Tag Archives: hips

Avoiding Knee Pain During Hill Training

We have an annual hill climb challenge at Active Life Condition called the Grind.  It’s about a 2.2km trail that ascends 237m up Blue Mountain in Collingwood, Ontario.  With this challenge seems to come a sudden increase in the amount of hill climb training volume and in the past, this has led to the surfacing of knee aches and pains.  I wanted to highlight an often-overlooked weakness that can contribute to knee pain to help mitigate these issues.

Often the knee itself isn’t the initial problem but becomes the primary concern when other structures in the body aren’t functioning optimally.  Hips and ankles are the two most common areas that directly effect the health of your knee.  When we look at the biomechanics of a hill climb, due to the incline and increased forward angle of the torso, the demand placed through the hips differs from walking or running on a flat surface.  The force that is driven through the ankle and foot also changes dramatically due to these angles and combining this with the uneven ground surface of a trail, the demand for ankle and foot mobility intensifies as well.  Having the stability and awareness to maintain the proper alignment to channel these forces through your body in the safest most efficient manner is crucial, and what we often see is the poor knee having to take up the slack being sandwiched between rigid or unstable hips and ankles.

The glutes get a lot of attention when it comes to hills or stairs, but I find the hip flexors tend to be a little more overlooked.  With an incline they are required to move the thigh higher into a range of motion often not used and generally weaker.  This leaves them prone to quicker fatigue and compensatory patterns occurring to achieve the hip flexion movement.  The videos below lend an explanation as well as an exercise tip to help create strength within this range.  Remember, this is just one of many things that could be occurring, it’s important look at the big picture, and take everything into consideration.  Enjoy!

Movement tip: Isometric Straight Leg Raise Adduction

In the past I’ve mentioned how I’ve felt that the hip adductors seemed to have been a little neglected with the glute focus that’s been so prevalent in the past few years.  I’m happy to see a lot of higher profile “guru’s” starting to bring them back into the fold again due to their importance in core, pelvic and knee stability.

If we look at their functional anatomy we can see that they play a huge role in core and pelvic stability.  In my experience I’ve found that many patients with deep core dysfunction also have dysfunction with their hip adductors or vice versa.  If you follow the deep front net of Thomas Myers Anatomy Trains, this makes sense as you can see how these structures are interwoven with one another.

In my practice I’ve found a lot of people unable to coordinate this sling which leaves them very vulnerable to back strains or more serious injuries.  In working with a soccer team over the winter months (who won a tournament in Italy in the Spring.  So proud of them!), my colleague and I noticed many of them were giving up a lot of power due to this instability.  This movement prep exercise was discovered to try and help them connect and strengthen this line.  I’ve found it to be quite effective with most populations.  It requires the deep core and hip adductors to work together creating that link.  Give it a try!

Isometric Supine Straight Leg Raise Adduction

  • Attach a large O-band to a secure anchor about knee to mid-thigh height.
  • Lie on your back with body parallel to anchor placing feet inline with the anchor point.
  • Position yourself away from the anchor point at a distance that will provide a challenging tension for you.
  • Loop the O-band around the mid-foot portion of your inside leg.
  • With the band under tension, clamp your body into the ground maintaining a neutral spine.
  • Use your hamstrings and glutes of the outside leg to squeeze into the ground and anchor your sacrum and hips keeping them square with shoulders throughout.  Lock down this position.
  • Ensure that rib cage does not rotate or glide laterally out of alignment with hips.  These are common errors.
  • Start movement by raising inside leg up to about 30-45 degree angle and squeeze in toward mid line of body keeping leg straight with knee and toes point up toward ceiling. Hold contraction for specified time.
  • Slowly release but do not let leg drop before repeating next repetition.

Suggested variables: 

2-3 sets, 4-6 reps of 5-10 second holds per side.

Movement Tip: Half-Kneeling Short Range Hamstring Curl

This is a movement that I picked up from Dr. Spina’s FRC material.  I love it because it addresses the top range (short range) portion of a hamstring curl or knee flexion which is so often neglected.  Most hamstring movements focus on the mid or low range, and the movements that are supposed to include the top range are often performed poorly, leaving it out anyway.  In many cases people don’t even have to flexibility to perform work for this range and that’s the other reason why I like this movement.  It also works on quad flexibility at the same time, in particular the rectus femoris that crosses both the knee and hip joint which is often a restricting muscle for many people.

I like using this as a movement prep/warm-up movement especially on a lower body focused day.  The set-up is key to making this an effective movement and for those that can’t get into this position, the video below offers an alternative set-up.

Cramping or muscle spasms in the hamstrings are common when first attempting this movement.  This is a normal response and will pass once your body and brain adapt to the pattern.

This exercise should be performed slow and controlled throughout.

Start in a half-kneeling rec fem stretch position keeping head, shoulders, hips and planted knee aligned with one another.  Hold the foot of your back leg up as close to your butt as you can manage.

Slowly release your foot while squeezing hamstrings and glutes controlling the negative all the way down to the ground.  Try not to let your foot just sling shot out of your hand.  Slowly curl your leg back up to the top position as far as possible before assisting with hand as little as possible and returning to start.

Suggested variables:

2-3 sets, 3-6 reps/side, slow and controlled throughout. (4-5 seconds to lower, 3-4 seconds to return to start.)