Chronic Knee Pain? The Hips don’t lie!

Knee and thigh pain are some of the most common complaints that we see in our athletic patients, whether it’s from basketball, football, soccer or running.  Many times, patients will have already had previous treatments to the knee that have not helped.  Some have even gone through rounds of x-rays and MRI’s with no help – still painful.  Knee pain can be confusing because if the knee hurts there should be a problem with the knee right?  Not always!  Many times there are muscle imbalances that can contribute to knee pain.  Here is  one example of a very common muscle imbalance causing knee pain.

With any movement, all of our muscles are working together.  Some stabilize while others cause movement.  If one muscle is not working properly another has to compensate for it.  When we walk, run, or squat certain muscles are supposed to abduct our hip, which means stabilizing our leg and knee, keeping it from bending toward midline.  Without proper function/stabilization of this muscle our knee bends in putting excess pressure on our knee. SLST

To test the strength of these hip muscles, we have the patient stand on one leg and perform a small squat or dip, keeping the torso perpendicular with the ground.  If the hip, knee and ankle all stay in one line during the test, the patient’s hip strength is good (figure A).  If the knee moves towards the midline during the test, the patient’s hip strength is poor (figure B).

Just because there is poor muscle imbalance of the hip does not always mean I just need to work out my hip and problem solved.   There are lots of different treatments depending on why it’s imbalanced.  Is there soft tissue inflexibility?  Capsular tightness?  Joint immobility? Muscle weakness?  Or poor motor control?  Fixing these movement issues, not just stretching/adjusting the knee will have the quickest results.

As important and lifesaving as X-ray, CT, and MRI can be, sometimes it is an unnecessary expense.  If your knee is painful with you move, how can someone find out why it’s painful if they don’t watch you move?  If you are having pain in your knee, or anywhere, that other treatments haven’t solved email me with questions or give us a call.  (801)-893-1010.  Remember the longer you compete on an injured or weak area, the longer it will take to get back to 100%!  

Example:  A 36M distance runner complaining of right knee pain for over a year.  Patient has had multiple treatments with no lasting success.  Knee test revealed no knee injury or weakness.  Hip testing revealed tight anterior hip capsule with poor motor control in hip abduction.  Within 3 treatments he ran a trail marathon pain free.