Knee pain (of non-traumatic causes) is very seldom caused by issues at the knee. Research done over the last decade has shown that the causes of a knee injury originate from deficiencies in the hips or trunk.
By looking at a few common knee injuries we can see how biomechanical problems at your hip/core can cause issues at your knees.
Anterior Cruciate Ligament (ACL) Injury
ACL tears are one of the most common knee injuries sustained by individuals who engage in athletics and recreational activities. Studies have shown that those with higher knee valgus angles (see picture) are at a higher risk for suffering an injury to the ACL due to abnormal stresses placed on the knee in such a position. It has also been demonstrated that a decrease in hip extensor strength (usually gluteus maximus) causes greater knee valgus angles. This weakness in hip extensor strength causes athletes to rely more on their quadriceps muscles and passive restraints (such as the ACL and other ligaments) when performing athletic activity which increases the risk for injury.
Iliotibial Band Syndrome (ITBS)
ITBS is a very common knee injury in runners, cyclists, and military recruits. Recent research has suggested that one of the strongest predictors of individuals who went on to develop ITBS were excessive hip adduction (due to weak hip abductors such as the glut med). These same researchers put those suffering from ITBS on a 6 week hip abductor strengthening program and found that 92% were able to return to pain-free running, showing that strength/motor control at the hip can be an effective treatment for treating a condition at the knee.
Why Should We Care?
Understanding this concept is important because it changes how we treat and rehabilitate knee pain. Rather then continually ice/heat of the knee, we can focus on strengthening and retraining our hips and core for long term recovery. In order to recover from knee pain we can:
1) Improve glute (butt muscle) strength – This helps create stability at the hip and will protect your knee from taking on abnormal stresses
2) Improve core strength – Deficits in core control have been shown to be good predictors of knee injuries. Development of core stability should be an integral part of the training protocol.
Evolve Performance Healthcare specializes in the long term recovery of pain and injury, including knee pain. If you're like to schedule a free consulattaion please call our clinic at (503) 954-2495