Pain Relief Strategies: Knee Pain & IBS Connections
Week In Review – Clinical Insights from the Hip to the Gut
On this week’s episode of Week In Review, the clinicians at The FARM unpack three compelling cases that reinforce the importance of returning to fundamentals, looking beyond isolated pathology, and understanding the body as an integrated system. From the soccer field to the golf course, these stories highlight how effective care often comes from simplicity, curiosity, and a willingness to look beyond the site of pain.
Case 1: Hip Flexor Tendinopathy in a Soccer Player
The first case centers on a common but often mismanaged issue: hip flexor tendinopathy in a competitive soccer player. This condition, frequently attributed to overuse or poor hip mechanics, is often treated with endless soft tissue work or hip flexor stretching. But in this case, the team approached the problem differently—by revisiting the fundamentals of movement and breathing.
Instead of treating the symptoms in isolation, the clinicians used breath control and gait-based movement progressions to reestablish proper trunk-pelvis coordination. The athlete’s recovery accelerated once diaphragmatic control, pelvic stacking, and efficient propulsion mechanics were restored. It’s a reminder that even in high-level athletes, poor basic motor control—especially in the sagittal plane—can lead to repetitive strain at vulnerable muscle-tendon junctions. Rather than fancy tools, this case was resolved with foundational principles applied with precision.
Case 2: Medial Knee Pain and the Pain/Function Audit
Next, the team dives into a medial knee pain case that serves as a masterclass in clinical reasoning. The athlete, a mid-distance runner, had vague and fluctuating medial knee pain with no obvious mechanism of injury. Imaging was unremarkable. This is where the concept of a pain audit and functional audit became essential.
Instead of chasing the site of pain, the team conducted a full kinetic chain assessment with particular focus on foot mechanics, tibial rotation, hip strength, and even trunk rotation. They found deficits in single-leg control, poor hip-pelvic stability during loading, and compensatory pronation strategies that overloaded the medial compartment of the knee. By implementing global movement corrections and re-training deceleration mechanics, the athlete returned to pain-free running within weeks.
This case reinforces why every treatment plan must include checkpoints—both pain audits (symptom tracking) and functional audits (capacity tracking). Symptoms can lie, but function rarely does.
Case 3: IBS, Pelvic Floor, and Motor Control in a Youth Golfer
The final discussion explores a unique and fascinating overlap: a young elite golfer with persistent IBS symptoms and unexplained hip instability. What emerged was a deeper look into the gut-motor axis, specifically how chronic gastrointestinal issues can influence pelvic motor control.
Through movement screening and visceral mobility testing, the team discovered that recurrent IBS flares created pelvic floor guarding, anterior pelvic tilt, and disrupted lumbopelvic rhythm during swing mechanics. The treatment? A multidisciplinary approach that combined visceral mobilization, neuromuscular re-education, and stress regulation through breathwork and nutritional timing.
This case exemplifies the value of systems thinking in clinical care—highlighting how even non-musculoskeletal conditions can cascade into performance-limiting dysfunction when not addressed holistically.
Each of these cases reaffirms a core principle at The FARM: effective care doesn’t start with fancy tools—it starts with clear thinking, thorough assessment, and the discipline to return to the basics.
