How to Relieve Medial Knee Pain, Low Back & SI Pain, Groin Pain + More

The adductors are one of the most overlooked and neglected areas of the body, and releasing the fascia here can bring a LOT of relief to a wide variety of aches and pains.

It’s tempting to single out the adductors as the main target for this stretch, and I did that in the video for simplification, but they’re not the only players here, and for issues like medial knee pain they aren’t even the main player.

This isn’t an overly complicated technique, but I do want to make sure you get the most out of it. So…

Let’s look at some anatomy first:

With this technique we’re targeting EVERYTHING in that inner thigh region, not just the adductors.

Looking at the above image you can see how connected ALL the thigh muscles are, and it’s not difficult to see how they could affect anything in the pelvic region. For low back pain specifically, we will be targeting the adductors with this technique, specifically the pieces of fascia way up high in the adductors where they meet the pelvis.

Releasing the fascia in this entire region can seriously relieve SI and ischeal tuberosity or sits bones pain, low back and hip pain, as well as everything downstream like knee pain and even plantar fasciitis, if your PF shows up more in the arch of the foot than heel.

Now let’s move on to addressing key issues.

If you have medial (inside) knee pain:

Keep in mind that there is usually a PATTERN present with ANY pain and it’s rarely isolated to a single muscle group.

There are quite a few causes of medial knee pain, but one of the most common contributors in EVERY pattern I’ve seen is congested fascia at the junction where several low inner thigh muscles connect.

There are many reasons this area can get tight or knotted up, and for any solution to be truly lasting we would need to discover the root cause and address THAT, not just this one area. Since I can’t work on you myself to discover what that root cause is, this is my best attempt to help you get relief as quickly as possible.

For all you curious cats, one of the patterns for medial knee pain can involve an imbalance in the thigh fascia from left to right (one side dominant/tighter), which can cause a pelvic tilt and compensatory tightening of the myo-fascia in areas such as the gluteus medius or TFL; and sometimes it can involve scar tissue in the same side ankle from a previous sprain or rolled ankle (even if it happened decades ago!), which can lead to gait changes and another set of compensatory problems. As you can see, it can sometimes appear complicated (until you figure it out, and then it all makes sense).

But for now…let’s focus on this one technique and see what happens.

For my fellow anatomy nerds, if you have medial knee pain you’ll want to target the VMO, adductor magnus, sartorius and gracilis junction.

This is what I show you how to do in the first part of the video.

If you have low back pain of ANY kind:

Looking at the picture to the right, if you imagine those adductors (the pink muscles) shortening…what kind of effect do you think it will have on the pelvis?

Most of the time low back pain happens due to an imbalance from left to right SOMEWHERE in the thighs, which then causes a pelvic shift, tilt or rotation. It could be the adductors, quadripceps (especially the hip flexor part of the quads) or IT Band, or a combination of these; the hamstrings are rarely the cause of low back pain, rather they tend to get recruited along with the glutes and TFL to stabilize your pelvis once the imbalance is detected by your brain.

The fascial line of the inner thigh can play a huge role in EVERY kind of low back pain, from regular old low back pain in the QL (or quadtratus lumborum) area to sciatica and SI pain, ischeal tuberosity or sits bone pain, hip pain, pubic pain etc.

With low back pain there can be a variety of factors, and this is just one. Releasing this fascial line can be hugely beneficial and bring a lot of relief, but it is NOT necessarily a full solution (for some of you it may be). For those of you who don’t get complete relief from this technique, I suggest also using the quad and hip flexor release, and possibly IT Band as well.

BEFORE you go to town on this one, I recommend TESTING both legs to see which one is more tender and start with that leg.

In order to get full relief for low back pain, your goal MUST be to restore balance in the legs so your pelvis isn’t tilted, shifted or rotated in any way. If one of your legs is tighter and you release both legs equally, you will be LOOSER overall but still imbalanced left to right, which is the cause of your pain. ALWAYS SPEND MORE TIME ON THE TIGHT SIDE.

