The hip and knee from a functionality perspective are very closely connected. There are many muscles that attach above the hip and below the knee joint. So, depending on the position or activity, the same muscle can move the hip and the knee. This close association crosses over in dysfunction as well, as patients with knee pain move differently, and the hip joint is primarily affected. But which one is the instigator, the hip or the knee?
In an attempt to answer the query, an investigation into patients with patellofemoral pain (PFP) who didn’t have hip pain, were asked to carryout either knee or hip exercises. Each set consisted of nine men and nine women.
The knee exercise group carried out quadricep or knee strengthening exercises while the hip exercise group undertook in hip strengthening exercises. The specific hip exercises included hip abduction (outward resistance) and hip external rotation muscle strengthening exercises. Both groups performed their exercises three times a week for eight weeks.
Interestingly, all participants noted a reduction in pain and improved function; however, the patients in the hip exercise group reported greater improvements than those in the knee exercise group. These results persisted for the next six months.
Why did hip exercises help patients with PFP knee pain more so than knee-specific exercises? Weight-bearing dynamic imaging studies have shown that patients with PFP knee pain frequently have a lateral or outward displacement of the kneecap, as well as lateral tilt due to femur/hip internal rotation (IR) rather than just abnormal patella motion due to muscle imbalance.
Other recently published biomechanical reports stated that patients with PFP demonstrate excessive internal rotation and adduction (inwards positioning) of the hip that isn’t generally found in pain-free subjects. Furthermore, those with PFP usually have weak hip abductors, extensors, and external rotator muscles than pain-free individuals.
Osteopathic treatment focuses on whole body care, and patients are often surprised that Osteopaths frequently treat hip, knee, ankle, and foot conditions. Initial patients examinations frequently reveal abnormal movement patterns, pelvic rotation, lower lumbar spine dysfunction, leg length discrepancy and that may contribute to a patient’s main complaint. Often, treatment must address these issues for the patient to achieve a successful outcome.
Adapted Article: Credit https://chiro-trust.org/joint-pain/hip-exercises-help-knee-pain-seriously/