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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Visit Niki’s Website: Yoga Anatomy for the Perplexed

Here are some of the other articles posted here by Nikki Vetten:
  • Movement Habits and their Effect on Yoga Practice March 11, 2013 By Niki Vetten There are three particular movement habits in asana practice that either cause or indicate problems with the hips: These will be covered in detail in separate posts, to keep posts shorter 1. Allowing the hip to push out to the side and not maintaining a level pelvis in the horizontal plane – lateral pelvic ...
  • Understanding and Managing Sacroiliac Pain in Yoga Practice March 11, 2013 By Niki Vetten It is common for yogis to develop painful sacroiliac joints, with serious consequences: dysfunction at the sacroiliac joint inhibits the hip muscles and starts a vicious cycle of hip instability and body misalignment. Painful sacroiliac joints must be treated and stabilised to avoid chronic pain and it is not advisable to continue with ...
  • Lower Back Pain and Alignment March 11, 2013 By Niki Vetten Another cause of lower back pain is found in the alignment of the left and right sides of the body, some bodies are structurally asymmetrical: one leg is shorter than the other, or the pelvic halves are different sizes, people can be born that way, or their structure can be altered by bone ...
  • How Hinging From the Hips Creates Weak Gluteal Muscles March 11, 2013 By Niki Vetten Yoga practice usually starts with some form of Surya Namaskara and most sun salutations include moving from Samasthitih or Tadasasna to Uttanasana and back upright many times. These movements are often made by keeping the back straight and folding forwards at the hips, with the knees locked and rising back to vertical in ...
  • Using hip muscles effectively in yoga practice – part 1: bridging and back bending March 7, 2014 By Niki Vetten Weak Gluteal muscles are very common amongst yoga students and teachers alike and cause Sacroiliac pain and dysfunction, lower back pain and hamstring injury. Causes and symptoms are covered in the article on yoga butt and this post looks at the effects of various hip movement cues taught in yoga. Different instructions are ...
View more articles by Niki

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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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