The Hip Bone is Connected to the Knee Bone: Patellofemoral Pain in Running

By /

patellofemoral pain in running

One of the things that’s often missing from modern medicine is a realization that a problem at one joint without pain may be causing another joint to experience pain–the old hip bone’s connected to the knee bone.

In that same vein, there was an interesting study published this week on knee cap pain (patellofemoral syndrome) in women runners. This study has implications for how physical therapists should prescribe patellofemoral pain syndrome exercises. The researchers wanted to see if weak gluteal muscles in the hip might have something to do with too much stress on the knee cap. They did find that in females with patellofemoral pain in running, the gluteal muscles were weaker and showed late activation.

How could weak and late firing butt muscles cause problems in the knee cap? See the diagram I created above. When you run and land on one leg, the butt muscles at #1 above need to contract to keep your hip and body from collapsing down. To understand this better, place your hand on your backside and try running in slow motion a few times. You’ll see as you land on one leg, the gluteal muscles of that side contract. Also note that at the same time, the quadriceps muscles need to contract to also prevent you from collapsing (#2 above). To see this for yourself, try slow motion running again with one hand on the butt muscles and one hand on the thigh muscles (don’t get caught doing this in the office or at home as an explanation may be in order). Since both of these muscles work together to support the hip and body as you land on that leg, if the butt muscles are weak or fire late, the quadriceps muscle has to contract extra hard to keep the hip from collapsing downward.

What lives at the end of the quadriceps muscle? The knee cap! The over contraction of the quadriceps causes the patella (knee cap) to be pulled extra hard against it’s groove, wearing down cartilage under the knee cap. If this problem goes on long enough without being fixed, the cartilage will wear out and patellofemoral arthritis will set in.

How can you fix this problem? You need to find out why the butt muscle is contracting late and is weak. This could be as simple as strengthening it, or as complex as an irritated nerve in your back causing the weakness in the gluteals (see our practice’s book, Orthopedics 2.0 for more information). See a qualified sports physician (one that will take the time to look at these issues rather than a 5 minute visit and a declaration that surgery is the only option). Also sports physical therapists or athletic trainers who understand biomechanics (both few and far between) are also safe bets. However, in particular, a lateral release surgery for the patella is not indicated for this problem, as cutting the supports around the knee cap would make little sense if the problem is really a “pain in the butt”!

Learn about Regenexx procedures for knee conditions.
Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

If you have questions or comments about this blog post, please email us at [email protected]

NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

Get Blog Updates by Email

We do not sell, or share your information to third party vendors.

By submitting the form you agree that you’ve read and consent to our Privacy Policy. We may use email, phone, or other electronic means to communicate information about Regenexx.

We will provide information to help you decide whether you want to schedule an evaluation with a Regenexx Physician.

Insurance typically covers evaluations and diagnostic testing (if recommended). Most insurance plans currently do not cover Regenexx Procedures.

Category: Knee, Latest News
Copyright © Regenexx 2021. All rights reserved.

CONTACT INFORMATION

Address

9035 Wadsworth Pkwy #1000
Westminster, CO 80021

Phone

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.

LinkedIn
Email
TO TOP