Dr. Ken Kinakin D.C., CSCS
Dr. Ken Kinakin is a sport medicine doctor, chiropractor, certified strength and conditioning specialist and personal trainer! He’s also the author of the book “Optimal Muscle Training” and has competed in bodybuilding and powerlifting for over 20 years. Dr. Kinakin lectures around the world to doctors and personal trainers on the areas of weight-training, rehabilitation and nutrition. He is also the clinic director for the AIM Health & Wellness clinic (see www.aimhealthgroup.com), with a rehabilitation and training centre in Mississauga, Ontario. Dr. Kinakin founded the Society of Weight-Training Injury Specialists (SWIS), an organization that educates and certifies doctors, therapists and personal trainers in the area of exercise muscle testing, rehabilitation and treatment of weight training injuries (see www.swis.ca).
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Knee Pain or Old Ankle Injury?

QUESTION: A while back I turned over on my ankle during a cardio session. I messed up my ankle pretty bad and couldn’t much weight training for a few weeks without feeling pain. I’m glad to say my ankle doesn’t really hurt anymore, but now, out of no where, my knee acts up every time a do squats or some cardio. What’s up with that? It seems to be getting worse! I never had knee problems before and I’m a young healthy adult with no known genetic predisposition to arthritis.

ANSWER: The ankle is one of the most complex joint in the body as it has to withstand thousands of steps a day of your bodyweight and also give constant neurological feedback to the brain so that you can stand upright. Any injury to the ankle can cause problems further up the body just like a tire out of alignment on your car can cause your steering wheel to shake. Many times the cause of an injury is not where you feel the pain. It’s where the stress loads up beyond what the body can handle. We see this many times with relation to the ankle and knee.

How An Injured Ankle Can Cause Knee Pain

The common scenario of how an ankle injury can cause knee pain usually goes like this: You are going for your daily run and your foot hits an edge of a pothole. Your ankle twists and you immediately feel pain on the outside of the ankle. You rub it and slowly walk home putting most of your weight on the good leg. When you are home you ice it and limp for the next few days until the pain has diminished and it appears that the injury has gone away. Usually it has, that is until you try to run hard on it once again and now the outside of your calf is painful and it radiates into your knee. In fact, every time you run now, the knee acts up halfway into the run and you have to favor the leg to finish the run. You are confused as you can’t remember injuring your knee at anytime. The reason why you can’t remember injuring your knee is because you never injured it. The knee pain is in response to an old ankle injury that you forgot about and had never healed properly.

The muscles that get damaged in a twisted ankle injury are on the outside of the calf muscles and are called the peroneal muscles. These muscles get stretched and damaged when you twist your ankle and are responsible for preventing you from rolling over on your ankle again. If you repeatedly injure your ankle, it can alter the movement of the lower leg bones and joints causing compression or tension on the common peroneal nerve as it wraps around the knee. This will cause the peroneal muscles to not only be weak because of muscle damage, but also joint dysfunctions and nerve compression can cause it to go weak. When this muscle is weak, the knee becomes unstable, which can cause knee pain, even though it was not directly injured.

Fix the Knee by Treating the Ankle

The way to treat the ankle is to determine if there is an old injury that you forgot about still causing you problems. The first thing is to see if you have any pain in the ankle or on the outside when you pull your toes up towards your nose or when you point your toes towards the floor. Then turn your foot inward and outward. You should feel no pain in any of those ranges of motion. The second thing you can do is gently press into the outside of the calf muscle starting at the ankle and moving upward towards the knee. You may find one or two tender spots. These tender spots can be an old injury in the muscle causing the muscle to become weak when it is stressed by long runs or heavy weight lifting. The best way to treat that is to get Massage Therapy on the muscle and also a technique called Active Release Technique (ART) that can restore normal function to the muscle. If the ankle is painful in any of the ranges of motion or feels restricted compared to the other ankle, a chiropractic adjustment to the ankle and foot can restore normal joint motion and can improve flexibility. Rehabilitation tubing exercises of turning your foot outward will strengthen the muscles so they become more stable and therefore putting less pressure on the knee.

If you have a knee pain that appeared out of nowhere and nothing seems to be helping it, try these few tests and if they are positive, get it treated. It may be the solution to an old problem.

To read more on the use of sports medicine in bodybuilding, click HERE. 

Dr. Ken Kinakin is a Chiropractor and a Certified Strength and Conditioning Specialist. He is the founder of the “Society of Weight-Training Injury Specialists” – SWIS and can be reached at www.swis.ca