3 Common Causes of Knee Pain
These three factors can often cause knee pain when running or performing any activity that involves movement.
1. Tight hip muscles.
A tight IT, iliotibial band, often is a major contributor to knee pain. If the IT band is not stretched out regularly, it can pull on the patella where it is attached and disrupt the normal track of the patella when the knee bends and straightens1. The IT band begins at the tensor fascia latae (TFL) muscle of the hip, and runs down the side of the leg and attaches laterally on the patella. The IT band is made up of strong connective tissue called fascia. It is best elongated by breaking up the knots and adhesions that form in it1. The most common way this is accomplished is by foam rolling along the IT band, shown below. Foam rolling can be quite painful along this area initially, but is an extremely important preventative measure to knee pain. Additionally, a tight piriformis muscle can also contribute to knee pain. This is a much deeper, hip stabilizing muscle. It can be stretched by performing the simple figure 4 stretch, shown below.
2. Weak hip muscles.
Strengthening the muscles of the hip is crucial in preventing and treating knee pain. The gluteus medius (glute med.) is an essential muscle for hip stabilization2,3. The hip muscles, namely the glute med., must be able to stabilize the hips when moving, and especially during running when there is significantly increased force put through the legs1. If these muscles are not strong enough to stabilize the pelvis and femur, knee pain can be presented because of overcompensation in other muscle groups due to this hip muscle weakness3. Below is a simple diagram showing the muscles of the hips.
3. Quad dominant, weak hamstrings
Another very common cause of knee pain is having weak hamstrings. Many runners and athletes are quad-dominant. This means that their quad muscles strength far exceeds that of their hamstrings. The quad muscles are knee extensors, and the hamstrings are the antagonist knee flexors. A balance in strength must be maintained between the two muscle groups in order to properly stabilize the knee and avoid knee issues4. This is commonly referred to as the hamstring to quad ratio or H:Q ratio. The average range for H:Q ratio is about 0.5 to 0.84. This means that on average, the hamstrings are about 50-80% as strong as the quads in normal people. In a recent study it has been shown that as this ratio approaches 1.0, a decreased risk of ACL injuries and hamstring strains occurs4.
There are several exercises that can be done to strengthen the hips and hamstrings. Please give us a call and schedule an appointment to see one of our Physical Therapists!
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- Cheung, Roy, Andrew Smith, and Del Wong. H:Q Ratios and Bilateral Leg Strength in College Field and Court Sports Players. Journal of Human Kinetics33.-1 (2012): n. pag. Web.