Core Talk: The hip and knee

This week, we move up the chain from the foot, to the knee and hip. It is important to understand that as we move to other regions of the body, one cannot forget the impact the others can have on your system. All of the systems of our body, and all of the various regions of the body, have the potential to affect another.

I am grouping the hip with the knee because it is well documented in research that a weak hip will likely increase the stress put on the knee. This means, in order to have an efficient knee, you will have to have an efficient hip (and foot for that matter!). Both the knee, and the hip, have muscles that function in a stabilizing capacity. These would be the muscles we would consider “core muscles of the knee” and “core muscles of the hip.” A lot of these muscles are shared muscles between the two. Let’s. break it down a bit more.

AN EFFICIENT KNEE VS INEFFICIENT KNEE

Photo from Complete Anatomy by 3D4Medical

An efficient knee is one that can move through a full range of motion with ease, has good control throughout that range, and can function efficiently weight bearing and in non-weight bearing.

An inefficient knee is one that might be stiff in one or multiple directions, have poor control (which you might notice with things like your ability to come down stairs smoothly, step up on curbs, or stand up from sitting) and you might experience pain either in weight bearing activities or non-weight bearing activities.

AN EFFICIENT HIP VS AN INEFFICIENT HIP

Photo from Complete Anatomy by 3D4Medical

An efficient hip is one that has good mobility and range of motion in all directions, has good control through that range (especially during weight bearing activities), and is pain free. 

An inefficient hip is one that is stiff in one or more directions, and has poor control (which you might notice with pain at your hip during sitting or standing). You might notice one leg gets more fatigued than the other. It might even be difficult to stand from a sitting position, just like with an inefficient knee.

THE CORE OF THE KNEE AND HIP

When it comes to the “core muscles” of the knee, your quadriceps plays a big role.This is the reason it is such a big focus after a knee surgery. Other muscles at the knee joint that play a role with stabilizing are the hamstring muscles and your gastrocnemius muscle (part of your calf muscles).

Some of the core muscles at your hip are the gluteus muscles, especially the two smaller ones (gluteus medius and minimums.) These are usually considered to be important stabilizing muscles to protect and decrease strain to your knee. You also have deeper muscles that function similar to the rotator cuff of the shoulder in that they create a “cuff” around the hip joint and help to stabilize the hip in its socket. We need this, especially with weight bearing activities. A sign of dysfunction with this may manifest  as you standing more on one leg than the other, or allowing your hip to “pop” out, as if you are holding a child on your hip. This isn’t a bad thing in a single moment, but if it is a habitual pattern, it may be an issue.

It is often said about the knee, that “it is the joint that is stuck between the foot and the hip”. In other words, knee issues likely have components from foot dysfunction and/or hip dysfunction. This isn’t to say that the knee can’t have problems; it cannot be looked at in isolation! So next time your knee hurts, think about what your foot and hip may be doing as well!