February 10th, 2012

Health N' Sports: Hip Muscle Strengthening

Staff Report

Health N' Sports: Hip Muscle Strengthening
photo courtesy of sports-injury-info.com

 Louisivlle Orthopaedic Clinic explains knee pain

Anterior knee pain, or patellofemoral pain, is a common overuse injury runners of all ages present to medical professionals. While several biomechanical factors have been implicated in the etiology of anterior knee pain, typical advice has included strengthening the inner quadriceps muscle above the knee and wearing a knee brace with a “donut hole” to help correct faulty patellar tracking.  Recently, more research has suggested muscle weakness or imbalance of the hip muscles is a common problem in runners with knee pain. 

Especially in runners, injury is common when core strength is inadequate as it is critical to stabilize the spine, support the shoulders and hips, and drive the arms and legs.  A complete assessment of core muscle strength in the runner should encompass not just the abs and back muscles but all the muscles of the lower trunk and pelvis including the hip flexors, gluteals, and hip abductors and adductors on the inner and outer hip region.

The two hip muscle groups frequently found to have poor strength in injured runners are the hip abductors and external rotators, which require contraction of the gluteal muscles and spinal stability. The abductors are responsible for lateral movement of the leg but also play an important role in stabilizing the pelvis on the opposite during the stance phase of running. Thus, one simple test to assess for inadequate hip strength is too look for a dropping of the hip on the side of the recovery leg while there is a collapsing of the knee inward on the support leg. This may lead to over-pronation of the foot and increased stress on the knee leading to this so-called “runners knee”.  This biomechanical mechanism has also has been associated to many common overuse injuries including Achilles tendonitis, iliotibial band injuries, and pirifomis issues (butt pain).

A physical therapist can do an assessment to pinpoint imbalances that may be caused from decreased flexibility or weaknesses that would lead to injury and advise as to what treatment may be needed to correct problems found.  These may include specific strengthening and muscle training exercises, postural changes, and manipulation of the spine and/or extremities.

Try these exercises to strengthen your outer hips:

Side bridge with hip abduction: lie on side with legs straight, one leg on top of the other.  Place forearm under shoulder perpendicular to the body. Keeping side of bottom foot on ground, raise hips up off ground while raising upper leg away from lower leg. Return and repeat. (try to work to 2 to 3 sets of 10-30—for runners repetition is key!) note: to make this exercise easier you may bend the bottom knee while keeping the top leg straight.


Standing hip abduction with theraband: in standing position, wrap theraband around lower leg. Keeping leg straight, raise leg out to side paying attention to keeping abdominals contracted and pelvis level (keep supporting leg straight).


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