Is the Pain in Your Knee Coming from Your Hip?

Pain in the front of the knee, referred to as patellofemoral pain PFP, is a common yet perplexing and clinically
challenging orthopedic condition. Patellofemoral pain typically arises during with ascending or descending stairs,
squatting, kneeling, prolonged sitting or tightening the quadriceps and is more common in women than men. The pain is
specifically located around the knee joint or the kneecap itself.

Research has focused on identifying the root cause for this type of knee pain. While previous research identified the
patella moving abnormally as a possible cause for knee pain, more recent data has suggested that the pain is linked to
impaired muscular control at the hip. The researchers found that lateral movement of the patella during weight bearing
was the result of the femur rotating inward underneath the patella, causing the patella to move laterally.

A recent article in the Journal of Orthopaedic and Sports Physical Therapy investigated the influence of hip muscle
activation in women during running, jumping and stepping activities. Women with patellofemoral pain demonstrated
increased hip inward rotation and diminished hip muscle force production, specifically in the gluteal muscle groups.
Force production in these muscle groups was 14-17% less than for asymptomatic women.

How can this help runners?

Strengthening the gluteal muscles to improve control of the knee may be helpful in preventing knee pain. Try the
following strengthening exercise for the hip abductor muscles. Work up to 2 sets of 10 repetitions several times/week.

• Begin lying on your side with the bottom knee bent and the top leg straight

• Lift your top leg upward, keeping the knee straight and the foot level

• Tighten the abdominal muscles to stabilize the spine and do not allow the hips to roll backward

• Repeat

Written by, Stephanie Penny, PT, DPT, a physical therapist with Lakeshore Sports Physical Therapy, PC.
Dr. Penny may be reached at sp@lakeshoresportspt.com.

These instructions are provided for educational purposes only and not intended to diagnose or treat any disease. Check with your
doctor before beginning any exercise program and immediately discontinue any exercise that creates pain.