Cris LaBossiere

Cris LaBossiere
Strength training and mountain biking. My two favorites

Saturday, June 4, 2011

Strengthen Hips To Reduce Knee Pain

There are a few basic hip exercise that I prescribe to nearly everyone I train whether they are high performance athletes or first timers.  One of the first steps I take when starting with someone is an assessment of core, hip, and ankle stability and strength, and most people score low on most tests.  Indeed when I first learned of these tests over 15 years ago, I scored low on them myself.

Poor hip strength is linked to knee pain (2), and a variety of hip strengthening and movement corrective exercises will reduce or eliminate common knee pain and greatly improve athletic performance in foot speed, moving sideways, and producing power.

The trouble is some of these exercises are perceived as being tedious and unusual compared to standard strength training exercises, while the final stage of advanced exercises are hard to do both strength-wise and in terms of maintaining focus on retaining good form.  I've seen these factors result in many either dismissing the corrective exercises as too weird, taking too long to get results, or conversely many will do the rehab exercises at far too high of an intensity to be useful; overworking the person instead of gradually progressing them forward.

Within a couple months of hip and core strengthening mechanics can be corrected (3, 4) and knee pain can be greatly reduced, especially in woman, whose greater thigh bone angle and generally wider hips make them more susceptible to knee pain.

An Indiana University press release on June 3 (1), 2011 explains how stronger hips from a 2X per week (30 to 35 minutes) hip strengthening program improved running mechanics and lessened knee pain.  Click on the link below for more details.

Recently a 50 year old male athlete I've been working with won his age group in a short distance duathlon, the second duathlon he has ever entered. Paul Seier ran recreationally a few years ago but back, hip, and knee pain made the experience a literal pain in the butt.

Paul is also a competitive mountain biker, winning gold in the Manitoba Provincial Championships (2010) for his category (sport 40+ mens).

Part of what makes Paul's story compelling is that he's a regular guy with a family, runs a business with his wife, and has only so much time to exercise.  Also important to know about Paul, he previously suffered from chronic low back pain, reoccurring spasms in hip muscles, and knee pain.  All of these have been resolved through massage therapy (thanks Bryan!) and a long term progressive exercise program that incorporated the exercises referenced in the research article links below.

By following what research recommends to both reverse and prevent typical overuse injuries and pain due to poor mechanics and muscle weakness, Paul was able to enter duathlon races without any pain or suffering.  Paul reports that he can't believe how good he feels when he runs now; no pain, lot's of power, and no soreness afterwards.

It's true, your running can be pain free.  Do what Paul did, start with the basics, very gradually increase running (Paul started with only a few minutes of running once per week, and now runs on average 1 or 2 times per week, and rides his bike 1 or 2 times per week, and does basic hip strengthening exercises once per week).

A little goes a long way so long as you do it right and overcome two of the most difficult obstacles for increasing performance: the urge to exercise too hard too often, and the urge to follow traditional no-science based injury prone high-voulme, high-intensity exercise programs with no base conditioning.

Paul Seier- right, Cris LaBossiere- left

(1) ACSM: Stronger Hips Improved Running Mechanics, Lessened Knee Pain - ScienceNewsline

(2) Eccentric Hip Muscle Function in Females With and Without Patellofemoral Pain Syndrome

(3) A Proximal Strengthening Program Improves Pain, Function, and Biomechanics in Women With Patellofemoral Pain Syndrome

(4) The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome -- Noehren et al. -- British Journal of Sports Medicine

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