Knee Pain May Not Start at the Knee: A JANMI Postural Chain Case Study

Dear Readers,

A fit and active woman in her late 40s recently came to JANMI Clinic with one-sided knee pain that had developed over approximately three weeks.

She works long hours in an office but also trains regularly in Taekwondo. At first glance, the obvious place to focus was the painful knee.

But at JANMI, one of the first questions we ask is:

Why has this particular area become overloaded?

Knee Pain Can Be Part of a Bigger Movement Pattern

The knee does not function independently.

It sits between the foot and ankle below and the hip and pelvis above. Every step, squat, kick, turn or change of direction requires these regions to coordinate while the trunk manages forces above them.

During the postural and movement assessment, several characteristics stood out:

Posterior pelvic tilt

Pronounced forward head position

One shoulder positioned lower than the other

Associated rotation through the ribcage

Significant guarding through the trapezius and pectoral region

Overactivity around the suboccipital region

The knee itself also showed substantial muscular loading.

Rather than viewing these findings as isolated problems, the JANMI approach considers how they may interact as part of a wider movement strategy.

Understanding the Muscles Around the Knee

The knee depends on several muscular systems for movement and control.

The quadriceps are major contributors to knee extension and help manage forces during activities such as walking, running, squatting and kicking.

The hamstrings cross the back of the knee and contribute to knee flexion and dynamic control.

The gastrocnemius also crosses the knee and ankle, meaning that calf function can directly influence knee mechanics.

The soleus does not cross the knee, but its role in ankle control means that changes in lower-leg mechanics can indirectly influence how forces are transferred upwards.

The iliotibial band and associated hip musculature also form part of the lateral mechanical system influencing the relationship between the pelvis, femur and knee.

When these structures are repeatedly asked to compensate for limitations elsewhere, muscular tension and workload can increase.

The JANMI Postural Chain Perspective

Instead of asking only, "What is tight around the knee?" we explore the wider chain:

Ankle to Knee to Hip to Lumbar Spine to Ribcage and Scapula to Neck.

This does not mean that every case of knee pain originates somewhere else.

It means that when assessing persistent or unexplained musculoskeletal discomfort, examining the wider movement system can provide useful clinical information.

From a biotensegrity perspective, the body can be viewed as an interconnected system in which muscular and fascial tension, compression and movement are distributed across multiple regions.

If one part of that system changes its behaviour, other regions may adapt.

The painful area may therefore sometimes represent the place currently experiencing the greatest demand rather than the only area requiring attention.

Office Work Meets High-Demand Sport

This particular case was especially interesting because the client's lifestyle contained two very different physical demands.

During the working day, prolonged sitting created relatively low movement variability.

During Taekwondo training, her body suddenly needed rotation, balance, hip mobility, rapid force transfer, single-leg stability and powerful lower-limb movements.

If the pelvis, ribcage and lower limb are not distributing those forces efficiently, the knee may have to absorb more of the workload.

This is why being fit and active does not necessarily protect someone from developing movement-related overload.

How JANMI Approaches Knee Pain

The JANMI Method combines local soft tissue assessment with examination of the wider postural and movement system.

Treatment is therefore not based simply on finding a tight muscle and releasing it.

We assess which links appear restricted, overloaded or poorly coordinated. Hands-on soft tissue therapy can then be used where appropriate to reduce excessive guarding and improve available movement.

The next stage is equally important: movement.

Once additional mobility or capacity becomes available, personalised exercises are used to help the body integrate those changes into more coordinated movement patterns.

The JANMI principle is:

Assess the link. Check the chain. Restore capacity. Integrate movement. Reassess.

Treat Locally. Reason Globally.

Knee pain deserves a careful assessment of the knee itself.

But sometimes the most useful clinical question comes immediately afterwards:

What is happening above and below it?

Looking at the ankle, hip, pelvis, lumbar spine, ribcage, scapula and neck can reveal a much richer picture of how an individual is organising movement.

At JANMI Clinic in Marylebone, London, our approach combines detailed postural assessment, advanced soft tissue therapy and personalised movement strategies to understand each client's individual pattern rather than treating symptoms in isolation.

The goal is not simply less pain.

It is a more adaptable body that can distribute movement and load efficiently across the whole system.

JANMI Method

Postural and Movement System

Better Movement. Stronger Lives.

Disclaimer: This article is for educational and informational purposes only and is not intended to diagnose, treat, cure or prevent any medical condition. Knee pain can have many causes and should be appropriately assessed by a qualified healthcare professional. Individual assessment findings and treatment responses vary.