The cause of my knee pain: a twisted pelvis?

Hello!  This post is all about another visit to a specialist to figure out the pain I’ve been having in my right knee.  If that’s not interesting to you (Hi Laura and Andrea!), here is a riddle:

There are six people at a table and a cake sliced into 6 pieces. Each person has a piece of cake in front of them, yet the cake pan still has a piece of cake in it. How is this possible?

—–

Okay…so I saw another PT last night for a second opinion about what is going on with my knee.  Shout out to Salt for mystery injuries and multiple diagnoses!
The PT listened to me explain my 7-week IT band/knee pain and then did an incredibly comprehensive screening.

The appointment lasted almost an hour, and he helped me figure out not only my knee pain/IT band, but also the hamstring soreness that has plagued me for 2 years, AND the heel whip that I thought was just a quirk in my running form.  I’m feeling pretty good about all of it, and I’ll try to best to explain what he said…though I apologize if I get anything wrong…the ears are my thing, not the muscular or skeletal systems.

IT band syndrome:

  • Turns out that my sacrum (bone in the middle of the pelvis) had tilted and gotten stuck in a twisted position, making one leg functionally longer than the other.  This could have been caused by a number of things, as simple as reaching for a water bottle on the car floor while buckled, sleeping on my stomach with one foot at a certain angle, picking up a pencil, etc.
  • In attempt to shorten the functionally longer leg (my right leg), my whole right leg buckled slightly inward, and the arch of my foot flattened.  I’ve always had low arches, but prior to this appointment, the arch on my right foot was significantly lower (flat, really) than the arch on my left.
  • The leg length discrepancy and overpronation from the flat foot likely caused IT band syndrome.

To fix the twisted sacrum, he pushed on my lower back, and it felt like welcomed pressure–kind of like how it feels good when you crack your back, but nothing cracked or popped.  ..and VOILA! My legs were back to the same length and the arch in my right foot was back!  Still low, but there.  I was also able to twist more symmetrically (before he did that, it was significantly easier to twist to one side than the other).

He thought that the leg length difference from the tilted pelvis was likely the root of my IT band problem…so if the sacrum stays in place, I *should* be okay to run. !!!!!!!!!!!

Upkeep suggestions: Stretch & roll quads; push kneecap toward toes 3x/day (until my right knee stops cracking)

High hamstring pain:

My high hamstrings (where your hamstring meets your butt) have been sore for two years, and I thought it was because I had weak hamstrings.  He screened my lower body muscle strength and found that everything was strong except my glute max muscles (the main butt muscles).  Hamstrings were fine, as were quads, gluteus minimus, and gluteus medius.  He concluded that my hamstrings are working overtime, and my glutes aren’t engaging as much as they should (or at all) when I run, or even when I do squats, lunges, etc.

Suggestions: lots of glute exercises (focus on engaging the glutes); tuck your tail while running to engage glutes (this also helps with posture!)

Heel whip:

This was a total bonus learning moment.  A heel whip is when you quickly twist your heel outward as you’re lifting off each step.  I have a wicked heel whip, and the soles of my shoes, as well as the calluses on the insides of my big toes, will prove it (I can literally touch my big toes together and not even feel it because the calluses are huge).  Oftentimes a heel whip is  caused by tight calves–specifically a tight soleus, which is the deeper calf muscle.  I stretch my calves daily, but surprise!– there are two calf muscles, and I’ve only been stretching one.

So that was all pretty awesome to hear…a quick fix is every injured runner’s dream.  I’ve run twice in the past two days (6 miles + 4 miles) without IT band pain.  We’ll see how the next week of running goes!

—–
Did you solve the riddle??
How often do you stretch?

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16 thoughts on “The cause of my knee pain: a twisted pelvis?

  1. I have been sitting here contemplating that riddle and can’t figure it out… please say you’re going to answer that in your next post!? haha

  2. YES! I hope this is a fix for you!!! I had no idea that you could twist your pelvis. That’s pretty weird, but cool that you got it figured out. 🙂

    And I have no idea about that riddle. I’m terrible at things like that!

  3. The pan is in front of one of them!

    OMG you should totally add a riddle to all of your posts!!!! If you don’t I might totally steal that!

    I AM however interested in your running.
    Ok, that is SO FASCINATING! I find it absolutely amazing how the body is so inter-related. It’s wild how something in your glute can affect your back and your heel (making this up) and you never feel it in your glute!

    I am so happy you have causes to your issues so that hopefully you can work your way to being pain free!

  4. Glad that you found an awesome PT to fix you up! Anatomy is so weird – that’s what I’ve learned from running. Every teeny tiny imbalance is magnified so much.

    There’s a slice still in the pan, right? Now I want cake.

  5. Pingback: New shoes and a sister date | the mile report

  6. What an awesome PT! And crazy that he could manipulate it back into place – I really hope it’s not temporary. Although, at least now you know, you can always go back and get it untwisted again. One of the first things you learn as a trainer is that if a client has pain or injury in a joint, it’s almost always something going on at the joint above or below it that’s actually the root cause of it, so it makes total sense to me that your hip/pelvis were to blame for your knee pain.

    • Thanks for the comment! I’ve wondered if it’s a temporary fix too. So far, so good.. but if it starts to be a reoccuring problem, I’ll have to look into what I can do to stabilize it. Maybe the glute strengthening will help keep everything in place(?)

  7. Pingback: knee news, a cappella, and Ingrid Michaelson | the mile report

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