Kinetic Chains
Why Your Knee Still Hurts After 8 Months of Physical Therapy
Here's a picture. Your knee hurts. You go to physical therapy, you do the exercises, you ice it, you rest it, you do the whole RICE thing — and it still hurts. Eight months later you're sitting there going, what the hell, I thought this was supposed to fix it.
This is the problem we're addressing on the podcast this week. Pain is a symptom of a systemic problem, and that's basically what a kinetic chain is. Your body works like a chain — there's multiple links on it — and if you feel pain in one spot, yeah, the pain is happening there, but your whole body is affecting that pain point. It's easy, but it's not simple. Let me explain what I mean.
Open chains, closed chains, and why most PT only gives you half the picture
There's two ways you train your body — open chain and closed chain. If I put my hand on my head and rotate my shoulder, my arm is on a surface with limited motion — that's closed chain. If my hand's free and I can move my shoulder or move my body around my hand — that's open. Most PTs lean heavily on closed chain work. Foot on the floor, grab a band, do your shoulder extensions. That's fine, but it's only part of the solution. You also need the ability to move your spine around your shoulder — and a lot of shoulder pain actually comes from the spine moving asymmetrically, not from the shoulder itself.
My whole approach is built around functional patterns, which basically means everything revolves around the gait cycle. Our bodies evolved over millions of years to run, throw, walk, carry — we were nomadic, we moved through space constantly. All our muscles are built to work horizontally, to move an object or move power — a punch, a spear, a kick — through the body to generate as much force as possible. That's a kinetic chain.
Think about a boxer throwing a punch. You don't just throw your arm. You use your legs, your hips, your whole body rotating to amplify the power. Same with a client of ours trying to qualify for Boston — if we just trained her legs and ignored everything else, she'd never hit her time. She needs ground force, rotational force, forward propelling force — the way she swings her arms, turns her chest, bends her ankle, drives her hips. If you look at it the traditional way — "you're not fast enough, your quads aren't strong, let's just work that" — you're missing the whole picture.
It's going to feel fake before it feels normal
In the beginning, this stuff is going to feel choreographed. Like you're pretending. Like it's not actually going to stick. There's a process for becoming the best version of yourself, and it's three phases: awareness, autonomy, automation.
Awareness is when a coach — or you, watching yourself on video — points out what's actually happening. You get exposed to that enough times, you start correcting it with less and less oversight — that's autonomy, same as an adult knowing they need to brush their teeth without their mom reminding them. Do that for a couple months and it becomes automatic — you stop thinking about it entirely.
But it's not linear. It's a cycle. Once one thing goes automatic, you notice something else you couldn't see before because you can't focus on twenty things at once, especially early on. So you fix that, and the first thing you corrected starts slipping a little, and you go back and mix it back in — until eventually you're using your legs, your arms, your spine, your neck all together and it just feels good.
The clients who get results fastest are the obsessed ones. They come in and go, I sat there all day thinking about my posture, I ran and I was thinking about it every step. Those are the easy ones. The ones who come in stressed and I ask if they rolled out and they go, "didn't have time" — man, that's rough.
What's actually happening to your body if you sit at a desk all day
Athletes develop physiological adaptations for their sport. Fighters round their shoulders from constant grappling. Swimmers, I just learned this recently, have straighter lower backs than sprinters because they're constantly staying flat on the surface of the water. Runners hinge at the hip more and sit in more anterior pelvic tilt because of the knee drive. Your body adapts to whatever stimulus you constantly expose it to — but what's optimal at 30 isn't necessarily optimal at 70.
Same thing happens if you're desk-bound, or on your feet all day at a warehouse or in nursing. If you sit all day and never do corrective work, the front of your body — quads, hip flexors, abs, chest, shoulders — gets chronically shortened. It's basically on all the time. And the back of your body — hamstrings, glutes, your mid-back erectors, your lats, the back of your shoulders — gets chronically long and loose, like a rubber band that's lost its elasticity. That's why your back feels tight even though it's actually over-lengthened, not short. It's never getting the chance to contract.
Picture a healthy spine — the load spreads evenly across every joint. An unhealthy spine only bends at one segment, because everything else around it is locked up, so all the pressure concentrates in that one spot instead of distributing through the whole chain. That's exactly where pain shows up — where there's too much movement and not enough stability to control it.
The joint-by-joint theory, and why gym-only guys sometimes fall apart on a trail
Here's the actual mechanism. Your bones float inside your body — your muscles are what hold your joints together and create that separation. Certain joints need to be stiff so the ones next to them can move freely. Your neck needs to be fairly stiff. Your mid-back needs to be mobile. Your shoulders need to be mobile too — if your spine's stiff, your shoulders end up stiff by default. Your lower back needs to be stable. Your hips need to be loose. Your knees need to be stable. Your ankles need to be mobile again. Stiff, mobile, stiff, mobile, stiff — that alternating pattern is how your body finds symmetry.
My dad had a guy join him on a trail run recently — steep climbs, technical terrain, a lot of angle changes at the hip and ankle. This kid trains hard in the gym, told my dad he'd be fine. Fifty minutes in, he's doubled over saying he can't handle the pain in his back. And it makes total sense once you understand the theory — traditional lifting trains one muscle at a time, usually sitting on a machine, which means you never teach your body to stabilize one joint while mobilizing the joint next to it. So his hips were probably way too loose because his lower back never learned to lock down and create real abdominal pressure. Put him on uneven ground where his body actually has to find stability on its own, and the whole chain falls apart.
I'll be honest, I get a little worked up about this one. It's cool to want to look good, everyone does. But at some point you have to ask if you've traded the stuff you could actually do as a kid for a body that just looks good standing still. Guys who only train in isolation, you tell them to sprint and they'll pop a hamstring in five steps. Because their body never learned to find balance against gravity — it only knows how to move on a fixed machine, in one plane, sitting down.
One thing you can actually go try
If you want to start training this, grab a cable machine and practice rotating your upper body while keeping your hips locked facing forward. Most people, when they row or chop sideways, let their hips spin with the movement — same motion, same muscles firing, no actual chain being trained. Instead, keep the hips still and rotate just through the upper spine. You can do this with a kettlebell, a dumbbell, a landmine — anything where you consciously stabilize the hips and rotate above them. That's the beginning of teaching your body to link segments instead of moving them all as one stiff block, or letting them all wobble independently.
There's a Max Holloway quote I think about a lot — you've got show muscles and you've got go muscles. Show muscles are the ones you flex in the mirror. Go muscles are the ones that stabilize you so you can actually produce force when it counts. That's your core, your back, your glutes, the muscles in the bottom of your feet. That's the stuff that matters when you're 75 and you catch your foot on something and your body needs to save itself in half a second. Nobody's thinking about their squat PR in that moment. You either have the stability built in or you don't.
The takeaway
Your body is a linked system, not a collection of separate parts. The idea that you can train muscles in isolation and expect to move well is, honestly, kind of a myth the fitness industry sells you. Watch a professional boxer against a bodybuilder and you'll see the difference immediately. Train the chains — front, back, the rotational lines through your spine — and add rotation into your training, not just push and pull in straight lines.
If you've been doing everything "right" — the exercises, the stretching, the isolated strength work — and something still hurts, it's worth asking whether you've actually been training your body as one connected system, or just working the one part that hurts and hoping the rest sorts itself out. It usually doesn't. It's easy. It's just not simple.