The origin of (most) knee pain

The knee is the punching bag for the foot and the hip“.

A wise man once told me that the majority of non-traumatic sporting injuries that occur at the knee originate due to a weakness above or below the knee itself.

When the knee is under load, its position is determined by various muscles around the core, the hip, the shin and the foot. They all work in unison to keep our knee in the optimum position. The classic way to determine if your knee is in the correct position is to draw a line from the bony part on the front outer edge of your hip, down through the centre of your knee cap. A line is then taken along the tibia and drawn back upwards. Where the two lines intersect, an angle is taken which determines what is called the Q angle (See image below).

The normal Q angles are:
For men: Anything +/- 3 degrees either side of 14 degrees
For Women: Anything +/- 3 degrees either side of 17 degrees

When this angle is outside of the normal range, a variety of different knee problems can occur.

I personally dont tend to use the above method to identify dysfunction, as it does not take in to account how the body reacts during weight bearing or when running. One good way to see if you have an increased Q angle yourself is to try doing a few unsupported single leg squats in front of a mirror (dont hurt yourselves!). Perform this to see whether your knee ‘kicks in‘ or if your ‘hips shift‘ outward. Being able to keep your pelvis level and having your knee bend over your 1st to 3rd toes indicates a reasonably happy knee joint. If this is not the case then its worth seeing a good manual therapist to determine where the weakness may be coming from.

Clinical tip: A good indication to figure out if you are seeing a good sports therapist is to see if they check the lower back, hip and the foot as well. Not just your knee 😉

Talking of Punching bags, its Pacquiao vs Mayweather this weekend!

Have a good one,


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