How Hip Problems Cause Knee Pain

By Niki Vetten

Pain felt at the outer or inner sides of the knees is often directly related to the hips and can have a variety of causes, which need to be assessed and treated by a specialist.

As explained in Knee Injury and Pain in Yoga, the Gluteus Medius stabilises the pelvis in a horizontal plane and when the Gluteus Medius is not functioning, other muscles take over. Hip stabilisation then occurs via the Tensor Fascia Latae (TFL) muscle, which is connected to the Iliotibial Band (ITB). The ITB attaches to the outer side of the knee and pain is felt there if the TFL is compensating for the Gluteus Medius. A physiotherapist may massage and stretch this for you but the problem always returns, because the hip muscles are functioning incorrectly and are the actual source of pain.

Pain in the inner side of the knee, below the kneecap is related because the Sartorius muscle attaches here and it also becomes overactive when hip stabiliser muscles don’t work as they should. It is relatively easy to spot malfunctioning hips in yoga: in standing balancing postures like Vrksasna or Utthita Hasta Padangustasana, the hip pushes out to the side and the pelvis tilts downwards and it is difficult for the person concerned to keep their pelvis level. The hips also usually feel painful and tight.

Teachers and students need to be aware of the importance of keeping the pelvis level during any asana practice- an inability to do so shows an existing problem but bad habits can also create the same problems over time. Hip problems like these can be effectively treated by a good Biokineticist, but if hips are not treated, lower back pain and Sacroiliac joint problems can develop.

Hip weakness also places rotational stress on the knees, Pain at the Kneecap and Knees and Padmasana will look at rotation in more detail. Another related article on this site: Lateral Pelvic Tilt in Yoga Practice

Reading sources: Ellenbecker, De Carlo, DeRosa, 2009, Effective Functional Progressions in Sport Rehabilitation De Franca, 1996, Pelvic Locomotor Dysfunction

Author: Niki Vetten

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Here are some of the other articles posted here by Nikki Vetten:
  • Lower Back Pain: Some Yoga-Related Causes March 11, 2013 By Niki Vetten The causes of lower back pain are varied and complex. Physiotherapy texts state that in most cases it is impossible to pinpoint the exact body tissue that causes the pain and because humans have an upright posture, it is virtually guaranteed that everyone will have an episode of lower back pain in their ...
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  • Lower Back Pain and Posture (Pelvic Tilt) and how Yoga affects Pelvic Tilt March 11, 2013 By Niki Vetten Posture is not simply a matter of standing up straight, like your mother told you to; posture is created by the Hamstrings and Hip Flexor (mainly the Iliopsoas) muscles. If the Hamstrings are stronger than the Psoas, the pelvis tilts backwards and if the Psoas is stronger than the Hamstrings, the pelvis tilts ...
  • Lateral Pelvic Tilt in Yoga Practice March 9, 2013 By Niki Vetten When the hips are can’t be held level in a horizontal plane while standing on one leg, lateral pelvic tilt occurs, caused by weakness of the Hip abductor muscles, especially the Gluteus Medius. The pelvis tilts down to one side and the head of the Femur is pushed outwards. This is called Trendelenburg ...
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2 Responses

  1. Teresa lee says:

    There are a lot of my students who are suffering from knee injury. This is a great help

    • Monica Gauci says:

      Another common reason for knee injury, especially in a practice where a lot of half or full lotus is practiced (eg, Ashtanga Yoga) is from failing to fully flex the knee joint when entering these postures. Completely closing off the knee joint means that all the rotation will happen at the hip joint where it is intended to happen. Knees will object loudly to excessive rotational forces!
      For a more detailed description refer to Gregor Maehle’s first book on the Primary Series, Ashtanga Yoga, Practice and Philosophy.
      Hope this helps…

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