The hip and knee are anatomically very close to one another. Functionally, there are several muscles that attach above the hip and below the knee joint. Hence, depending on the position and/or activity, the same muscle can move the hip and/or the knee. This close relationship crosses over in dysfunction as well, as patients with knee pain move differently, and the hip joint is ultimately affected. But which one is the real culprit, the chicken (hip) or the egg (knee)?
In a quest to answer that question, one study asked patients with patellofemoral pain (PFP) and without hip pain to perform either knee exercises or hip exercises. Each group consisted of nine men and nine women. The knee exercise group performed quadricep or knee strengthening exercises while the hip exercise group engaged 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 per week for a total of eight weeks. All participants experienced improvements in pain and 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 than knee-specific exercises? Weight-bearing dynamic imaging studies (x-rays) have shown that patients with PFP knee pain frequently have a lateral or outward displacement of the knee cap as well as lateral tilt due to femur/hip internal rotation (IR) rather than just abnormal patella motion due to muscle imbalance (the “old” theory).
Other recently published biomechanical studies have reported that persons with PFP demonstrate excessive internal rotation and adduction (inwards positioning) of the hip that isn’t generally observed in pain-free subjects. Further, those with PFP tend to have weak hip abductors, extensors, and external rotator muscles than pain-free individuals.
Chiropractic care focuses on whole body care, and patients are often surprised that doctors of chiropractic frequently treat hip, knee, ankle, and foot conditions. Posture and gait assessments, which may be included in an initial patent examination, frequently reveal abnormal movement patterns, leg length discrepancy, pelvic rotation, and lower lumbar spine dysfunction that may contribute to a patient’s chief complaint. Often, treatment must address these issues for the patient to achieve a successful outcome.
You may wonder, what is wrong with my knee?
Pain in the knee or pain on the knee is a problem that needs attention. Kneecap pain can be particularly annoying.
Do I have a muscle strain in the knee or neuropathic pain?
You may be worried about a torn meniscus or a Baker’s cyst or kneecap pain.
Pain in the knee or pain on the knee is concerning for sure. Some who may be concerned about neuropathy may be concerned if this is neuropathic pain. Many who have been diagnosed with neuropathy have been on high-dosage chemicals and wonder why their knee pain remains persistent. Pickleball, golf, and tennis are common sports to cause knee pain. Some try strong chemicals to no avail. Some have tried applying chemical gel to the affected area with temporary relief at best.
As a last resort, some type in pain management to find relief. Hopefully, you won’t have a torn meniscus but if you do it doesn’t mean surgery is your only option. Obviously, most want to avoid a knee replacement. Sometimes it can be a patellar tendon irritation easily resolved with conservative non-surgical treatment. Persistent or worsening pain intensity and/or frequency necessitate a visit to see a professional before it becomes a surgical case.
At Coast Chiropractic Centers we look forward to providing relief to those suffering from any type of pain. Call me, Dr. Tim Harcourt, at (239) 278-3344 or stop by on your day off for a walk in visit and mention this article for an awesome discounted first visit to include history, exam, and adjustment or Class IV high-intensity laser treatment.
If you would like to avoid getting knee pain in the first place or to take a proactive approach to your health and wellness, our membership program called Club C may be just the thing for you with great cost savings, convenience, and even more importantly, a plan to get your health back and keep it.
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