For low back pain, you will want to target the ENTIRE LINE of fascia in that inner thigh.

More than likely the most tender spot will be WAY UP HIGH near your pubic bone, so make sure you target that area.

For the HIGH SPOT, we are targeting the fascia in these muscles and/or where they connect: adductor longus, gracilis, pectineus and obdurator externus, to name a few. You can even manage to grab the attachment for the psoas here and affect it through this stretch.

For GROIN pain and/or pulled groin muscles:

Right off the bat on this one I’ll say if you have a PULLED groin muscle, you will be better off first going after your high quad and hip flexor fascia. In my experience this is one of the main causes of a pulled groin muscle. SOMETIMES it can be coming from downstream in the adductors, and that’s certainly worth investigating also, which is why I’m including groin pulls in this blog post.

If you are currently in an acute stage with a groin pull however, I recommend AGAINST trying to release anything at the SITE of pain (remember: where the pain is is RARELY the problem!), and instead work everything around it: quads and hip flexors and LOW adductors, maybe even hamstrings.

For groin PAIN, this technique can be quite beneficial. I would start with the low adductor region and anything else that feels tender there (VMO and sartorius being a great starting place), and then work your way up to that super high adductor fascia.

TIPS to get the most out of this technique:

  • REMEMBER you are attempting to “PIN” and “shear” that fascia, so don’t just roll around on the ball. For the BEST RESULT, your mission is to pin a piece of that inner thigh to the ball even as you roll it slightly, while MOST of your movement happens from your leg rotating and/or bending and straightening.
  • Hunt for the BEST SPOT (you know you’ve found because it will SUCK the most!)
  • Once you find it, stay there and work that one spot for a good 30 seconds to a minute, and then move on to another spot.
  • You may find 3 or more good spots in one small region. Believe it or not a CENTIMETER can make a huge difference! So definitely experiment with where you place the ball AND your weight.
  • If this bothers your knee, move away from your knee and start there. Then see if you can get closer to the knee. Sometimes, if you’re REALLY tight here it’ll pull on the patella (kneecap) when you put your weight on the ball, but usually it just takes releasing some of the tissue for it to chill out.
  • MOVE SLOWLY (definitely do not move as fast as I was moving in the video, I was just wanting to show you what to do without taking forever).
  • Give this a good 3-5 minutes, and then get up and walk.
  • If you’re using this to address knee or low back pain, see how they feel now.
  • If you have low back pain and you started on one leg and your back pain goes to ZERO, skip the other leg for now. If your back pain stays the same, try the other leg, and/or try another technique such as the quad release.

As always I hope you find this useful! I LOVE hearing from you, so please comment with your questions and/or success stories after trying this technique. What happened? What did you use this for (like back pain, groin pain, knee pain)? Did it work? Come talk to me in the comments below 🙂

If you liked this technique please “like” and share it!

  • Donna says:

    Hi there,
    Just came upon this for what I think is a pulled groin muscle – had thought it was hip flexor but seems to be more in the groin, maybe a combination of the 2?? Since I think it may be pulled or strained, are you suggesting to go with the roller only per your other video on hip flexor issues or do you see an issue with doing both? I was a little confused in the text above about if the groin is pulled vs. just sore. Also, it has gotten progressively worse so I’m taking some time off of exercising. Used to do barre classes and had to stop due to the pain, am doing pilates now which for the most part has not hurt but I recently did too much pilates cardio (jumping) and yard work (pushing on the shovel with my foot) so I’m not able to exercise at the moment. I took 3 weeks off thinking that would be enough but after going back for a few classes it is starting up again. Can you guesstimate how long it takes most folks to recover from this injury? Thank you so much for your helpful videos!

  • James says:

    Wwwwwwoooooow! This simple insight into leg side weakness / pulling and the video exercise has been a game changer for me. I’ve been having SI pain that wouldn’t budge until I came across this page. THANK YOU!

