Get Hip to Prevent Knee Injury

Enjoying sports and an active lifestyle motivates us to stay healthy and prevent injuries, if possible. Knee injuries such as injuring the anterior cruciate ligament (ACL) can be devastating to many athletes and fitness warriors alike and can result in dropping out of beloved sports, and it can even become a catalyst for depression.

For this reason, injury prevention and integrating functional strength movements can enhance the body and mind. In an attempt to prevent injury, people sometimes narrowly focus only on the targeted joint, when it is actually the joints above or below that have the most impact on performance and injury. I would even say that the knee is a “dumb” joint, in that it only does what the ankle and hip tell it to do. Because of the larger and stronger muscles that surround and guide it, the hip has powerful influence on the strength, power and control of the movements that involve the knee. So, when the hips’ prime movers and/or stabilizers — which guide successful movements for the lower body — are weak, the knee takes a beating, and its ligaments and joint structures are primed for injury. Therefore, being proactive means focusing on exercises that can be integrated for enhancing hip strength.

There are multiple planes of motion and loading forces that the hip joint needs to strengthen in order to flow through movements with strength, power and coordination. An example would be controlling and preventing unwanted side-to-side movement in order to effectively propel your movement forward. Not only does the lateral movement waste energy on your targeted path, but it also forces joint segments such as the knee to collapse inward excessively and increases the potential for injury.

For this reason, we have focused on two exercises that strengthen the hips in multiple directions and one exercise that works to strengthen the ability to decelerate. Most non-contact knee injuries occur during the deceleration phase of movement, so this becomes a powerful training strategy to prevent knee injuries.

Three-Point Arm Reaches on One Leg

Purpose: Strengthen the muscles of the hips, and maintain vertical alignment in a single-leg stance. Balance, stability and strength are all required to maintain vertical alignment in the lower body, while the upper body acts as a driver to shift the load in three directions with an arm reach.

Start: Stand on a single leg, fully extended and tall, with three cones placed in front of you. The center cone should be directly in front of your foot.

a. Bend at the ankle, knee and hip, maintaining vertical alignment while reaching your opposite hand over the center cone at waist height. Push through the heel, keeping the core engaged as you return to your standing position.

b. Repeat the movement with the same leg and arm but now reaching over the left cone. Be sure to continue to maintain vertical alignment of the ankle, knee and hip.

c. Repeat the movement with the same leg and arm but now reaching over the right cone. Be sure to continue to maintain vertical alignment of the ankle, knee and hip.

d. Now repeat the sequence with the other leg and arm reaching over each cone.

Tweak: If the reaches are too easy, increase intensity by squatting deeper in your stance and reaching lower to the top of the cone while maintaining good form.

3-D Reaching Lunges

Purpose: The functional position of this hip-dominant lunge is used in acceleration and deceleration of locomotion in multiple directions. Strengthening these muscles will enhance performance and decrease risk of injury.

Start: Stand tall with the core engaged and feet hip-width apart. Hold the medicine ball or weight with both hands in front of the body.

a. Forward: Step forward, bending just slightly at the ankle and knee while bending more exaggeratedly at the hip. At the same time, reach over your knee and toward your toes. Maintain a long spine with core engaged. The trailing leg remains extended, weight shifting to the lunging leg. Return to the starting position by pushing into the floor with your foot until standing upright and fully extended.

b. Lateral: Step in a straight line laterally while keeping the toe facing forward as you perform the reaching lunge.

c. Rotating: Imagine you are standing in a square box, and you are rotating as you step so that your foot faces the back corner of the box. Use the same form to perform a reaching lunge.

d. Now repeat on the other leg and with your arm reaching over each cone.

Tweak: Start with your body weight only, just reaching with the hands until you become stronger and proficient at the movement. Then, you can progress by adding weight with a medicine ball or dumbbell.

Drop Squats

Purpose: This exercise focuses on loading the muscles eccentrically to gain strength while, at the same time, teaching the body to emphasize the posterior muscles of the lower body and hips. This reinforces strong landing mechanics and prepares for the deceleration phase of lower-body movements.

Start: Stand tall with the core engaged and feet hip-width apart.

a. Split the feet quickly into a wider, shoulder-width stance as you quickly sit back into a squat position.

b. Keep your chest up and eyes forward as you quickly raise your arms forward to assist in counterbalancing your body weight as you sit back into the squat.

c. Make sure the body comes to a complete stop at the bottom of your squat and that your ankle, knee and hips are aligned to make sure that the knee does not collapse inward.

Tweak: Start with just your body weight, and drop only to a half squat. Once mastered, then drop into the squat until your upper leg is parallel with the ground. Another way to increase intensity is to keep the arms up and hands clasped behind your head, which loads the body more.

These may not be the “sexier” movements in our exercise menu, but they are definitely “big-bang-for-your-buck” exercises that are harder than they look and yield very positive returns, especially for knee injury prevention. So, go give them a try and get more hip!

Diane Vives, MS, CSCS, is an Advisory Member of the Under Armour Performance Training Council. An internationally recognized fitness expert, she has appeared in several publications such as Women’s Health, Shape, and Muscle & Fitness Hers.