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Patellofemoral Knee Pain and Hip Strengthening

Patellofemoral Knee Pain and Hip Strengthening

Date: August 29, 2022

If it is my knee that hurts why am I doing exercises for my hip? What happened? Did my therapist forget where I said it hurt?

Evidence has shown that strengthening your hip can decrease your knee pain, allowing you to get back to meaningful activities. While it may seem counterintuitive, hip weakness can lead to knee pain. Often, to generate a change in symptoms, physical therapy needs to include your hip, which may be where your knee problem began even though you didn’t realize it.

Can hip weakness cause knee pain?

The entire body is intimately connected with itself and pain or weakness in one area can lead to pain or dysfunction in another. However, the body can compensate for weakness, dysfunction, or pain though, it can contribute to pain in other areas. For physical therapy to provide the best benefit possible, it has to address all contributing factors. Your physical therapist will provide a thorough evaluation that examines all possible contributions and develop a plan of care that will help you decrease pain and return to meaningful activities. This often includes exercises for strengthening your knee, but also your hip.

What is patellofemoral pain syndrome?

Pain located at the front of your knee is called patellofemoral pain syndrome and is one of the most common causes of knee pain more often affecting women. Pain is often worse squatting, stairs, and running, though it can also affect sitting, especially with your knee bent. While this pain may limit your activities, it often responds well to a course of physical therapy.

Why hip and knee strengthening is important

Research has looked to see how working on hip and knee strengthening, as opposed to knee strengthening alone, positively impacts a patient’s outcome. One study found that on a pain scale of 0-10 (with 0 being no pain and 10 being the worst pain you can imagine) patients’ pain score decreased by 3.3 points compared to those who did no strengthening exercises and 1.5 points for those who did just knee strengthening. Patients who did hip and knee exercises were also able to increase their daily activity with the completion of hip and knee exercises.

Ultimately, patellofemoral pain will benefit from strengthening exercises for your knee, however, the addition of hip strengthening exercises will further decrease pain, increasing activity tolerance. If at any point during your physical therapy treatment you have a question like this or about anything else, always feel free to ask your PT. We are always happy to explain our thinking and want to make sure you are comfortable with all aspects of treatment.

Let Aligned Orthopedic & Sports Therapy Help You Recover From Your Knee Injury

If you’re having knee pain and are considering physical therapy, contact us online today or give us a call at your nearest clinic location! Our physical therapists are ready to help you get your knee back to full strength!

  1. Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral Pain Syndrome. Am Fam Physician. 2019;99(2):88-94.
  2. Nascimento LR, Teixeira-Salmela LF, Souza RB, Resende RA. Hip and Knee Strengthening Is More Effective Than Knee Strengthening Alone for Reducing Pain and Improving Activity in Individuals With Patellofemoral Pain: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2018;48(1):19-31. doi:10.2519/jospt.2018.7365
  3. Ismail MM, Gamaleldein MH, Hassa KA. Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial. Eur J Phys Rehabil Med. 2013;49(5):687-698.
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