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Is Your Knee Pain Being Caused by Tight Hips?

Is Your Knee Pain Being Caused by Tight Hips? 

If your day includes any amount of walking, running, jumping, going up and down stairs, squatting, or bending, you rely on your knees. You'd find it very difficult to lead a normal life without using your knees.

At the very least, experiencing knee pain will slow you down because the knee is used in nearly everything that you do. Depending on the severity of the ailment, knee pain may even halt your activity entirely.

Whether you experience knee pain when running, knee pain when squatting, or knee pain during your everyday activities, we’ll share why the potential root cause of your knee pain may be coming from somewhere else.

We have a unique angle on knee pain and often look at the function of the hips first. Discover how addressing the stiffness and restriction in your hips could provide you with some much-needed knee pain relief.

How are the hips and knees connected?

The hip joint and knee joint are directly connected with each other because they share the same bone, the femur. The top of the femur inserts into the hip socket of the pelvis, while the bottom of the femur comes together within the knee joint. Because of this, you can see how the hips and knees work together as you move about throughout your daily life.

Basic anatomy and function of the knee joint

The knee represents one of the largest and complex joints in the body. The knee connects the thigh bone (or femur) to the shin bone (or tibia). Other bones that make up the knee joint include the kneecap (or patella) and the fibula, which is a smaller bone that runs alongside your shin bone.

The knee is a hinge joint, where the primary movements coming from the joint are flexion and extension, or bending and straightening your knee. There are many tendons and ligaments, such as the ACL, MCL, LCL, PCL, and meniscus, which support the strength and stability of the knee and limit its side to side movement. The knee also has the ability to rotate internally and externally, which comes from the femur and tibia as the knee joint flexes and extends.

Because of these characteristics, the knee joint is considered to be a stable joint in the body.

How can tight hips affect knee pain?

The hips are one of the more mobile joints in the body. As a ball-and-socket joint, the hip is able to move in many different ranges of motion, including flexion, extension, abduction, adduction, internal rotation, and external rotation. These motions are much greater at the hip joint when compared to the knee.

When there is a restriction at the hip, the motion must be created somewhere else. Your body is a master of compensation and will respond by creating mobility elsewhere in order for you to complete the tasks you perform each day (e.g. walking, running, squatting, hinging).

One of the more common areas that compensate for a lack of range of motion coming from the hips are the knees. Any kind of movement that you create with your leg starts at the hip joint and then works its way down the chain. Your knee joint is next in line.

Christine Koth, physical therapist, breaks it down in this video:

Common knee issues related to tight hips

Tightness in the hip joint impacts the alignment of the knee. Repetitive and strenuous activity with the knee out of alignment leads to accumulating wear and tear around the knee, increasing the chance for injury.

Some knee pain related issues that can develop as a result of tight hips include:

  • Patellofemoral (kneecap) pain
  • Patellar tendonitis
  • Iliotibial band syndrome (IT band)
  • Knee arthritis
  • Injuries to the meniscus, ACL, MCL, and other ligaments around the knee


If you are experiencing any of these issues and haven’t considered the role your hips could be playing in your knee pain, you should have a discussion with your doctor or physical therapist.

3 simple steps for improving your knee pain

While it might seem complex, solving knee pain caused by tight hips doesn’t have to be hard. With a consistent approach, you can make improvements over time and correct for the root cause of the issue. All you need to do is follow the “3 R’s” to increase your hip mobility and decrease your knee pain – release, realign, remember.

Step 1: Release the tension in your tight hip muscles

Whether it be from too much sitting, overuse, compensations from past injuries, most people seem to have tight hips. Sometimes adding in some gentle hip flexor stretches or glute stretches can provide some relief, but the tightness often comes back. This is because muscle release is different from stretching.

Releasing built up tension requires prolonged pressure directly to the tight, sensitive, and contracted areas of your muscles (think of muscle knots or trigger points). This pressure needs to be held long enough (we recommend at least 90 seconds) as you take deep, relaxed breaths until you feel the muscle begin to soften.

The most common muscles that are tight around the hips that you can release are the iliacus, psoas, tensor fascia latae (TFL), piriformis, and your deep hip rotator muscles. You may find that one side is tighter than the other.

Step 2: Realign your hips

After releasing tension in your muscles, the next step is to perform a corrective exercise to help set your pelvis and hips back into a better alignment. Because of tightness and imbalances in the muscles that you just released, it is common to have one side of your pelvis that is rotated forward (anteriorly) more than the other.

This exercise will be performed only on the side that is anteriorly rotated in an effort to bring the alignment of that pelvic bone back into a neutral position that is more even with the opposite side of your pelvis. Follow along with the below video to perform the pelvic realignment exercise.

Step 3: Remember how to use your muscles properly

Once you’ve released tension in your muscles and realigned your pelvis, you are in a great position to strengthen the muscles around your hips that may have become weaker and underutilized. This helps your brain to remember what muscles it needs to use to stabilize your hips and remain in better alignment.

Some of the more important muscles to focus on include the gluteus maximus, gluteus medius, and the abdominal muscles. You can perform exercises such as glute bridges, clam shells, and planks to help target these areas. Try these using your own bodyweight, or with the addition of using a loop resistance band to increase the difficulty of the exercise.

Even increasing the strength of your hip flexors can help with knee pain. In this article, you'll learn some of our favorite exercises for hip flexor strength. But don't forget to first release your muscles around the hips, as this will help you improve your ability to contract and strengthen these muscles through exercise.

We have seen this 3-step approach lead to lots of success for people experiencing knee pain and we hope that you’ll see great results as well.

By Christine Koth . Mon May 23

Author Bio

Uncovering the cause of your pain is my mission. As a bestselling author and holistic physical therapist with decades of experience, I have helped countless people, just like you, recover from long-standing issues. I've discovered a major cause of pain hidden in the hip and this has lead to my "Iliacus Queen" and hip expert status. I'm here to help you discover causes like this. It doesn't have to be complicated to live a pain-free life. We can do this. I look forward to supporting you on your healing journey.