Stop Knee Pain With Hip Strength

Knee pain is something that many people who come to see me are suffering from, and especially occasional dancers. What I’ve noticed over time is that very often, the knee has to do the work of the ankles or hip, and compensate for a lack of mobility or strength (or both!) in one of these joints. I already have a couple of posts about ankle mobility and foot posture, so today I’ll address the other recurring culprit: strength and stability in the hip.

A bit of theory…

The first step is to think about your movement differently. This will allow you to use everyday tasks like climbing the stairs to condition your body for more optimal use, and reduce the load on your knees. Additionally, I’ll present a few exercises in case you don’t have that many stairs in your life, or if stairs are too challenging to use as a conditioning tool, or not enough.

When bringing your body up from a bent legs position (plié, squat, step on a stair…), there are basically two ways of thinking about the movement to recruit strength: you can think of the knees extending (straightening), or you can think of the hip extending (the other joint being moved by the necessity of staying upright and not falling on your face).

knee pain stick figures

For some reason, it’s very easy to think of the knee as producing the brunt of the strength, because we generally have a better awareness of our knees, and if they’re already a bit painful, they will draw more attention. However, in the optimal function of a human body, the hips will have a much more prevalent role. Indeed, the biggest and most powerful muscle in our body, the gluteus maximus, extends the hip, therefore providing the power we need to bring ourselves back up. Additionally, the musculature around the hip socket is extremely well equipped to stabilise the joint, and balance our whole body on top of the leg. This means that if we think of using our hips more that our knees to come back from a bent leg, we will be using our bodies in ways that utilises its resources much more efficiently.

… and lots of practice!

There are two things you can do to recruit these muscles to help you come back up. One is an image that I’ll present a bit later, to use the gluteus, and one is to get some awareness of your hip joint and focus on it as you walk up stairs, or do pliés or squats. First let us locate the hip joint. You can go back to this post for a way to find it, or look at the picture below and try and understand how that relates to your body.

knee pain skeleton

To start gaining some awareness of the joint, I also recommend the following exercise: stand on one foot with the other leg extended, heel on the floor. Now imagine that you have an arrow stuck in your knee (it arrived from exactly in front of you), and make this arrow play wind shield wiper. Notice anything happening a bit below the skin, in the crease between your leg and your torso.

knee pain knee windscreen wiper

Notice how the pelvis stays facing forward, whatever the orientation of the knee.

Now that you have a bit of a better idea of where this joint is, walk up some stairs (or do a few pilés or squats), while focusing on this area. This will, with time, help you balance your weight on top of your leg, and give you more stability and more power. Ideally (for instance to climb a stair), you want to be able to balance on one foot and come up from a bent leg on one leg. I use stairs for that, climbing slowly and not using my back foot at all. If this is too challenging, you can do one-leg pliés (see picture) to build strength and control. Focus on your hip joint, thinking of it as your source of power, during all these exercises.

knee pain one leg plie

If this isn’t challenging enough for you, try walking up said stairs in the same way, but two by two or even three by three. Alternatively, work towards one-legged squat variation, in particular the pistol squat.

knee pain pistol squat

And a last, fun image to end with, to help recruit your glutes when going up a stair: think of an old catapult, those with an arm ending in a spoon in which a projectile would go. There’s one of those under your leg about to propel you upwards, and the spoon is just encasing your buttock. Think of the force of the spoon propelling you upwards!

knee pain catapult step

Catapult picture by wikipedia user Vonmangle~commonswiki.

And that’s it for today! I hope your hips will carry you far and wide!

Continue reading: Ankle MobilityDiscover Your Knee, A Key to Flexibility Training.

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