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Published on April 24, 2017

Your Hips Have Key Role In Avoiding Knee Injuries

Many of your more athletic movements like running, jumping and cutting are inherently unstable. To do these moves, you require neuromuscular control to maintain stability and improve performance.

To get that control, especially in your hips, you need what we call "proprioceptive feedback" which is a basically your brain and nerves working to maintain control with information they get from the body.

Your brain will modify the movement patterns, and if you have poor neuromuscular stability, you can lose control. If that control of the nerves and muscules of the hips goes away, so does control of your knees. That's how many injuries happen and when you may need our expertise.

The knee's anterior cruciate ligament, or ACL, feels its greatest strains occur when the frontal and transverse planes of the joint disagree, and this can cause what we call an "anterior tibial shear."

More simply, the mechanism of the non-contact ACL injury often happens when we plant our foot into the ground while rotating the upper body. While the body rotates, the knee is unable to do the same because you're planting that foot. Abnormal force moves from the ground, up the leg to the knee and can cause the ACL to fail. It's all about the strain on the ligament, and it's usually greater when the knee is extened.

To understand the hip's importance and why its stability helps prevent knee injuries, specifically ACL injuries, we need to look at how the hip and the knee work together. Many ACL injuries come from “plant and twist” motions and you can avoid these potentially traumatic situations by training the hip and the nerves and muscles that make up its system.

Preventative measures such as having athletic training staffers, or strength and conditioning staff develop hip stability programs for athletes. Hip strength and stability can help, but we also see a fair amount of athletes who have experienced recurrent, non-contact ACL injuries. Working with professionals can help you prevent an injury - and that's always preferable to treating one!

It's too easy to say you either returned to play too soon or have not rehabbed that knee properly, but research proves that rehabilitation protocols focusing solely on quadriceps and hamstring strengthening put you at increased risk for recurrent ACL injuries, in part because factors that help to stabilize the joint that controls the femur and its articulation with the tibia. Put simply, you could be at increased risk for recurrent ACL injuries if you have reduced hip strength as related to the knee.

If you're recovering from an ACL injury, work diligently with your physical therapist to make sure your hips, as well as your lower-leg muscles, are getting stronger and more stable. An estimated 38,000 ACL injuries occur in U.S. girls and women each year and the average cost to treat them is about $17,000. We spend nearly $650 million as a nation to address ACL injuries and in some cases, we need to switch the focus and insure the hip is helping the knee and its unique nerves, ligaments and tendons to get back to stability.

That's why we are working hard to spell out the intricaties of this rehab approach. Without addressing your hip as part of the ACL recovery, you could be setting yourself up for another knee injury.

This story refers to the work of Hewett, T., Myer, G., Ford, K., Heidt, R., Colosimo, A., McLean, S., van den Bogert, A., Paterno, M., Succop, P., namely, the article "Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes." from the American Journal of Sports Medicine. 33(4): 492-501, 2005.

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