Understanding Your Knee Pain: Is It Your Hips?

When your knee hurts, it’s natural to assume the problem is, well, in your knee. But in the world of physical therapy, we have a saying: “The culprit often returns to the scene of the crime, but it doesn’t live there.” More often than you’d think, the root cause of knee pain isn’t the knee joint itself, but weakness or dysfunction in the muscles around your hips.

Think of it like the foundation of a house. If the foundation (your hips and core) is unstable, it’s going to cause problems in the structures above and below it, like the walls (your knees). This concept is called the kinetic chain—the idea that your entire body is interconnected.

The gluteus medius, a key muscle on the side of your hip, is a major player in knee health. Its job is to keep your pelvis level when you walk, run, or climb stairs. When this muscle is weak, it can allow your thigh to rotate inward and your knee to collapse toward the midline. This “knock-kneed” pattern, known as dynamic valgus, puts a tremendous amount of stress on the ligaments and cartilage of your knee joint, leading to pain over time.

So, how can you tell if your hips might be contributing to your knee pain? Here’s a simple self-screen:

Single Leg Squat Test: Stand in front of a mirror on one leg. Slowly perform a small squat, going only as deep as is comfortable. Watch your knee. Does it dive inward toward your other leg? If so, it’s a strong sign that your hip stabilizing muscles aren’t doing their job effectively.

If you’re tired of icing and resting your knee without seeing results, it might be time to look elsewhere. A thorough physical therapy evaluation can identify these patterns and create a targeted strengthening program for your hips, providing a long-term solution for your knee pain.