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Stairs & Knee Problems

Stairs & Knee Problems

Written By: Paul Kochoa, PT, DPT, OCS, CGFI

Generally, with patients who have knee problems, I end up asking them about how their knees hold up with stairs. They usually complain of pain with stairs, especially going down stairs.

Last year, in the October issue of the Journal of Orthopaedic and Sports Physical Therapy, McKenzie et al. investigated female subjects with patellofemoral pain syndrome (PFPS) descending stairs and compared them to females without PFPS doing the same activity.1   Although their sample size was small (only 20 subjects) and the study’s generalizability is low (all participants were college-age female athletes with various sports backgrounds), it did bring up several key points that were confirmed with other studies.

The biggest key finding in the study was that females with PFPS descended stairs with more hip adduction (movement of a limb towards midline) and internal rotation (inward rotation of a limb) than females without PFPS.

So what does that all mean?

In reference to my previous post (My Favorite Exercise), the hip is where it’s at. The females who had knee problems due to PFPS (which accounts for about 40% of all knee problems, so it’s pretty common), had problems controlling their knees during stair descent. Basically, their knees started pointing inward when they stepped down from a step. Those subjects who didn’t have PFPS were able to control their knees better, preventing them from collapsing inward during the step-down.

What does this have to do with the hip?

Well, the knee’s inward pointing during the step down is a combination of an inward rotation of the leg and adduction of the hip. This combined motion is directly related to the muscle in your hip called the gluteus medius (I like to call it the “queen” of the hip). When contracting the “queen”, the leg moves into outward rotation and abduction (movement of the limb away from midline). See the relation?

If you have knee pain, don’t just look at the knee joint. Look above to the hip and see if the issue lies there.

The physical therapists at Professional Physical Therapy and Training can differentiate the cause of your knee pain, whether it be from the knee alone or from another body part, and perform appropriate treatment interventions to decrease pain, and then prescribe specific exercises and movements to target the deficient areas.

Hopefully one of them will be the single-legged deadlift…

1. McKenzie K, Galea V, Wessel J, et al. Lower Extremity Kinematics of Females With Patellofemoral Pain Syndrome While Stair Stepping. J Ortho Sports PT. 2010;40(10):625-632.

Image courtesy of nuttakit / FreeDigitalPhotos.net

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