Changing the Way You Hinge Helps Hip and Knee Pain
Low back, hip, and knee pain—these issues might seem independent of each other, but they often share a common thread: how we load into the hips and surrounding musculature. The way we engage the hips and pelvis plays a critical role in how forces are distributed throughout the body, especially into the lower back and knees. When this pattern is inefficient or compensatory, it can lead to pain, stiffness, and even injury.
So, how can we adjust our movement to reduce pain, restore mobility, and improve the way we load and strengthen these key areas? It starts by going back to the basics and re-learning one of the most fundamental patterns of human movement—the hip hinge.
Train the hip hinge
The hip hinge is one of the most fundamental movement patterns, both in the gym and daily life. It's at the core of exercises like the deadlift, straight-leg deadlift, and good morning. Ironically, these very exercises—when performed with poor mechanics—can often contribute to low back, hip, or knee pain. But the solution isn’t to avoid hinging altogether. Instead, it's about re-learning how to hinge properly. When done correctly, the hip hinge becomes a powerful tool for not only building strength but also rehabbing common pain patterns and mobility restrictions. Whether working with someone brand new to exercise or an elite CrossFitter, refining the way you hinge can be a game-changing approach to pain relief, performance, and long-term joint health.
Who needs to incorporate hip hinging into their rehab?
This can be difficult to answer up front, but it CAN be anyone. Like I said, elite CrossFitters to even those who have no interest in lifting weights. From those suffering with low back pain to even foot and ankle problems. The use of specifically training through a hip hinge can solve and be used for many different problems.
How to properly train the hip hinge
The best place to start for this is the kickstand hinge, or essentially a single leg hinge. Watch the video below to see a walkthrough of the kickstand hinge…
What are the most important things to remember?
· Keep a soft bend in the forward knee, do not let the ankle of the knee change!
· Push through the heel on the way down, push through the midfoot (center of the foot) on the way up.
· Move slow down, pause and push HARD into the ground while still paused, then use that tension as you push back up (knee angle still does not move).
· Keep as much length through the spine as you can, like you’re stretching your sacrum and head away from each other the best you can.
· We want to feel the load and muscle activity primarily in the back of the hip.
This movement can be especially hard to do the way we intend to do it. This can be even more difficult for people who have a background in lifting weights! Old patterns will limit and fight against the loading pattern we are looking to get into.
Why is the kickstand hinge so helpful for people with low back, hip, and knee pain?
Low back pain
An exceptionally common contributor to low back pain is compression in the low back, back of the pelvis (glute and deeper tissue) and compensatory patterns of loading the lower extremity. By working the kickstand hinge, we can encourage the lumbar paraspinal muscles to lower their level of activity and typically overactive state in hip extension. By allowing these muscles to lengthen and relax in hip extension as the muscles of the back of the hip begin to take the load, we can reduce the amount of compression happening in the low back, while re-training the long-term loading and muscle activation strategy for the future.
Hip pain and restriction
A common issue with lower extremity rehab is to train the glutes into more compression. Yes, glute activation, strength, and motor control are a significant component to solving many people’s problems. But it is also equally common that the glute muscles and other tissue of the posterior hip are compressed and tight. Clam shells will not help this problem!
Instead, we need to train and load through the hip while LENGTHENING these tissues. The kickstand hinge does this better than anything else. Mobility at the hip can be dramatically improved from this drill as we lengthen the tissue around the back of the hip, push the head of the femur into the back of the hip capsule, and do it all while under load and weight bearing.
Knee pain
Injuries to the knee, like meniscus tears, ACL tears, and tendinopathies as well as chronic issues like arthritis and patellar femoral pain syndrome can all be connected to excessive and improper loading into knee flexion. A common link to these injuries is the inability to load into the hip, putting excessive pressure into the knee. By re-introducing the ability to rotate and slide into the back of the hip joint, we can return to a lower extremity loading pattern that uses the hip as the primary source of force absorption.
Conclusion
The way we hinge at the hips is more than just a technical cue—it’s a foundational movement pattern that influences the health and longevity of our hips, knees, and lower back. By retraining the hinge, particularly through drills like the kickstand hinge, we not only improve mobility and strength but also address the root causes of common pain patterns. This approach allows us to offload stressed joints, lengthen tight and compressed tissues, and create a more balanced and efficient movement strategy. Whether you're an elite athlete or someone managing chronic discomfort, refining your hip hinge could be the key to unlocking long-term relief, improved performance, and resilience in daily activities.
-Dr. Nick DC, MS, TPI, CSCS
If you would like to learn more about your body, pain, and performance, send Dr. Nick an email at contact@integratedrpc.com or call at (585)478-4379, or schedule a FREE discovery visit at Contact.
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