Your femur is the longest bone in the body. It makes up the ball of the ball and socket hip joint and the most superior part of the knee joint. Whatever is happening in your hips affects your knees and whatever is happening at the knee affects the hip. When we walk, the muscles of the hip keep our pelvis stable and level in stance phase, our weight bearing portion of gait, allowing us to advance our opposite leg forward in swing phase. If our hips aren’t strong, stable, and level our weight bearing hip drops creating an abnormal pull in our knee. Overtime, this breaks down our knee joint in an abnormal pattern eventually causing pain.
How Do We Fix This?
The simple answer…strengthen your hips!
One of the first muscles we address is the gluteus medius. It’s one of the stabilizers of our hip in the stance phase of gait. Our favorite exercise is the clamshell. We also love the lateral wall sit.
The hip flexors are an important muscle group in limb advancement and knee health. One of your hip flexors (benders) is also grouped with your knee extensors (straighteners). We like to stretch our hip flexors because they always feel ‘tight’, but they are also likely weak and need to be strengthened. Our go-to’s are the supine march with resistance and penance. To stretch them we recommend a standing hip flexor stretch.
Your quads include four muscles in the upper front of your leg. They are responsible for knee extension (straightening) and assist in the tracking of the knee cap as you bend and straighten your knee. We love penance, sit to stands, and step downs to strengthen this group of muscles to support your knee.
Your gluteus maximus is the biggest muscle in your hips…it’s your booty. It’s job is to extend your hip and this is something you do with every step you take. Doing sit to stands or step ups with a bias toward your heel will engage your glutes. Another favorite of ours is the bridge.
Hamstrings are easily forgotten about, but they are an important part of knee function and walking. They attach along the back of our upper leg to just below our knee. We have three of them and they are most commonly tight or short and weak. To strengthen we like to have people modify a bridge with either a posterior pelvic tilt or with their feet on a ball. To stretch them use a standing single leg hip hinge or laying on your back using a yoga strap.
The IT band, or iliotibial band, attaches at your iliac crest, gluteus maximus and a little muscle called your TFL, or tensor fasciae latae, at the top of your thigh. The IT band runs the length of your thigh and attaches on the lateral aspect of your tibia (shin bone). It’s job is to stabilize your hip and knee. The IT band is a thick band of fascia with not much stretch. However, your TFL length can influence the pull of your IT band. The job of the TFL is to internally rotate your hip and it’s located just below the ASIS or pointy part of you hip and if you twist your leg in, you should feel it flex under your fingers. In order to decrease the tightness in this little muscle we recommend trigger point release using a tennis or massage ball.
This is a long explanation to say, if you have knee pain, look at your hips and think about strengthening them as well as lengthening or stretching.
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