Have Kneecap Pain? Exercise Your Hips!

The body is always interesting. For decades some physical therapists have treated knee pain by having their patients perform knee exercises. However, more recently physical therapists have figured out that most kneecap pain is actually coming from a hip problem. Let’s dig in.

The knee cap has to track evenly in the groove or it can become painful and wear away the cartilage on one side or the other. Since the most common way the knee cap is shifted is toward the outside (lateral) and there is a muscle that can pull it toward the inside (the VMO or vastus medialis obliqus), for decades physical therapists would give patients exercises for that muscle. However, there’s another reason the knee cap can track toward the outside. That has to do with the leg bone itself moving inward. That moves the groove for the knee cap, which is controlled at the hip. So which is it? Do you need to exercise the knee muscles? The hip muscles? Or both?

The hip muscles do all sorts of things and one of them is to hold your hips externally rotated. When these muscles get weak, the body caves inward, much like we see in our modern computer and phone-centric worlds (see above). When that happens, the knee cap groove at the end of the femur moves inward. Hence, much of hip physical therapy for patellofemoral problems is working on the hip external rotators. Meaning exercises where you rotate the feet or hip outward, for example, clamshell exercises.

This new research is a meta-analysis of 13 studies on exercises to help patellofemoral pain. The authors broke the studies how into hip+knee, hip-only, and knee-only exercises. They found that hip+knee and hip-only exercises worked about as well as each other to get rid of PF pain, but that knee-only exercises were inferior. This fits with what we know about how this problem develops.

The upshot? If you want to get rid of knee cap pain, the answer lies in strengthening your weak hip muscles! So make sure you get your clamshells and glute bridges in today.

Source: https://stem-cells.in-the.news/