by Devin Cox,  LAT, ATC, CEAS I, CP-S

When people think about having knee pain, they most likely aren’t thinking about if they have enough tibial internal rotation. You are probably thinking about your footwear, the way you are running or working out. Those could all be a factor but it could also be caused by having restricted tibial range of motion.

What is normal tibial internal rotation then? Normal range of motion would be 20 to 30 degrees. We need to have this for our knee to perform what is called the “screw-home” mechanism. This is the rotation between the tibia and the femur. It is considered a key element in knee stability for standing upright. This is a critical function of the knee, and it only occurs at the end of knee extension. Basically, this is what will “lock” or “unlock” the knee.

If we don’t have enough tibial internal rotation, then this will place extra stress on our knees. Whether that is while running, squatting, or playing sports. We need to have the range of motion. If not over time it could lead to patellofemoral pain syndrome, lateral and medial knee pain. If this is something that is ignored for a long time, then it could potentially lead to more serious knee injuries down the road.

This isn’t an end all be all for knee pain but is just another area to look at. Especially if everything else has been investigated and nothing has been found. Then it wouldn’t hurt to look at tibial internal rotation and see if that might be the missing piece. If the range of motion is decreased, then let’s try and place the last piece to the puzzle.

The first step is to measure your range of motion.  At Compass we just a digital inclinometer to obtain a precise measurement of your range of motion.  If we establish that that is a lack of range at the knee that might be causing your symptoms we will determine the cause of this limitation and provide treatment and at home exercises to regain this lost motion.