No matter how old or how active you are, the control from the hip & knee on the body’s function is extremely important. Many issues can arise with dysfunctional hip-knee control, including patellofemoral joint pain, hip/groin pain, and low back pain. This article will look at why such issues may arise, and some key things you can do to improve your hip-knee control. 

One of the biggest issues can be knee valgus. This is where the knee joint will track inward, relative to the rest of the thigh & leg. 

There are many reasons why an individual may display or develop a knee valgus pattern; including but not limited to, weakness through the posterior and lateral hip musculature (glutes and hip rotators), foot and arch biomechanics (“flat foot”, or “collapsed arches”), and congenital and/or structural deformities (e.g. rheumatoid arthritis, osteoarthritis or hip dysplasia). 

For foot/arch issues, having a thorough assessment of the foot position, muscular activation/control, and/or footwear may be important.

If the cause of the knee valgus is more related to weakness through the hip muscles, then the best course of action is to spend approximately 2-3 months working on strengthening and increasing the control of these muscles. Unfortunately there is not a “one-size-fits-all” approach to correcting these muscular deficiencies. Some examples are below but individual assessment is recommended. 

  • Squat - “bottom backwards” (sitting into a chair direction), and “knees maintaining their position above the ankle joint”.
  • Crab Walks – side stepping whilst maintaining the squat position above & can add a theraband around thighs.
  • Lunges - challenging the hip-knee alignment whilst moving and countering the effects of gravity wanting to pull the knee inward as you descend. 
  • Step downs - to work on quadriceps (thigh muscle) and glutes (buttock muscles) under eccentric load (i.e. when the muscle is working as it is being moved into a more stretched position. 
  • Standing hip abduction/extension - again often used with a theraband or ankle weight, to increase the load, the emphasis here is on maintaining good pelvis symmetry, and short movements.