Do weak hips cause inward knee collapse when running?

Triathlon Forum
1

21km into my Ironman marathon, my knee started to hurt so bad that I was forced to limp. I took some pain killers, and 40min later I felt absolutely no pain so I ran my heart out till the finish line, doing some serious damage to my knee in the proccess.

Upon further inspection, it appears that when I run, my knee collapses inwards. This, I presume, is what’s causing the knee pain…What can I do to correct it? How long will it take?

Here is a slow mo vid of my landing: http://www.youtube.com/watch?v=j4ZxoouRt6w

2

I recently had a dartfish running analysis done. I have had numerous annoying lower leg injuries on my right side the past few years (shin splints, ankle sprain, Achilles, etc.), and the video, along with some simple strength flexibility tests on the table, showed that I had overall instability on my right side, most likely resulting from weak/imbalanced glute/hamstring muscles on my right side. My right hip drops on impact, while my left remains level. Some changes in my form and some exercises the PT showed me seem to be helping.

So to answer your question, I’d say given my case, yes, it is possible it is weak hips, but YMMV.

3

I have had the same issue and it stems from two things in my case: weak glute meds, and a weaker vastus medialis in relation to my vastus lateralis. The latter was due to a ton of bike training with little to no running. It caused patellar tracking issues. Strengthening the VMO and the glute med hav corrected this “collapse” to a large degree. It has taken me a while to correct it but you may see relief fairly quickly depending on the severity of your imbalance. Simple activation exercises of the VMO and glute prior to running helped a lot as well.

4

If your knee moves medially, that indicates weakness in the gluteus medius, gluteus minimus as well as potentially an imbalance between a weaker vastus medialis (inner quad) and a weaker vastus lateralis (outside quad). It may not necessarily mean weakness or early onset fatigue (especially if it happens that late in the marathon). Another possibility is to look at your running mechanics, which may be why certain muscles are fatiguing early. Look for someone who does functional movement screens in your area for a good assessment.

5

As others have said, target the gluteus medius. That is the muscle you need to strengthen to provide hip stability.

I spent 9 months trying to overcome ITBS and did everything recommended…you name it, I did it. Nothing worked until I stopped everything else and really focused on my gluteus medius. @ Thanksgiving I couldn’t run 2 miles. I ran 11 miles yesterday, marking my longest run ever.

http://www.bodyresults.com/e2gluteusmedius.asp

Also do therapy band “monster walks”, both squatting and standing.

Do all these exercises as part of your training and as if your life depended on it and you will see the benefits pretty quickly.

6

x2 on the monster walks… that might be all ya need

7

x2 on the monster walks… that might be all ya need

Those, hip hikes, rear lunges and clam shells are what rehabbed my right leg.

8

Have you tried rear lunges from defecit (start on a step - step backwards with one foot into a rear lunge) they’re pretty good and up the ante from straight lunges. I also did some rear lunges using a slide board the other day, great for focussing on the stability of your front leg.

9

I have been told this quite a few times at PTs over the last 2 years.

I went from normal cartilage for my age to bone on bone 3 spots, 2 medial and 1 patella, in a year.

My knee collapsed medially when running. I had big surgery to realign my leg to have my weight be on lateral side of my knee.

Lots of clams and see a good PT for hip strengthening exercises. I saw a IM PT who thought most all runners and triathletes have weak hips in his experience with all levels of athletes. Depending on how they evaluate you, it is possible to cheat so your glute medius doesn’t seem weak.

Also go see a sports Ortho or Sports Med doc to get checked out.

10

Looks like your foot collapses medially (pronatory motion) a high amount as well, maybe adding to your knee stress. Hip abductor and external rotator strength is very important but actually recruiting the muscles while running is an entirely different concept. I’d do the hip exercises for strength and recruitment before and after runs to insure the muscles are turned on and active. Eventually do form work on the treadmill trying to keep the knees and feet wider apart while getting a small glute contraction while you are in single leg stance. Work lots of hip extension strengthening as well.

11

Have you tried rear lunges from defecit (start on a step - step backwards with one foot into a rear lunge) they’re pretty good and up the ante from straight lunges. I also did some rear lunges using a slide board the other day, great for focussing on the stability of your front leg.

Yeah, I did those off a step and we bought a wobble board that has different bases (VewDew board) and I work with that when the kids don’t surf on it. :slight_smile:

12

from Joe Friel…love him or hate him.

poor core strength is evident in a dropping hip on the side of the recovery leg with the support leg knee collapsing inward regardless of what the foot may be doing.

work on your core strength!

13

You probably toe-out too a bit. I have posted over and over about this and toeing out when running from knock knees.

