Runner's Knee Quick Case: Tibial Internal Rotation Assessment in Clinical Practice Patterns

Chris Johnson, of Zeren PT and Performance and I shot 3 cases where we both evaluated and treated runners with different issues a while back. Here is a snippet of me assessing one with chronic knee pain after moving to Seattle from a very flat area.

The video below shows me going through an assessment and explanation of Tibial Internal Rotation in relation to his previously assessment lack of ankle mobility and lower limb stability on the involved (left) side.

Whether it's chicken or the egg, you'll find a loss of Tibial IR in relation to

knee, hip, ankle, lumbar pain on the ipsilateral side
loss of single limb stance stability
loss of ankle mobility
hip pain
loss of ability to load the lumbar spine on the ipsilateral side

What do all of these patterns have in common? A loss of ability to load efficiently in the

ankle
knee
hip
lumbar spine

What does this look like?

Tibial Internal Rotation Dysfunction - Runner's Knee Pain

Sometimes a knee is just a knee in relation to where you should look. Other times you'll definitely need to look proximally and distally to see if there are asymmetries in ability to accept load.

The full case series will be coming to Modern Manual Therapy in the future!

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...