Change Your Mechanics to Improve Your Knee Pain

Do you have knee pain? Have you tried changing your movement mechanics? Did you know there is a difference between a knee strategy and a hip strategy? A Knee Strategy has been shown to increase risk of Tibiofemoral joint injury, Patellofemoral joint pain, Patella Tendinopathy, ACL sprains, as well as IT band syndrome. Utilizing a Hip Strategy with movements such as squatting, stair climbing, and jumping will reduce demand on your knees, which may reduce your knee pain or help prevent you from having knee pain in the future! Read more to understand the difference between a Knee vs. a Hip Strategy.

Let’s bring it back to Newton’s Third Law: For every action (force) there is always an EQUAL and OPPOSITE REACTION. “Ground Reaction Force” is the force equal and opposite the force in which we impose on the ground. Based on this ground reaction force we will be able to distinguish the level/moment arm of each joint. LEVER ARM= The perpendicular distance from the line of force to the axis of rotation. The larger the lever arm the GREATER the External Moment/Torque on a given joint.

Basically the larger the moment arm -> larger external moment which induces a larger internal moment AKA LARGER DEMAND on the muscles at that joint.

Knee vs. Hip Strategy

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Here Arash is perform the squat with a hip and a knee strategy:
A HIP STRATEGY is used during the first two repetitions, where the work is primarily being done by the hip extensors. This has been shown that this movement is roughly controlled 50% by the hip extensors, and only 25% by the ankle plantar flexors and 25% by the knee extensors.
Note: excuse my butt wink, I have poor hip flexion range of motion!

During the last 2 repetitions he performs with a KNEE STRATEGY (knees forward), which will put a LARGE demand on the knee extensors AKA quadriceps. It has been shown this movement is controlled by approximately 50% by the knee extensors (20% hip extensors and 30% plantarflexors).

Unfortunately, we live in a knee dominant world, we are here to tell YOU to start sitting a little bit deeper into your squat (by using a hip strategy) whether you are plopping on to your chair/couch/toilet or squatting at the gym.

Lunging with a Knee Vs. Hip Strategy

There are three primary things to consider when looking to bias either the GLUTES or the QUADS in the lunge.

1️⃣Tibia Angle A tibia that is forward = more forward knee migration. This translates to a greater degree of knee flexion and thus a longer lever arm on the quadriceps. Essentially, the more forward the knee travels past the toes, the greater the demand on the quadriceps while decreasing demand on the glutes.

2️⃣ Trunk Angle A forward trunk = longer lever arm for the glutes. In the same fashion in which a forward knee increases the quad lever arm, the trunk does the same thing for the glutes.

3️⃣Hip extension vs Knee Extension This is one of the harder ones to see. Even if the biomechanical set up in the is correct to hit either the glutes or quads, if your CONTROL over which muscles you are firing isn’t right, it does’t make a difference at all. In the ascent phase of the exercise, you ideally will be using your quad to drive knee extension and glutes to drive hip extension. They should BOTH be occurring.

However, many times people tend to focus on just one – many times knee extension – and miss out on hitting the glutes. Notice how my knee “snaps back”, that’s a tell tale sign that I’m initiating my lunge movement primarily with knee extension. Stay on the lookout for the knee snap back if targeting the glutes!

Reduce Knee Pain with a Jump

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💥Hip Strategy💥 . Tag a friend that has knee pain❗️ . Great post by @rehabscience. Want to lessen your risk for injury when performing sport-related tasks such as jumping, landing or cutting? . Learning to implement a 'hip strategy' when decelerating is thought to be an effective technique for taking advantage of the force generating capability of the large hip extensors (glutes) and knee extensors (quads) and decreasing overall stress on passive subsystem structures such as ligaments, cartilage and bone. . The hip strategy consists of three elements, which are depicted nicely in this video. . 1️⃣Trunk flexion – leaning the trunk forward while keeping the spine neutral causes the center of gravity to shift forward, which reduces stress on the front of the knee and may allow for greater recruitment of the glutes. . 2️⃣Hip flexion – sitting back as if preparing to sit in a chair also helps activate the posterior chain, including the glutes, and encourages the subject to absorb force with their muscles instead of bones and ligaments. . 3️⃣Limit anterior knee migration – keeping this component in mind will work to ensure that adequate hip flexion is occurring and will also reduce stress on the patellofemoral joint and patellar tendon at the front of the knee. . All of these strategies will help encourage force attenuation by the neuromuscular system and may be helpful in reducing injury risk and/or the development of pain. . 🔥💣PrehabX MEMBERSHIP COMING 🔜 ✅ Exercise library of 700+ easily searchable videos ✅ Home Exercise Program Functionality ✅ Bi-monthly webinar's and Q&As ✅ Private Facebook Community Group 🤓🧠 Join us in redefining your educational experience as a PrehabX member _________________________________________________ . #kneepain #lowbackpain #prehab #theprehabguys #TPG #fitness #exercise #PT #DPT #DPTstudent #physio #physiotherapy #mobility #athlete #workout #recovery #rehab #prevention #rehabilitation #jumpersknee #jump #athlete #pain

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The first step in mastering a hip strategy is understanding how to appropriately hip hinge. The video below will help improve your ability to hip hinge!

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For more gluteal exercise look at this, this, this and this!

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