Runner's Knee Quick Case: Tibial Internal Rotation Assessment in Clinical Practice Patterns | Modern Manual Therapy Blog

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...






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