Written by Nash Woods
Knee pain is no fun. Knee pain deriving from CrossFit training is generally a result of hip tightness or dysfunction. Luckily, there are a few mobilizations and movements that can be a catch-all for general knee pain. This is by no means an exhaustive list and doesn’t address things like arthritis or traumatic injury. But in an otherwise healthy individual this list should help organise the hip capsule in a way that can address some of the pain.
In a perfect world you should be able to squat to depth and back up without the knee ever traveling medial to the big toe. But life gets in the way. Generally what we see is that a weak pelvic floor and obliques combined with tightness in the hip flexors cause a loss of a neutral pelvic position and the body will default to an anteriorly tilted pelvis. Because the pelvis is tilted anteriorly, the glutes cannot act to properly abduct the femur and keep the knee tracking over the toe, therefore the tensor fasciae latae takes over as the main abductor in the hip. This is where we run into issues like IT band syndrome and see a lot of lateral knee pain. This poorly organized hip capsule will also result in medial quad and hamstring tightness because instead of finding strength and stability in the lateral chain of the hips knees and ankles we have to now rely on the medial chain, which wasn’t designed for squatting. And its true function, which is hinging, will be compromised by the overuse that we have in the squatting movements. So how do we fix all this junk? Let’s start by trying to address anterior pelvic tilt.
Start with using a med ball or sandbag in a bear hug hold. Your arms should wrap around the center of the ball with the elbows higher than the shoulders. From there get a stance that is slightly wider than squat stance with the toes out. Now try to get your hips to meet your ribs without bending over, let your knees bend as much as necessary to achieve this position. It should look something like this.
Notice the lack of lumbar curve. What we are doing with this hold is trying to achieve a posteriorly tilted pelvis with the pelvic floor and obliques engaged (think hollow hold). From here try to get your knees as far away from each other as possible without losing the hollow body position. If you have a lot of the dysfunction in the hip that I described above, your glutes should immediately start firing and maybe even cramping up. In this position the tensor fascia latae can’t compensate like it has been. This is a great way to discover any areas with tightness that could be affecting the hip. My recommendation is to test your range of motion with this med ball hold, then spend a couple minutes mobilizing areas that feel tight with a foam roller or lacrosse ball. Then test again. Prioritizing spending time in a good hip position. Remember that smashing and passively opening tissues up are really only effective if we accompany them with an exercise or drill to stress the body into accepting that new position.
Common areas that will need to be opened up are the TFL, glutes, and adductors/hamstrings. Try to pin some of that tissue and move the hip and knee ranges of motion for your mobilizations.