OK to stretch groin for knee pain/anterior pelvic tilt ?

[soreknees]

Hello, i've had knee cap tracking issues for awhile now. They click on the outside edge of my knees and i think it gives me knee tendonitis if i over do exercise (also got bony bumps below knees on the shin). I was cycle touring for a year or so doing a lot of hills and i remember my VMO's feeling very cramped at certain times to the point i had to stop for awhile by the side of the road.

I cannot do an asian squat without my heels being off the ground and squatting without leaning forward is difficult.

I think i have anterior pelvic tilt and need to externally rotate my femurs to stop the knees clicking and have been stretching my hip flexors ALOT with the ''sled hip flexor stretch'' on EXRX which always stops my knees clicking straight after doing it, but i don't seem to be making much progress with overall feeling once the muscles have relaxed. I've been doing loads of planks, hip thrusts, bridges, clams to strengthen my glutes, and stretch the calves and quads.

One thing i would like to know is that my groin adductors are very very tight so would it do any harm or help to stretch them with say a butterfly stretch for what i'm trying to achieve ? eg could they also be pulling down on my pelvis and helping cause the problem or are they a symptom of it and stretching them would make it worse ? (any links about groin stretching for this problem would be great)

I'm in a part of the world where its difficult to find a physio so any advice much appreciated !!

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ps, when i say click on the outside of my knees. Its right where the patella rubs against the outer femur groove.

I've got rounded shoulders, lower back indicates APT , and the stomach sticks out slightly.

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[sarahleeandrews]

Spunds like the planks might be favoured by you and adding to the pattern you don't want to re-enforce (plus a wise person once said to me only do planks if you want to be a plank - they can effect your breathing). Stretching for more than 15 secs gently with NO pain will not do any harm. To really try and lengthen the muscles I would chose a yoga dynamic stretch in a kneeling lunge (hip flexor stretch) with adding the opposite arm extended out (lengthening the connection in the soft tissue from one shoulder to the opposite adductor, which will adress the rounded shoulders. They may be linked with you tright adductors, especially seen as you cycle a lot. The real questions are, why are your shoulders rounded (eg. habits, tightness in neck) and is this where the knee tracking problems stem from

[soreknees]

Spunds like the planks might be favoured by you and adding to the pattern you don't want to re-enforce (plus a wise person once said to me only do planks if you want to be a plank - they can effect your breathing). Stretching for more than 15 secs gently with NO pain will not do any harm. To really try and lengthen the muscles I would chose a yoga dynamic stretch in a kneeling lunge (hip flexor stretch) with adding the opposite arm extended out (lengthening the connection in the soft tissue from one shoulder to the opposite adductor, which will adress the rounded shoulders. They may be linked with you tright adductors, especially seen as you cycle a lot. The real questions are, why are your shoulders rounded (eg. habits, tightness in neck) and is this where the knee tracking problems stem from

Sarah,

Thanks for the reply.

I thought/read that planks were generally a good exercise to do for Anterior pelvic tilt with regards to tightening the ABS and reinforcing a straight back ?? I've just started doing reverse crunches whilst making sure my legs are up near my chest when i do it.
Also doing hip thrusts for the glutes and clams for glutius medius. And lots of hip flexor and piriformis stretching.

I've got more questions than awnsers but i was driving all day for years, then took time out to do a year on the bike, then did alot of travelling with alot of sitting around eating and reading. So alot of sitting. I cant to squats without feeling like i'm going to fall backwards and have trouble keeping the back straight and cannot do them with feet flat on the ground.

For all i know it could be tendonitis causing maltracking rather than the other way round, but found it interesting that my knees track smoothly (the right one more so) for a couple of minutes after doing the hip flexor stretches which seemed to suggest my femurs needed some external rotation.

So if i manage to correct my APT somewhat, do my groin adductors also loosen up more or tighten ?

Thanks for any help !

