If you’ve got knee pain, it could be originating in your pelvis.
To an extent, the pelvis can be considered the foundation of the entire skeletal system. The pelvis consists of the two ilia and the sacrum (often called the tailbone). The joints connecting the ilia and the sacrum are called the sacroiliac joints and the most common site of pelvic misalignment.
The pelvis is the foundation on which the spine sits and the connection to our legs via the hip joints. As the old song says, “the knee bone is connected to the thigh bone and thigh bone is connected to the hip bone” and so on. Could the answer be that simple?
When we are standing or walking, the weight of our body is absorbed by the discs of our spine and our pelvis. This load is then distributed throughout the legs by way of the hip joints, thigh bones (femur), knee joints, leg bones (tibia), ankle joints and finally the feet.
When the pelvis is out of alignment, the load of our body weight is distributed into the legs unequally. As a result, any one of the joints in the legs, particularly the knees, can be adversely affected over time. Additionally, there is an increased risk of an acute injury because of the resultant instability.
The knee joint is particularly susceptible to uneven weight distribution because it is a hinge joint, limiting its planes of motion. Additionally, its immediate counterparts in the kinetic chain, the hip and ankle joint, both have greater dimensions in mobility and are better able to tolerate disparate load distribution.
So the question at this point in your mind is probably “what causes the pelvis to go out of alignment?” There are basically five factors that affect alignment:
1. Congenital leg-length inequality (when a bone in the legs is shorter than its counterpart). It is estimated that the prevalence of this phenomenon is as high as 50 percent in the population. If the difference is greater than half an inch and especially if you are an athlete participating in running activities or your occupation requires extended periods of standing or walking, this can be significant over time.
2. Prolonged awkward postures common in poor sleeping and sitting habits can contribute to misalignment of the pelvis.
3. One-dimensional recreational activity, such as golf, and the resultant muscle imbalances is yet another contributor.
4. Slips and falls or comparable trauma can often throw the pelvis out of alignment.
5. And finally, congenital scoliosis can often affect pelvic alignment.
If your pelvis is out of alignment, it is to your benefit to get it back and keep it in alignment. Here are a few clues that your pelvis may be out of alignment. If you notice that one of your pant legs appears to be longer or your belt appears to slope down toward one side consistently, your pelvis may be out of alignment. If you have localized one-sided low-back pain or buttocks pain, your pelvis may be out of alignment. If you have one-sided hip or groin pain that gets worse with activity, your pelvis may be out of alignment. If you have low-level, gradual-onset knee pain without trauma, it is possible that your pelvis is out of alignment.
Correcting the modifiable risk factors that misalign the pelvis is often far more cost-effective and has tremendous value in preventing the resultant knee pain that frequently arises from lack of alignment. Think of it this way: Wouldn’t it be better to have your teeth checked frequently and cleaned before cavities arise than wait until you need a root canal?
— Sevak Khodabakhshian is a doctor of chiropractic with Thousand Oaks-based Omega Rehab & Sport, where a team of physical therapists, chiropractors and athletic trainers applies an active-care approach to healthcare. He can be reached for comments, questions or suggestions by e-mail, at Sevakk@omega-rehab.com.