Dave Scott runs or used to run like this, and there are quite some fast runners, but its not desired, (ask any of them), and I’m not sure you can really totally change knock knees entirely, its anatomical a bit. You can strengthen your gluteus medius, and that hip flexor wad but I don’t think it completely fixes anatomically set hip angles.

You are going to be told to do a lot of one legged squatting, crab walks, exercises which strengthen your external and internal hip rotators.

There’s a good explanation of this. Go to mobility wod. Google Mobiliy Wod and Kelly Starrett addresses this issue constantly, on knee valgus. If I have some time, I will send you some links to the videos where he addresses this, but yes, it could be from hip.

Do you toe out when you run?

There’s a really really interesting approach to this and that is using kinesio tape and taping the glute med to make the runner more aware of USING THE GLUTE while runniing instead of allowing the TFL swing the leg around. The tape functions to remind the runner to use that muscle while running. Apparently, its gotten good results and does reduce some knee collapse Google Kiniesio Tape and Knock Knees or Kinesio Taping and and ITBS. They use step down tests to watch knee collapse, there’s pictures of it. Its interesting.

There’s also a lady who runs a lab on the east coast, somewhere at a University who addresses thiis by giving runner feedback to use glutes while running on a treadmill. Quite popular. She’s done some studies and has successfully gotten people out of ITBS issues. Forget her name.

Here’s a link to video about this with a runner, there are two videos, there’s another below it:

http://www.mobilitywod.com/2012/01/episode-361365-pathomechanics-and-it-band-hell.html

14

I am a physiotherapist (physical therapist) from australia and we see this a lot with our athletes. I agree that you definitely need to improve hip control as stated by many of the above posts. One thing which has not been mentioned is whether you are possibly over striding when you run (you would need a side on view of your running to analyse this). Your foot should not land in front of your knee otherwise you cause a decelerating effect of your femur on your tibia and this can creat added torsion in both your hip and knee. If you are this can cause significant issues in and around the knee.

15

Balance Board Question.

I really like balance boards. I have 2 (Bongo and Vew-Do)and I keep one at work and one at home. I use the work one a few times a day.

Do you do anything specific with yours or do you just ride and play with it?

I use the more difficult Bongo board at home on concrete - I usually just ride it but do occasionally add a few squats. It also can make planks and push ups more difficult.

By the way - for those of you who have not used a balance board regularly - they are very fun and a bit addictive.

Thanks.

David K

16

As others have said, target the gluteus medius. That is the muscle you need to strengthen to provide hip stability.

I spent 9 months trying to overcome ITBS and did everything recommended…you name it, I did it. Nothing worked until I stopped everything else and really focused on my gluteus medius. @ Thanksgiving I couldn’t run 2 miles. I ran 11 miles yesterday, marking my longest run ever.

http://www.bodyresults.com/e2gluteusmedius.asp

Also do therapy band “monster walks”, both squatting and standing.

Do all these exercises as part of your training and as if your life depended on it and you will see the benefits pretty quickly.

What’s “pretty quickly”? How long did this take?

17

Balance Board Question.

I really like balance boards. I have 2 (Bongo and Vew-Do)and I keep one at work and one at home. I use the work one a few times a day.

Do you do anything specific with yours or do you just ride and play with it?

I use the more difficult Bongo board at home on concrete - I usually just ride it but do occasionally add a few squats. It also can make planks and push ups more difficult.

By the way - for those of you who have not used a balance board regularly - they are very fun and a bit addictive.

Thanks.

David K

I put the roller on the Vew-Do and stand there watching TV going back and forth but not letting the board hit the ground (kinda like surfing).
The other way that I was TOLD to use it :slight_smile: was to stand with the ball base on it, in the middle and point my toes at the corner of it (diagonally) and press the edge down, but don’t mash it down where it slams into the floor. More of a controlled motion. I was not pushing off of my big toe on the right leg and that was the fix for that.

18

Thanks a lot for the link, I’ve been doing similiar exercises to monster walks, and I’ll set something up so I can do them exactly how the video shows them being done.

Happy to hear that you can go from 2miles to 11miles without pain! Congratz m8, perseverance will always win :slight_smile:

Glute Medius here I come!

19

I really like that idea of backstep lunging with the front foot on the stability board, I will get that going into my program. Thanks for the suggestion m8!

20

Eventually do form work on the treadmill trying to keep the knees and feet wider apart while getting a small glute contraction while you are in single leg stance…

So when running along a straight line, our feet should never land on that line?
Or when we run on a beach, our footprints shouldn’t be in the a straight line? Does that inward hip tilt demonstrate weak hip?