Knees are a simple joint in that they essentially only bend and straighten (and can rotate a little). As such, the knee joint itself is usually not to blame when pain is experienced in the knee; the knee joint is stuck in the middle of the hip and ankle, with nowhere to run, and nowhere to hide. There are many other parts of the body that can contribute to knee pain, such as the ankles, the hips, calves, quadriceps, lower back and, you guessed it, hamstrings.
In this article we’re going to discuss the role that the hamstrings have in correct and incorrect functioning of the knee joint, and how things can go wrong. We’ll also talk about what you can do to begin to fix your knee issue.
THE ROLE OF THE HAMSTRINGS IN NORMAL FUNCTION
This is a very interesting topic, for the hamstrings’ role in lower limb function is almost the opposite of what general wisdom might suggest. I’m sure you’re aware that the hamstring acts to bend the knee. You might even know that the hamstring plays a part in extending the hip (bringing your leg backwards at the hip). When used in isolation, on a weights machine or treatment table, this is true. When used in real life function, however, the role of the hamstrings is actually vastly different. When walking or running, the hamstrings actually have three main roles – to decelerate the hip, to decelerate the knee joint, and to decelerate the internal rotation of the tibia to set up the hip, knee and ankle joints for pushing off when you take your next step. If you don’t know what this all means, don’t worry; that’s what your physio is for!
The knee is very rarely flexed by the hamstrings in normal functional activity, and to think of them – and train them – in this way is doing them a great disservice!
THE ROLE OF THE HAMSTRINGS IN KNEE PAIN
These old hams, they played three, they played knick-knack on my knee. (Sorry, I’ve been listening to way too many nursery rhymes lately with my little one, and had nowhere near enough sleep last night!)
When the hip and the ankle joints are functioning correctly, there’s seldom any reason for knee pain. If you read the previous section, you’ll know that the hamstring plays a role in controlling all three of these joints (hip, knee and ankle), and so you can imagine how dysfunctional hamstrings could cause pain in one or more of these three joints.
In general, your muscles act not only to move joints, but also to stabilise them. The hamstrings are no different; they help to position the hip, knee, patella and ankle just so, so that everything works in perfect synergy. If they are tight, weak, imbalanced or any combination of the above, they will eventually knick-knacker your knees. They can have a direct effect, by causing misalignment, extra joint compression, increased joint strain, or increased ground reaction forces, or indirectly by causing other muscles (eg quads, glutes or calves) to work incorrectly and thus cause irritation and pain. In the short term, this can cause discomfort, and in the long term, it can cause more serious injuries like meniscal tears, patellofemoral pain syndrome, and bursitis, among other things.
HOW CAN I FIX MY KNEE PAIN?
This information is general only, and obviously not applicable to everyone, depending on their actual kneeds (geddit?)
If you have dysfunctional hamstrings, and therefore dysfunctional knees, you likely need an exercise program set up specifically for you to strengthen, loosen and improve the control you have over your hamstrings. Any physio worth their salt will tell you that solely treating the knee joint when there’s knee pain will not be enough to help you meaningfully improve your symptoms or function. Your physio will be able to guide you in which exercises are appropriate for you, and will provide hands on treatment to enable you to perform these exercises in the most productive and pain free manner. They will also give you information on what to avoid so as to give yourself the best chance at improving quickly and getting back to 100%!
And if you don’t have knee pain, but are concerned about your future sporting performance and avoiding knee injuries, we can help with that also! (There’s data out there that shows that improper hamstring function can greatly increase your chance of sustaining a serious knee injury, like an ACL tear!)
Call LifeForce health solutions in Golden Grove on 82892800 to organise an appointment with one of our experienced physiotherapists to help make your knees the bee’s knees. Or is that the bees’ knees? Like, is it one bee and its knees? Or the collecive knees of all the bees? And why do bees have particularly good knees? Perhaps they have been busy little bees and have done their stretches and exercises and have awesome hamstrings… I’ll stop now – going to go catch up on some sleep. Now, if only I had someone to sing me a lullaby!