[sarahleeandrews]

Hi Soreknees,

Planks encourage rigidity and are commonly still thought to be good for the core. Newer evidence suggests that the abdominals are not as important as once thought. In fact many people overtrain them at the gym and cannot leave enough space in their abdominal cavity to breath. There are many other exercises (in pilates, tai chi practise encourages the low back to open, and in yoga to be able to do a lot of the balance poses, you need correct pelvic alignment) to encourage your pelvis to tilt in the opposite way, which encourage mobility and length through the spine, so improving strength of the back muscles (which are our postural ones that hold us upright). There are many muscles which attatch to the pelvis bones at the front that span out like a star in all directions. You will need to take the exercises slow and really feel in control, ie. A pilates bridging exercise is a good start or hip thrust as I think you call it-maybe try slowly with one leg crossed over the other.

So your ITB is tight and pulling your knee cap, and your VMO's too short as they cramp? Is the bony 'spur' on the shin bone on the outside where the shin muscles attatch?

Have you ever had any injuries anywhere? Do you get headaches? Do you walk or run?

[soreknees]

Hi Soreknees,

Planks encourage rigidity and are commonly still thought to be good for the core. Newer evidence suggests that the abdominals are not as important as once thought. In fact many people overtrain them at the gym and cannot leave enough space in their abdominal cavity to breath. There are many other exercises (in pilates, tai chi practise encourages the low back to open, and in yoga to be able to do a lot of the balance poses, you need correct pelvic alignment) to encourage your pelvis to tilt in the opposite way, which encourage mobility and length through the spine, so improving strength of the back muscles (which are our postural ones that hold us upright). There are many muscles which attatch to the pelvis bones at the front that span out like a star in all directions. You will need to take the exercises slow and really feel in control, ie. A pilates bridging exercise is a good start or hip thrust as I think you call it-maybe try slowly with one leg crossed over the other.

So your ITB is tight and pulling your knee cap, and your VMO's too short as they cramp? Is the bony 'spur' on the shin bone on the outside where the shin muscles attatch?

Have you ever had any injuries anywhere? Do you get headaches? Do you walk or run?

Sorry about the late reply. I like to run everyday on the beach barefoot for no more than 2 miles. Years ago i injured my back.I overextended it doing a squat. I went to a chiro about that and he seemed to think overextending my back caused a muscle pull. I think i have never been able to do squats correctly (hence the injury and my back taking the weight) ,eg i feel like i cannot keep myself from leaning forward and my heels cannot touch the ground when i squat. This reinforces my opinion of the pelvic tilt being the problem?? One thing i notice is that if i sit in a cupped shape chair that fully supports my back in a bending outwards way, and with my knees abit lower than my hips, the clicking of the knees stops after sitting there for 20 minutes and i dont feel the uncomfortable tightness in my legs. Whenever i lift anything its always my back that seems to take over.

I've just started doing 1 legged bridge raising type exercises with my leg extended more on a couch to try and strengthen my hamstrings to ry and help pull my pelvis down at the back..
I've read that cycling can cause the VMO to lengthen and so when its needed it has to go into spasm for it to shorten so would that have caused my pain i wonder.

I'm now also targeting my rounded shoulders with external rotation exercises ans pecs stretching. Only started that yesterday.
One thing i forgot to say is that up untill fairly recently i was doing a minimum of 500 push ups a day for several months without any stretching and no back exercises. So i'm not sure my upper back is as strong when compared to the chest although i've always had rounded shoulders. I got bored with the push ups and started running for the cardio buzz. My neck points forward and i have quite pronounced front neck muscles. I think this has alot to do with my past job of keeping my head off the ground when working on the ground. The cycle touring was done on a bike too small for me with alot of hills so that was what did it i guess.

Sleeping on my back always doesnt feel comfortable as i my legs seem to tighten up. My legs feel fine after exercise its just the stiffen up at night.

My knees click more, the more i hold them out to horizontal. They dont really click much near vertical. The bony feeling bumps are where my kneecap tendon attaches to the shin i think. Theres soft saggy flesh around the bottom of my kneecaps when i stand up straight. If i suck in my gut and squeeze my cheeks i can flatten my lower back onto a wall.

Maybe its just wear and tear in my knees but i'd like to correct any posture problems i might have and see how it gos.

Thanks for any help.