Knee pain and the hip-knee continuum

Monday, March 9, 2020 - 22:47
Knee pain in the gym recently? It might be time to load up the hips!

Knee pain is one of the most common presentations we see here at Osteopathic Movement and affects 25% of adults at some stage in their lives (Nguyen et al., 2012). In active populations we see a number of conditions affect the knee such as Patella tracking syndrome, Osteoarthritis, patella tendinopathy, fat pad impingement, and more.

Unfortunately, we often see clients opt to rest these injuries and skip lower body exercises (or skip entire classes!) rather than modify the exercise to suit their needs. While this may temporarily relieve the pain, as soon as you go back to lower body exercises the pain will be as severe or worse than before due to the tissues becoming weaker and less able to tolerate the load needed to perform these exercises.

So what can we do?

A great way to modify lower body exercises is to shift away from knee dominant exercises and move towards more hip-dominant exercises.

As shown below, exercises such as lunges and squats have a strong focus on knee movement and a large amount of force going through the knee. Whereas exercises like kettlebell swings and deadlifts have more of a hip focus.



*Click on the above image to see a larger view

So if, for example, you are getting some knee pain while doing lunges at a station you can modify it by changing to a hip thrust or kettlebell swing. The beauty of this is that you are still getting an effective lower body workout and the stress on your knees will be much less!
Alternatively, if some exercises are flaring up your hip you can change to a much more knee dominant exercise.

And don’t worry, your trainer will be more than understanding if you need to change an exercise – anything is better than skipping a station!

Give it a go next time you get some knee pain!


Dr Ash Smith has a wealth of knowledge with sporting injuries, working with various Netball, Volleyball, Aussie football, and Soccer teams over the years both on game day and in the clinic. He has a strong focus on Exercise Rehabilitation as coupled with his Osteopathic manual therapy.