Are you battling persistent knee pain that just won’t go away? You’ve tried rest, ice, and maybe even knee-specific exercises, but the pain keeps coming back. Here’s something that might surprise you the real source of your knee discomfort could be coming from somewhere else entirely – your pelvis.

The research below showed that an adjustment of the pelvis and hip decreases muscle activity in the knee and reduces knee pain.

 

How Pelvic Issues Can Cause Knee Pain

Understanding Pelvic Alignment

When you look at the human skeletal system a rotated pelvis causes the legs to rotate also. Walking around like this means that the muscles of the leg need to activate to guard the rotational stress on the knees.

Over time the muscles fatigue and lead to a knee problem progressing. Eventually this condition will come to a point where damage to the knee is caused, that damage activates pain receptors in the knee, allowing you to know where your problem is.

By straightening the pelvis with a process of chiropractic adjustments and soft tissue therapy, the legs will straighten underneath and decrease rotational stress on the knee so the muscles can then relax and go back to normal instead of guarding.

When a pelvis is rotated, it indicates a locking of the joints in the pelvis and low back. The chiropractic adjustment unlocks this enabling the body to return to its default (balanced) position.

What The Research Shows Us

There’s a number of research articles showing a relationship between pelvic alignment and pain in the knees.

Pelvic & Hip Issues That May Contribute To Knee Pain

Anterior Pelvic Tilt

Anterior pelvic tilt occurs when the front of your pelvis drops lower than the back, creating an exaggerated arch in your lower back. Imagine a bucket of water tipping forward, that’s essentially what’s happening with your pelvis.

Anterior pelvic tilt is common, and prolonged sitting is one of the biggest culprits, as it keeps your hip flexors in a shortened position for extended periods.

Posterior Pelvic Tilt

Posterior pelvic tilt is the opposite, the front of your pelvis tilts upward while the back drops down, flattening the natural curve of your lower back.

It’s often caused by tight hamstrings and weak hip flexors, and while it’s less common than anterior pelvic tilt it can still create significant problems.

Twisted Pelvis

A twisted pelvis, also called pelvic torsion or rotated pelvis, occurs when one side of your pelvis rotates forward while the other stays neutral or rotates backward. Imagine your pelvis turning like you’re doing a twist dance move, but getting stuck in that position.

This can result from muscle imbalances, past injuries, sports that involve repetitive twisting motions. Lifting on one side, or carrying a child on one hip and not the other could also contribute.

Lateral Pelvic Tilt

This is where one hip sits higher than the other, creating a side-to-side imbalance rather than a front-to-back one.

Symptoms To Look Out For

  • Pain on the inside or outside of your knee. Aching behind your kneecap, especially when climbing stairs or sitting for long periods
  • A feeling that your knee might “give out”
  • Clicking or popping sensations in the knee
  • Pain that improves with rest but returns with activity
  • Uneven wear on the soles of your shoes
  • A tendency to lean to one side when standing

Relief From Knee Pain

The good news is that pelvic-related knee pain can often be successfully treated by addressing the source of the problem. The goal of treatment is to return your pelvis to a neutral, balanced position through

  • Chiropractic Adjustments
  • Soft Tissue Therapy
  • Strengthening Muscles

Simple Ways To Check Your Pelvis

Foot Alignment

One way to check of your pelvis is rotated is to stand in front of a full length mirror and if your feet aren’t parallel, your pelvis is rotated.

Mirror Test

Another test you can use when standing in front of a full length mirror. Look at yourself from the side angle, and notice the curve in your lower back. If there’s an exaggerated arch this may suggest anterior pelvic tilt, if your back is flat this could suggest posterior pelvic tilt. A gentle and natural curve is ideal.

Hip Level

Standing in front of a mirror, place your hands on the bony points of your hips. If one hand is noticeably higher than the other, this can be an indication of pelvic tilt or rotation.

 

Need An Appointment?

While these tests can give you some insight, they’re not a substitute for a professional evaluation. If you notice any of these signs, or you’re experiencing knee pain, it’s worth booking an appointment with your chiropractor for a thorough assessment.

Prevention is always better than cure, so it’s best not to wait for pain. Keeping your body’s joints moving correctly will keep your body straight.

Resources

Motealleh, A., Gheysari, E., Shokri, E., & Sobhani, S. (2016). The immediate effect of lumbopelvic manipulation on EMG of vasti and gluteus medius in athletes with patellofemoral pain syndrome: A randomized controlled trial.

Bucek, D. W. (2019). Reduction of knee pain in a 45-year-old woman after pelvic manipulation and kinesiology taping: A case report.

Shultz, S. J., Nguyen, A. D., & Levine, B. J. (2009). The relationship between lower extremity alignment characteristics and anterior knee joint laxity.

 

This article was originally published by Dr Ryan Lamp on May 16, 2016. It has been updated with more recent research.