Your Knee Pain is Coming From your Hips or Feet

Your Knee Pain is Coming From Your Hips or Feet

Unravelling the Hidden Causes of Knee Pain

Knee pain can quite local — the discomfort seems to sit squarely around the joint itself. But in many cases, the real cause is found above or below the knee, in the hips, pelvis, or feet.

As osteopaths, we see this every week: patients come in for knee pain, but when we assess the way they move, it becomes clear that the problem lies elsewhere in the chain. The body is beautifully interconnected — and understanding those connections is the key to long-term relief. We have also explored this concept in a prior blog titled Knee Pain & The Hip-Knee Continuum.

The Hips and Pelvis: The Foundation of Lower Body Stability

Your hips and pelvis form the foundation of your spine. They provide strength, stability, and alignment for your upper extremity and lower extremity, allowing them to act to generate force and hence, movement.

When hip muscles are tight, weak, or imbalanced, they can throw the pelvis out of its optimal position. For example:

• Tight hip flexors can tilt the pelvis forward, biasing the load being placed on the knees.

• Weak glutes can reduce pelvic control, causing the knees to collapse inward during movement.

Over time, these altered movement patterns can lead to common knee conditions like:

• Patellofemoral pain syndrome (pain behind or around the kneecap)

• Iliotibial band (ITB) syndrome (pain on the outer knee)

These are not “knee problems” in isolation — they’re symptoms of a breakdown in the kinetic chain that starts higher up.

The Feet and Ankles: The Foundation Beneath

Just as the hips and pelvis can affect the knees from above, the feet and ankles influence them from below.

When the foot doesn’t move as it should — for example, through overpronation (rolling inward) or supination (rolling outward) — the forces travelling up the leg become unbalanced.
This can lead to increased stress through the knee joint, often showing up as:

• Patellar tendinopathy (jumper’s knee)

• Chondromalacia patellae (softening of the cartilage behind the kneecap)

In short, when your foot mechanics are off, your knees are exposed to repetitive strain in ways that they may not have the capacity to handle. We go into greater depth regarding ankle and foot injuries in our blog Ankle Sprains.

The Interconnected Chain

Each step you take involves a coordinated dance between your hips, knees, and feet. When one link in the chain moves poorly, the others compensate.

That’s why knee pain so often reflects a global issue rather than a local one. To truly solve it, we must look at how the whole system is moving — not just the sore joint itself.

How Osteopathy Helps

At Osteopathic Movement South Yarra, we take a whole-body approach to treating knee pain. Instead of focusing only on the knee joint, we assess your movement patterns, posture, and muscle balance from head to toe.

Treatment often includes:

• Manual therapy to release tight muscles and restore mobility in the hips, pelvis, and ankles

• Joint mobilisation to improve smooth motion through the lower limb

• Corrective exercises to strengthen weak areas (especially glutes, quads, and calf muscles)

• Postural corrections and gait retraining to help you move efficiently and reduce strain

We’ll also guide you through self-management strategies — such as choosing supportive footwear, improving workstation setup, and performing mobility drills — to help prevent pain from returning.

The Takeaway

Your knee pain rarely exists in isolation. Pain in one joint can be a message from elsewhere — a signal that something along the chain needs attention.

By addressing the underlying hip, pelvis, or foot mechanics, we can reduce pain, restore natural movement, and prevent recurring injuries. The goal isn’t just to get you out of pain — it’s to get you moving better than ever.

Book Your Appointment

If you’re experiencing persistent or recurring knee pain, our experienced osteopaths can assess your entire movement system and create a tailored plan for long-term recovery.

• Learn more about our South Yarra osteopaths
• Check out our Osteopathic Clinic
• Book Online

Written by Dr Dayne Sweres (B.AppSci (CompMed), M.Osteo) – Founder, Osteopathic Movement, South Yarra.