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 we see related to this topic, is what’s called a 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 or hip dysplasia).
For congenital and structural deformities, surgical intervention may be required. This will sometimes be the case if the symptoms/issues regarding knee valgus are impacting quality of life, and if conservative management is not effective in reducing the impact.
For foot/arch issues (which can be many), 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 a biomechanical issue such as 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. Keeping this in mind, below are some commonly prescribed exercises given to correct a knee valgus pattern.
- Squat – with the emphasis being on “bottom backwards” (sitting into a chair direction), and “knees maintaining their position above the ankle joint”.
- Crab Walks – often performed with a theraband around the lower part of the thigh, and side stepping whilst maintaining the squat position above.
- Lunges – for a more dynamic exercise, 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.
