Could Hip or Ankle Immobility be Causing your Knee Pain ?
Nothing in our bodies work in isolation and quite often where we are feeling a pain may not be the source of the problem. Pain can be caused by a verity of factors including weak and/ or tight muscles.
Some joints are meant to be stable while others are meant to be mobile. When we have weak and/ or tight muscles it can lead to a joint that should be mobile becoming tight or immobile. When a joint that should be mobile becomes too tight then our bodies will look for mobility in other places. This can lead to pain.
Nothing in our bodies works in isolation. Although we can do exercises to target a specific muscle. In order to activate a specific muscle or movement at a joint not only does that muscle need to be working properly but there are several other muscles and surrounding structures either allowing that movement or preventing it from happening.
Our knee is a great example of this rarely do we do any movement with the knee that does not involve another joint. For example, walking and squatting are both movements that often cause knee pain. these movements require the hip, knee, and ankle to work together in a coordinated manner. If any part of this chain is not functioning properly then it can cause pain.
The hip is meant to be a mobile joint. However, many of us have tight hips. This comes as no surprise considering one of the primary causes of hip immobility is extended periods of sitting. This places the hip sockets in a constantly flexed position. Over time, this can lead to shortened hip flexors and deactivation of the glutes. Another reason for tight hips is overtraining in one movement or plane of motion such as running, or biking.
The ankle is also a mobile joint. When our calves become tight, we have had a pervious injury, or we wear high heeled shoes on a regular basis it can lead to poor ankle flexibility.
How does tight hips and ankles lead to knee pain?
When the foot and ankle do not have mobility, and/or the hip is lacking flexibility it causes a tug a war between the upper and lower leg with the knee being caught in the middle. This places stress on the knee joint and can lead to instability in the knee. Thus, working or stretching the muscles around the knee does not lead to relief of your knee pain.
Making sure both the hip and ankle are mobile can lead to an increase in stability in the knee and a reduction in pain. Below are 4 exercises to improve both ankle and hip mobility and stability. Performing these exercises for 30-45 seconds 1-2 rounds through can go a long way to improving the mobility and stability in your hips and ankles as well as reducing knee pain. It is important that when working through these mobility and then stability exercises that you perform the mobility exercise before the stability exercise. This is so we can relax any overactive muscles allowing the correct muscles to take over when we are performing the stability exercise.
Ankle Mobility Stretch:
For this stretch you will need a free weight, block, or a wall.
Start by placing the weight on the floor in front of you. Place the toes of the foot you are planning to stretch onto the weight. Your heal should remain in contact with the floor.
Slowly bend the knee of the elevated foot until you feel a stretch in the calf. If you heal starts to lift you have gone to far.
Before a workout this can be done as a dynamic movement this means instead of holding the stretch you are slowly moving from the starting position into the stretch and back to the start.
Single Leg Calf Raises to Toe Raises for Ankle Stability:
For this exercise you will want to be near a wall or other surface to use for support.
Standing with feet hip width apart lift the left foot off the ground so you are standing on one foot. Use the wall for support.
Using your right foot slowly lift yourself up on to your toes as high as you can go without losing control of the movement. Then slowly lower yourself back down.
Once foot is back on the ground in a slow and controlled manner lift the toes off the ground.
Do desired number of repetitions. Switch sides and repeat.
Tensor Fasciae Latae Rolling for Hip Mobility:
For this exercise you will need a ball the larger or softer the ball the less pressure there will be the smaller or harder the ball the more pressure there will be.
Place a ball on the floor on the lateral side of your hip just above the hip socket. Lay down on the ball. You can adjust your position based off how much pressure you want to use. Rolling your body slightly forward, backward, or directly over top depending on the amount of pressure you desire. You want to be able to relax into the pressure. It should not be so painful that you tense up.
You then can gently move your leg of the hip that you are rolling up and down while still on the ball to farther release the muscle. You may need to work up to moving the leg while on the ball.
You might even find that you need to start this exercise from the wall and not the floor.
Hold for as long as you like aiming for at least 90 seconds total. Repeat on other side.
Extended Range of Motion Side Laying Leg Lifts:
You will need an exercise bench for this exercise. However, it can be performed from the floor you just will not be able to get the extended range of motion.
Begin by laying on your side at the end of an exercise bench. Your lower leg should be bent and close to the end of the bench. Your upper leg will be straight and hanging off the bench. Turn the toes of your straight leg inward and push your leg slightly back.
Holding on to the bench for support if necessary, in a slow and controlled manner lift your upper leg using your glutes or bum muscles. Your leg will not go super high and should be ruffly in line with or just over your hip at the highest point. Then lower your leg as far as you can while maintaining control.
Do desired number of repetitions. Then repeat on opposite side.
If you are currently injured or unsure where the pain is originating a consultation with a physiotherapist or kinesiologist could be beneficial.
Clinical Exercise Physiologist