r/YourWellnessNerd

A recent systematic review of 22 studies found no consistent relationship between hip abductor or external rotator strength and dynamic knee valgus in healthy people, challenging the commonly held belief that hip weakness drives this movement pattern. As a physio, I have found that knee valgus is often multi-factorial – affected by ankle joint stiffness, restricted hip rotation, poor core control, and learned movement strategies, which can all cause the knee to cave in, often as a compensation for restrictions elsewhere in the chain.

Tightness behind the knee when stretching is almost always due to increased sciatic nerve tension, not hamstring tightness, because the sciatic nerve passes directly behind the knee, while the hamstring tendons wrap around the sides. The solution involves mobilising the lower back, releasing gluteal tightness, performing nerve glides (elephant walks), and using a slight knee bend during hamstring stretches to take tension off the nerve and actually stretch the muscle.

Consider trying these five key mobility exercises - the banded scapular stretch, shoulder internal rotation, lumbar extension, the couch stretch, and the banded ankle stretch - that target the areas commonly affected by modern sedentary lifestyles, including the upper back, shoulders, lower back, hips, and ankles. Consistent daily practice is important; use the contract-relax (PNF) technique to enhance results, and prioritise mobility work not to achieve extreme flexibility but to maintain the fundamental ranges of motion needed for healthy, pain-free movement.

A recent study compared eight popular exercises to determine which produced the greatest hip adductor muscle force, finding that the long-lever Copenhagen adduction exercise was the standout for adductor brevis, longus, and the adducting portion of adductor magnus, while squats and deadlifts generated particularly high forces in the hamstring-like portion of adductor magnus. Exercise selection should be individualised, and adductor problems should not be treated in isolation, as the hip joint, gluteal muscles, pelvis and lower back may all need to be considered alongside any adductor-specific loading.

Lower back pain is rarely just about the moment you "tweaked" things, but often the cumulative stress from dysfunctional mechanics - one of which can be stiff hips. Shifting focus from just treating the painful area to addressing a potential root cause can break the cycle of persistent back pain and restore natural, pain-free movement.

Knee pain when kneeling can often be caused by tight quadriceps muscles pulling on the kneecap and increasing pressure in the knee joint, rather than arthritis or wear and tear. A simple sidelying quad stretch with a contract-relax technique to instantly improve knee flexion tolerance, progressing to the more advanced couch stretch, can provide long-term results.