Sometimes when you have knee pain and you've been to see specialists and nothing seems to be the answer, you do wonder whether you'll end up needing divine intervention. With biomechanics becoming more widely understood, we now know that by sorting out your biomechanics, we can often reduce the need to get down on your knees and pray. The affects our biomechanics have on our body and the vicious circle of injury and pain it can cause is one of the main reasons knee pain can be recurrent.

A rotated pelvis for example can go unnoticed for many years until the compensations start to cause problems. This abnormal pelvic position often causes one leg to appear longer or shorter and the body must compensate for this. Typically one way it compensates is to overly flatten (pronate) the foot of the longer leg to shorten it, another way is to bend the knee more.

Unfortunately both of these options will increase the load on the knee. If the foot over pronates, it will cause the leg to internally rotate excessively. This rotation force will often be absorbed at the knee, which can result in pain. If the knee bends too much during mid-stance phase, this will de-stabilise the knee and it will naturally want to rotate inwards. If this is combined with an already over pronating foot, the problem is exaggerated. Both of these situations are likely to cause knee pain. Certainly if knee pain already exists this type of load will prevent it from settling down, even if it isn't the main cause of the problem.

Managing these biomechanical issues is critical if your knee pain is to be managed and allow you to return to long term running. Bearing in mind that 60% of the biomechanical problems with your feet are due to compensations for faulty hip or pelvic biomechanics, it is important that before we start thinking about orthotics, we need to check out the hips and pelvis.

The first thing to do is to manage the cause. In other words we need to re-orientate the pelvis to reduce the leg length discrepancy. To do this we have to reduce the muscle spasm in the outside of the hip (in a muscle called piriformis) to allow the joint to re-orientate itself. The best way to do this is by performing ?anti-spasm? exercises for the muscle. Stretching or flexibility work just won't cut it. You need to return the muscle to normal function, not just stretch it. Once the spasm is eradicated as much as possible, then the leg length typically returns to normal length. Now you have a level playing field. If the symptoms have not subsided and if you still over pronate, now you can safely have orthotics prescribed, as any remaining foot biomechanical problem will be inherent to the foot. Rehab on your knee will now have a better chance of working for you, if it's still necessary.

To fully complete your rehab talk to your local physio about exercises to stabilise your knee and pelvis. In other words exercises that allow your muscles to control your pelvis and knee without them needing to go into spasm. Part of this process is achieved by so-called ?core stability exercises?, but also you need to speak to your physio about plyometric exercises for pelvic and knee muscles that you can do in the gym.

As a result of one of the largest studies in biomechanics by Galileo Active we can all benefit from assessing our biomechanics, in the comfort of our home. They have developed a CD ROM software program that helps you asses your biomechanics with the software prescribing the exercises needed to remove these biomechanical problems and in turn help manage and prevent the types of knee injuries we're talking about in this article.

For further information please go to www.humanlabsports.com to visit our website where you will learn more and see what the system can do for you.