Knee Osteoarthritis is one of the leading causes of disability today. This painful condition limits an individual’s ability to walk, climb stairs, stand, and participate in recreational activities. Patient’s often demonstrate significant impairments in mobility and strength in both the knee, but also the ankle and hip. When evaluating patients with knee arthritis, Physical Therapists aim to examine and treat regions which either precipitate or perpetuate arthritic symptoms. Hip strength and coordination is a key area of our focus due to its’ influence on knee joint loading during gait and functional movements. Abnormal gait and movement may perpetuate the intra-articular joint inflammation and pain.
As highlighted in a previous blog, patients with knee osteoarthritis display weakness and atrophy in their hip muscles. A review of the available evidence in the Journal of Geriatric Physical Therapy (Y.V. Raghava Neelapal et al. 2018) reported on the effect of hip strengthening on knee pain and physical function in those who have knee osteoarthritis. The review article included 5 randomized controlled trails and a total of 331 patients. Consistent with our clinical practice, authors reported improvements in knee pain and function after their Physical Therapists implemented hip strengthening exercises into their exercise programs. Interestingly, despite improvements in hip strength and knee function, knee mechanics did not improve as consistently with the exercise interventions. Impairments in knee biomechanics require motor control or coordination interventions in addition to strengthening.