T Nation

Medial Knee Pain


#1

I realize my hip external rotators, and hips in general, need more mobility.
For the longest though I haven't been able to aggressively mobilize my hip external rotation ROM without aggravating the medial aspect of my knee, especially my right knee. I believe the pain is in my MCL.
Does anyone have similar experiences and what can be done to remedy this?
I want to improve my hip mobility but obviously not at the expense of me knee health.
Stretches/positions that hurt include the butterfly stretch, the leg on table stretch, 90/90 stretch etc.


#2

it sounds to me (this is a guess) that you are forcing external rotation of the hip too much when you do your exercises and that the knee is moving to compensate for the loss of range of motion at your hip. you need to figure a way to target the hip and spare the knee. can you try and focus a bit more when you do your exercises? focus on the movement coming from the hip and not letting the movement come from the knee?

  • best way i know of improving external rotation of the hip is to get something like a baseball and sit on it. dig it into one of the glutes. then roll around until you find the (probably tight and painful) lateral rotators. try and use just enough pressure so you are consciously aware of the muscle. try and use your brain to tell the muscle to relax. then try and coax it to relax by rolling on it with as much pressure as is helpful for getting it to relax. sometimes deep pressure will feel good / be helpful. sometimes a light touch is required.

i actually use a 1 or 2kg med ball (a bit larger than a baseball) which is perhaps a bit gentler because of the greater surface area. once i've found a tight / painful spot i try and relax the muscle to let the implement sink in. then, once it is sunk in a bit i try and move the leg. lift it up to the chest and back. internal and external rotation. it is kind of like pinning the muscle down then stretching it a bit by moving the limb through motion. works like magic for my mobility, anyway. spares the knees.


#3

Yes that makes sense indeed. I'm not sure how my external rotators got so tight, I'm no less active than before and place no less focus on mobility either.
Thanks for the tip. I've done this with the softball I have and it does indeed hurt, in a good way. Maybe I need to do it more. I'm always a little weary of soft tissue work though; seems every time I put more focus on it I end up further tweaking something. I have to always increase soft tissue work slowly.
How long do you usually sit there/stretch?
Do you happen to have a video link?


#4

http://www.athletestreatingathletes.com/self-muscle-massage/self-muscle-massage-pt-3-posterior-hip/

I've been doing my soft tissue work consistently for years now so what I do is probably not going to be so helpful for you.

I don't injure myself with soft tissue work anymore but I need to remember that I used to quite a lot. It is hard to learn where the fine line is between helpful hurt and hurt, sometimes. And hard to figure when an area needs to be left to recover, and when it stands to profit from more focused work.

Increase it slowly, yes. I think the focused tissue work (especially the techniques that involve trying to force things to release) actually damages tissue. Like how weight training damages tissue. Both of those take time to recover from. I used to be skeptical... But I've come to learn the value of the gentler techniques for avoiding / preventing injury. Wider sweeping gentler rolling to help promote blood flow etc. I don't know that it is possible to do too much of that (unless it is at the expense of other things).

If your efforts to increase your rotation have resulted in your having more ROM then the muscles will be working differently. You should feel that, yeah. I like to do the release before doing the exercises that increase the ROM. I've been particularly inspired by ballet turn-out lately so have been looking into that. No knee injuries when rotation comes from the hip... Knee injuries when turnout is forced beyond what the muscles / tendons / or perhaps even joint capsule of the hip allow... I find the pinning the muscle down then moving through ROM technique gives me instant mobility for whatever it is that I do after. Luck.


#5

Shit I don't get notifications apparently, sorry for the delay in replying.
This is good stuff, thank you! The link with the article and video are especially helpful.
I agree on the wider sweeps; I've noticed when go faster and wider I get more of a warm up and feel better.
And patience is obviously key. I've gone overboard trying to alleviate aches and pains in my traps and noticed that more is not really better.