Got knee pain? Check your hips


In a two-year study, women who developed runner’s knee had much greater hip adduction, or movement of their hip toward their mid-line, than women who didn’t develop runner’s knee.

In the study, published in Medicine & Science in Exercise & Sports, researchers did a gait analysis on 400 healthy women runners, and then tracked the women’s incidence of knee injury and pain over the next two years.

The researchers compared the running mechanics of  injured women with women who remained healthy. They found that the women who developed runner’s knee had much greater pelvic instability than the healthy runners.

When the women who developed runner’s knee ran, their hips collapsed toward the mid-line of their bodies instead of remaining level.

Numerous studies support to the growing consensus that hip function is the key determinant of whether you’ll develop runner’s knee.

The Overhead Squat Assessment (OHSA)

One of the best screening tools for assessing the risk of injury as well as muscle and joint problems that may be causing pain is the OHSA.

The OHSA is a dynamic movement assessment of the Kinetic Chain (muscles, joints and the nervous system). It demonstrates postural distortion patterns that are characterized by overactive and underactive muscles and joint dysfunction

There are 5 Kinetic Chain check points:

  1. Foot and ankle
  2. Knees
  3. Lumbo-pelvic-hip complex
  4. Shoulders
  5. Cervical spine

By observing each check point from the front, side and back, compensations can be identified.


The Fix

1.       Inhibit the overactive muscles with myofascial therapy and home self-myofascial release

2.       Lengthen overactive muscles with stretching

3.       Mobilize joints that aren’t moving properly

4.       Activate under-active muscles

5.       Integrate functional movement exercises

Sample exercises for knee pain due to knees moving in and hip abductor weakness:

1. Self-myofascial Release to adductor muscles, biceps femoris (outer hamstring), outer calf and outer quadriceps muscles

2. Stretch adductor muscles, biceps femoris (outer hamstring), outer calf and outer quadriceps muscles. Hold stretches for 30 seconds.

3. Activate gluteus medius with wall slides or clam shells: 2 sets of 10. Hold each repetition 2-4 seconds



4.  Integrate functional movement with lateral  tube walking: 2 sets of 10-12

About the Author

Dr. Geoff LecovinNaturopathic Physician/Chiropractor/Acupuncturist/Certified Strength and Conditioning Specialist/Corrective Exercise Specialist/Performance Enhancement Specialist/Certified Sports Nutritionist/View all posts by Dr. Geoff Lecovin