  • beanluc says:

    I’m using a water-polo ball. It’s a little bit smaller than a basketball, but a lot less slippery than either the basketball or a medicine ball. It’s got a very, very grippy surface – perfect.

  • Ian Ferguson says:

    Hi thanks for the informative video and article? I may be overthinking things but this can be accomplished with a foam roller as well correct? Thanks.

  • Premiership Football Physiotherapist Neal Reynolds talks about medial knee ligament injuries and how a professional football club would manage this injury – play video .

  • Kathryn says:

    I’m finding your blog very informative–just started experimenting with the hip flexor release so it’s too soon to say if it’s helping my sciatica but I’m hopeful. I was wondering whether a basketball could work for this adductor release. I’d rather not buy another piece of equipment if I can avoid it 🙂

    • Hi Kathryn – glad you’re finding the site useful! You could definitely try a basketball! Maybe between that and the foam roller you could get the desired results. Good luck!

  • James says:

    This is a fantastic article thank you so much for taking the time to put this together. I am pretty active and fit but I have many issues with my legs and lower back. I always seem to pull my groin, my lower back has a constant dull pain and my hips seize up (relieved only by making them crack).

  • Heather says:

    Thank you! My left knee (medial) has been bothering me and this was just what was looking for. I enjoy your vids weekly, learn new words and FEEL better!!

  • SMG says:

    Thank you for this! I have been struggling with this very problem for the last year. My left lateral gastroc & hamstring inexplicably tightened up something terrible (trigger points all up the leg to around my hip socket), forcing me into pronation (I’m typically a supinator). I had a hysterectomy to remove a very large fibroid tumor, and after was immobilized in the core, so I don’t doubt I also had some pelvic alignment issues related to readjustment. The leg problems wouldn’t go away, and eventually from misalignment I sprained my MCL something terrible (probably from extreme valgus & weak glutes – over compensating on stairs). Developed some lymphedema in that leg b/c of impaired lymphatic system (connected to scar tissue in the trunk from the surgery!) I was in PT in an office that was both exercise-based as well as visceral manipulation for MLD and breaking up scar tissue. It’s seemed like peeling an onion to work through all the issues – it’s been a long, slow road. The trigger points & the lumpy fascia you describe are exactly what I have and they all torque my knee joint – it has been really frustrating. I’ve come through it with a better sense of how everything is connected; but still can’t seem to loosen the lumps much. We just acquired a WBV machine, and oddly it’s been helping a little with the muscles; I’m hoping that the combination of what I’m learning from your website and this will be the key that turns the lock!

    So grateful for your expertise and willingness to share it! Some of your floor work has been hard for me with more limited mobility (and fear of reinjuring the knee) – I think I can figure out a way to try this so I’m not marooned on the floor with no way to get up!

    • Glad you find everything I’m sharing helpful, and I sure hope it gets you further along in your recovery! I love that you’re curious and courageous enough to adopt my techniques and make them work for you, even if you’re not on the floor. Whatever route you take, just make sure you’re doing your best to PIN those lumpy fascial areas and THEN stretch through movement. No amount of massaging, kneading etc will make those lumps go away, they have to be broken up and lengthened through compression and movement. Good luck and keep me posted!

      • Shane Matthews says:

        Very informative article, which is not too complicated to understand for a novice in this area. I really enjoy the article; I have been suffering pain in my left leg and hip for over 8 years;last year I had a Hip op on a hip impingement which I thought would solve the pain symptoms but after a year and a half I am still having problems and really affected my morale. I have tried a few therapist and pay a lot of money and time into them and came out with no success. I have lost faith in the profession and very cautious where I invest my money into treating this now. Is there any advice you can give me?. My symptoms are small lump on back of inner hamstring,which seems to grow in size depending what I have been doing, pain in back of knee area when standing too long, with dull ache in heel of foot. Also popping sound of knee area when bring my leg down towards for whilst it is bent. Adductors also feel weak when istonically contract them. Extremely lost and frustrated guy needing help. Regards Shane

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