--- title: "Knee Pain isn’t Always a Knee Problem" entity: "blog" canonical_url: "https://www.betterknees.com/blog/knee-pain-isn-t-always-a-knee-problem" markdown_url: "https://www.betterknees.com/llms/blog/knee-pain-isn-t-always-a-knee-problem" lastmod: "2025-12-03T21:15:00.000Z" --- Recently a former client -- one who returned to running after working with me ten years ago -- was talking with her neighbor. Her neighbor scheduled a free, online 20-minute[Strategy Session](https://betterknees.com/services) with me to determine if I could help her. ## Collecting clues about her knee problems My former client’s neighbor began by saying, “I try to run twice a week.” “I have to say, I know my running changed a lot when I injured my shoulder. I just slowed down because swinging my arms took me out of my stride.” “That happened two and a half years ago.” “Plus, I'm 61, so everybody's like, ‘You're just old.’” I winced in response to this. She laughed, and said, “Yeah, blaming it on age, that doesn't work for me. ” “It's not like one knee hurts, they're both just gripping [a sensation of tightness].” “ I can't do weight workouts, and I can't bend my knees to go into a squat for yoga. I can't sit in hero poses.” “And I should also tell you, I was just diagnosed with osteoporosis, which surprised me because I'm super active.” “Three years ago, it was slight [osteopenia, bone weakness], but it wasn't bad.” “They said since it declined in three years, we should probably address it.” “So my goal was to start lifting heavier weights, to strengthen my muscles to help with my bone density. ” I nodded. “And that's when I realized I cannot lift heavy because of my knees … yeah, so that's where I am.” ## Asking the critical questions I circled back to the restriction in her knees that she had described when she attempted to squat. And I asked what, if anything, was helping that. “Well,” she said, “ I can stretch the muscles, but nothing seems to be unwinding . I’m flexible, but it's just like everything goes back to a super tight, ridiculous position.” Then I asked her if the restriction was only in her knees. She thought about this a moment and then admitted that her low back had felt tight as well. My next question was related to how her knees felt first thing in the morning when she wakes up. “ My knees feel perfectly fine in the morning. My lower back is stiff in the morning.” “I'm actually getting a firmer bed because when we were in Europe for two weeks, I slept on super-firm beds. Like, every bed was really hard, and I woke up with zero back pain.” “And we walked all day, 7 to 9 miles a day. My knees were great, my back was great.” “ After that trip , I went for a run with my friend, and I'm like, ‘This is great!’” “ I didn’t have any knee pain . I wasn’t scared that my calves were going to cramp up.” “It was really weird, but then I did the HIIT (high intensity interval training) workout on my Peloton bike, and I was back to stiff knees and a stiff back.” “That was several weeks ago. And I haven't recovered yet.” “I ran for a whole week. I ran three times, 3 miles. No pain. Just out of shape, cardio-wise, because I haven't been doing the HIIT because I don't want to make my knees worse.” “ I don’t understand what’s going on. ” “‘Is it the pedals? Is it the saddle? Is it that I'm too far forward?’” ## Clarifying the root of the problem As she shared these insights, I was putting the pieces of her puzzle together. And I asked her if she had any limitations to how much she could bend or straighten her knees when she was lying on her back. “No, if I lie here, I'm perfectly fine. There's nothing wrong when I bend and straighten my knees.” “ But I've always had a hard time getting my quads and my glutes to fire. ” “I've been trying to do more isolated glute exercises and just learning how to activate the knee without pain.” I repeated back to her what the biggest concerns she had shared with me: - a “gripping” sensation in her knees - restricted knee motion when she was upright, but not when she was lying down - calf cramping - an inability to engage her glute muscles - difficulty with challenging cycling workouts, but not with walking or running Some of these symptoms – like difficulty “turning on” hip muscles, or restricted knee motion – often occur when someone has weakness inside their knees, or when they have osteoarthritis. But given everything she shared with me, I explained to her that her knees likely weren’t the cause for her knee concerns. Instead, these problems likely originated from her lower back. Given this, I knew the Inside Out Knee Health approach wasn’t going to be the solution she was looking for. ## Next steps to solve her symptoms “Okay, so the pain is not coming from my knees. That's just where I'm experiencing the pain?” I agreed, and I pointed out that her back may have felt better during her travels in Europe due to less sitting and more walking, rather than mattresses she slept on. “Yes, that totally resonates because now in the evenings, I sit and read my book or watch TV or whatever, and that's when I'm like, “This is not good for me.’" “Because I'm a massage therapist. I'm moving all the time during the day. But I do notice sitting will definitely bother me.” “After sitting to drink my morning coffee, I'm like, ‘Okay, I'm standing up.’” “And if I sit down on the floor to meditate, I can't stand up very well afterwards.” I pointed out that she was also sitting when she performed Peloton bike workouts. “Okay,” she said, “I think I get it. I need to focus on improving my back so I won’t be limited any more.” I help clients get Better Knees with the [Inside Out Knee Health](https://youtube.com/shorts/IadheI3L6W8)approach. Interested in working with me? Schedule [here](https://TheKelseyGroup.as.me/). ## Key Takeaways - Age was not the cause. Despite being told “you’re just getting older,” her symptoms were not age-related. - Activities that load the body differently reveal the root problem. Running and walking felt great, but sitting, intense cycling, and certain yoga positions aggravated the underlying issue. - Knee pain isn’t always a knee problem. Many symptoms that feel like knee issues—gripping, stiffness, limited bending can actually originate from the lower back. - Inside Out Knee Health works when the knee is the source—but not when the back is the driver. In this case, a back-centered solution was needed to unlock her knee mobility and reduce stiffness. For Inside Out Knee Health, here's a [guide](https://enjoystrongerknees.com/) to get started: You can access it [here](https://enjoystrongerknees.com/) . For personalized guidance to build [Better Knees](https://betterknees.patientbase.io/services) : Schedule a free 20-minute [Strategy Session](https://TheKelseyGroup.as.me/) . (Find your best time [here](https://TheKelseyGroup.as.me/) .) Disclaimer: The information in this blog post is for educational and informational purposes only and is not intended as medical advice. It should not be used to diagnose, treat, or prevent any health issue or disease without consulting with a qualified healthcare professional. The author of this blog and the website do not bear any responsibility for any actions taken based on the information provided in this blog.