A Hippie Issue

“A Hippie Issue”
Jill Vonderhaar Nader, PT

Many women that embark on an exercise program find that as they start something new they develop not only the general aches and soreness of exercise, but the onset of hip and knee pain.  This is can be just the result of increasing activity too quickly or starting on a new form of exercise such as running or weight training, but it can also be a result of imbalances in the muscles surrounding the hip and pelvic area. 
No matter if you are a size two or a size 20, a woman’s anatomy is designed more efficiently for childbirth, rather than running marathons.  This means a wider pelvis allowing for an increased angle from the front of the pelvis to the knee, called the “Q angle.” This makes our thigh slant slightly inward or more “knock kneed.”  On top of our anatomical make up, a woman’s ligaments and supporting structures to their joints are designed to have more natural “give” in the tissue as well.  Some recent studies have suggested that there might be a correlation between estrogen levels and female injury rates. Heightened estrogen levels may make a female more susceptible to ligament injuries and lengthened injury healing time during certain phases of the menstrual cycle. The changes in women’s bodies can also lead to weakness in the muscles that stabilize the hip joint and control the motion of the knee joint. Various injuries can develop, ranging anywhere from severe knee and hip injuries such as ACL and cartilage tears to knee cap pain and ITB syndrome (sharp pain on the outer side of the knee, mostly common in runners).
A balanced program that incorporates some basic strengthening and flexibility exercises can help ward off these problems early and allow you to be active longer without pain.
Please use caution with the following exercises; these do not substitute for a thorough medical exam. If you have any pain, please seek appropriate medical care.

Here are a few exercises to try:

1.    “Leg Lift with a Twist”
Lie on one side with your legs out straight and your thighs stacked on top of each other.  Lift the top leg until it is parallel to the bottom leg, knee cap facing forward.
Slowly turn your thigh so the knee cap faces up towards the ceiling slightly. Lift your leg a few inches higher. Hold for 3 sec. Lower and release the rotation. Repeat 8-10xs.  This strengthens the small hip muscles that help to keep your hip stable and align your knee cap when walking or running. If you can’t rotate the thigh comfortably, just lift and lower the leg slowly, knee cap facing forward.

2.    “Hip Circles”
Lie on one side, legs stacked on top of each other. Lift the top leg parallel to the bottom leg. Point your foot and “draw” tiny circles in the air (like you were tracing something the size of a grapefruit) by slowly moving the thigh. Pull your navel to your spine and try to keep your trunk as still as possible. The movement should only come from the leg, not the whole body. Repeat 10 small circles clockwise and counter clockwise.  As you get better, increase the size of your circles to the size if a beach ball.  You should feel all the work in the small muscles in the back of the hip.

3.    Foam Roller Massage
  Place on side of your hip on a foam roller. Start at the top of your thigh and slowly roll down the roller until you find a tender spot called a “trigger point” along your outside thigh (the IT Band).  Hold the roller on that spot for 20-30 seconds (it doesn’t feel good but it really helps!).  Release and find another spot down on the outside thigh. Keep working your way down towards the outside of your knee. Repeat on the other side.  Foam rollers can be purchased at fitness supply companies or www.pilates.com