Patellofemoral pain is the most common cause of anterior knee pain. There has long been links drawn between hip strength and joint angles, with patellofemoral pain, with little evidence on an individual’s overall function.
A recent study by Nunes et al (2019) tested 32 participants (16 with patellofemoral pain, 16 without) through a range of functional tasks. They assessed for differences in task performance in people with and without pain, and looked for any correlation on performance with hip musculature strength, power and endurance. The tasks included stair climbing, single legged chair stand, step downs, forward hop distance, and side hops. The number of repetitions completed in a time frame or distance covered were measured. The results:
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The patellofemoral group were 15% slower at climbing stairs
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They performed 12% fewer chair stands
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Forward hopped 20% shorter
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Lower isometric hip abduction strength correlated moderately with fewer step down repetitions and shorter forward hop distance
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Lower dynamic hip abduction strength correlated strongly with fewer step down reps, and moderately with shorter forward hop distance
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Lower dynamic hip extension strength correlated strongly with fewer chair stand reps, moderately with fewer step downs, shorter hop distance, fewer side hop reps
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No significant correlations were found between hip abduction or extension muscle endurance and functional tasks
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Lower hip abduction power was moderately correlated with fewer step down repetitions and shorter hop distance
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Lower hip extension power was moderately correlated with fewer step down reps and shorter hop distance
So what does this mean for my knee pain? Although this is a small study, it makes very clear correlations with pain, function and strength, which supports the existing research. People with patellofemoral pain have clear deficits compared to healthy controls and need to address these with a targeted strength and conditioning program, particularly targeting the hip musculature.
Work with your physiotherapist or strength and conditioning coach to come up with a program that addresses such deficits, minimised your pain, and works toward your goals.
REFERENCES:
Nunes, G., de Oliveira Silva, D., Crossley, K., Serra, F., Pizzari, T., Barton, C (2019). People with patellofemoral pain have impaired functional performance, that is correlated to hip muscle capacity. Physical Therapy in Sport 40:85-90, https://doi.org/10.1016/j.ptsp.2019.08.010 .
