terms of y-position in space) than the other and the whole leg starting from the butt just falls lower than the right side.

to really show the difference, I added my tripod case which shows the dip degree.

thanks for your help.


Oh yeah, forgot to mention the knee pain is only when bending the knee during certain movements, especially going DOWN stairs. Not so much going up, unless I really bend the knee way in front of my foot or go up 2 steps at a time. Step-ups are difficult for me at a height of more than one stair-step, the left side just feels super inhibited somehow and it hurts the knee.




This could take a bit but here are some things you need to think about.

Do you sleep with your hip flexed?

How often are you in hip flexion? (i.e. sitting etc..)

Do you foam roll?

Have you dont any tests to see if your psoas is tighter on the left side?

Typically a righty will have a tighter left psoas, possibly a more active TFL, but better internal rotation than the right. I like doing single leg balances where you lean over and push your hip back slightly, activating the glute with the footdown leg. Just a slight lean and push the hip back. Hold for :10 seconds, and then work on moving through a small range of motion to begin to emphasize the posterior chain is going to taking over hip extension duties. This should help the glute medius come around which will automatically shut down the TFL to some degree. Obviously your TFL has taken over too much of the hip stabilization duties from the glute medius, would almost guarantee that is what is causing your knee pain. Bulgarian squat holds will help stretch the psoas which could also be an issue inhibiting glutes I bet.

Let me know what you think.


My sleep position varies. Sometimes knees are tucked(hip flexed), sometimes lying flat. I sit quite a lot between school and work. I do foam roll, my quads and IT band, and roll on a tennis ball for my glute med/min, as both sides are often tense (and probably not activating properly).

I actually have worse internal rotation than on the right. Both my psoai(multiple psoas?) are weak, as I just found out from the standing up against a wall test. I have good core strength as I squat and fuck a lot, you'd think my psoas would benefit somewhere between the two. I actually wonder if my psoas is even activating fully on the left side.

Thanks for the balance, I'll put it to use and see what happens.