Would you believe me if I told you that having wide hips can lead to greater chances of injury? The wider your hips, the larger your Q angle is. The Q angle is the angle between the quadriceps muscles and the patella tendon. This measures the direction of pull of the quads on the patella. The larger the angle, the more lateral pull there is on the patella, causing excessive lateral tracking of the patella. In women, this angle should be less than 22 degrees while in men, the angle should be less than 18 degrees.
This lateral pull on the patella can put you at risk of patella dislocation if there is a large enough lateral pull. Along with patella instability over the joint, knee valgus is also common with a larger Q angle. Valgum in the knee is a misalignment in the knees which turns the knees inwards, causing them to touch when standing straight. This misalignment is both anatomical and related to muscular weakness, particularly a weakness in the gluteus medius. The gluteus medius is important in externally rotating the hip and a weakness of this muscle causes the hip to internally rotate, creating more knee valgus. Overtime, this misalignment will place stress on the MCL and its’ capsule while also affecting the ACL due to constant suboptimal patella tracking.
With all of that information you may think that if your hips are naturally wider, you’re out of luck and will always have an increased risk of knee pain or ligament strains. While we cannot change the skeletal structure of your hips, stretching and strengthening of muscles can go a long way in protecting your knee. When it comes to stretching:
Adductor (groin) muscles: these muscles can become shortened and ultimately tight with increased knee valgus. Stretches like frog pose and kneeling side lunge stretch target the adductor muscles!
Lateral quads: since the larger the Q angle, the more lateral pull on the patella, stretching the lateral (outside) portion of the quads can help lengthen these muscles and decrease the pull. Foam rolling the outside portion of the quad and the couch stretch (or modified to standing quad stretch) can be helpful!
When it comes to strengthening, check out the Instagram post on October 28 to follow along with these exercises, and more:
Gluteus medius: as a reminder, this muscle is responsible for external hip rotation. Strengthening this muscle will help rotate the knees back into alignment and away from each other.
Vastus medialis oblique (VMO): this is the muscle which is part of the quads and is the most medial (inside) muscle of the quads. This muscles job is to fully extend/lock out the knee. A lack of strength at full extension means the knee is able to track medially when standing straight, rather than be guided by this muscle and stay aligned.
If you start feeling some pain on the inside of the knee or feel weak/unstable in external hip rotation, give these stretches and exercises a try! You can always book with us as well to get fully assessed and find the root of the problem. In the meantime, give these a try regardless of pain since keeping your knees strong is beneficial in so many other ways!
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