When your knee hurts, you treat the knee. When your hip hurts, you treat the hip. But sometimes, the source of pain may not be exactly where you feel it.

Your body works as a kinetic chain—a system of connected joints and muscles. If one region (such as the lower back, pelvis, or feet) is misaligned or weak, stress may transfer along the chain. The knees and hips often become symptomatic because they bear significant load during daily activities.

At Karetrip, we frequently see patients concerned about knee or hip pain where postural imbalance and muscle weakness play a significant contributing role. Before considering invasive treatments, it is worth evaluating how daily standing, walking, and sitting habits affect joint mechanics.

1. The "Anterior Pelvic Tilt" (Lower Back Arch Pattern)

If your lower back appears overly arched or your abdomen protrudes despite being lean, you may have a posture pattern called anterior pelvic tilt. This can occur due to prolonged sitting and tight hip flexor muscles.

Possible Hip Impact

An altered pelvic position may change how the femoral head sits within the hip socket. In some individuals, this may contribute to anterior hip discomfort or impingement-type symptoms.

Possible Knee Impact

Changes in pelvic alignment may influence thigh rotation. Increased internal rotation of the femur can alter patellar tracking, potentially contributing to patellofemoral pain syndrome (commonly known as runner’s knee). Not everyone with anterior pelvic tilt develops knee pain, but in certain individuals it may contribute to symptoms.

2. Flat Feet (Altered Foot Mechanics)

Your feet act as the foundation for your lower limbs. In individuals with flat feet (overpronation), the arch collapses more than normal during weight-bearing.

Potential Biomechanical Chain:

• Ankle rolls inward
• Tibia (shin bone) rotates inward
• Knee experiences increased inward (valgus) stress
• Hip rotation may be affected

Possible Result:

Some individuals may develop medial knee discomfort or lateral hip pain (sometimes associated with trochanteric bursitis). However, symptoms vary widely depending on muscle strength and overall biomechanics. Supportive footwear, strengthening exercises, or orthotics may help selected patients.

3. Forward Head Posture ("Tech Neck")

Forward head posture—common with prolonged phone or computer use—shifts the body’s center of gravity forward.

Potential Muscular Effects

To compensate, posterior chain muscles (including hamstrings and calves) may remain relatively tight.

Knee Impact

Persistent muscle tightness can influence knee positioning and movement mechanics. While exact pressure percentages vary between individuals, altered biomechanics may increase stress on the patellofemoral joint over time.

This does not mean that phone use directly “wears out cartilage,” but posture patterns combined with weakness may contribute to symptoms.

4. Habitual One-Legged Standing

Many people unconsciously shift weight onto one leg while standing.

Possible Effects

• Uneven hip joint loading
• Increased stress on one knee
• Asymmetrical muscle activation

Over many years, uneven weight distribution may contribute to asymmetric joint wear in susceptible individuals. However, arthritis development depends on multiple factors including genetics, body weight, and prior injuries.

5. Corrective Tips for Daily Life

Small posture adjustments can help reduce joint strain.

The "Tripod Foot"

Distribute weight evenly between the heel, big toe, and little toe while standing.

Glute Activation

Gentle glute engagement during prolonged standing may help maintain a more neutral pelvic position.

Sit–Stand Rule

Avoid sitting for prolonged uninterrupted periods. Standing every 30–60 minutes and stretching hip flexors may help maintain mobility.

Strength Matters

Targeted strengthening of:

• Quadriceps
• Gluteal muscles
• Core stabilizers

often provides greater long-term benefit than posture awareness alone.

Conclusion

Your knees and hips are designed to tolerate load efficiently—but optimal alignment and muscle balance support that function.

Pain does not always mean structural damage. Often, it reflects overload, weakness, or biomechanical stress. Early physiotherapy evaluation can help identify modifiable factors before symptoms worsen. Posture check? Ask Rua for a “Gait Analysis” referral.

Not sure if your feet or hips are contributing? Chat with our AI agent, Rua. We can connect you with physiotherapists who perform structured gait and posture assessments.