🦵The "knee window" provides a quick and simple method to assess for increased pelvic drop, hip adduction, knee valgus, and a narrow step width 🏃♀️
🔎 To assess this "knee window", using the view from behind, we should see a gap, or window, between the knees throughout the majority of gait. If we see this gap close, it may indicate any combination of increased pelvic drop, hip adduction, knee valgus, or a narrow step width.
A narrow step width can result in:
⬆️ loading of the tibia & ITB (Meardon 2014, Meardon 2012)
⬆️ Peak hip adduction & rearfoot eversion angles as step width decreases. (Brindle 2013)
Increased hip adduction & knee valgus may result in:
⬆️ knee load, so important for those with patellofemoral pain (Nakagawa 2012, Stefanyshyn 2006)
⬆️ Peak hip adduction during running is a risk factor for future patellofemoral pain in female runners & associated with the persistence of PFP. (Noehren 2013, Davis 2020, Neal 2016)
⬆️ Lateral hip stress (gluteal tendinopathy)
🦵Ischiofemoral impingement
Pelvic drop
🤕 From Bramah's 2018 retrospective study, pelvic drop was the most important variable predicting the classification of participants as healthy or injured.
📊 For every 1° increase in pelvic drop, there was an 80% increase in the odds of being classified as injured. (Bramah 2018)
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📚 References
Bramah, C., et al. (2018). "Is There a Pathological Gait Associated With Common Soft Tissue Running Injuries?" Am J Sports Med: 363546518793657.
Brindle, R. A., et al. (2013). "Changing step width alters lower extremity biomechanics during running." Gait Posture.
Davis, I. S., et al. (2020). "Gait Retraining as an Intervention for Patellofemoral Pain." Curr Rev Musculoskelet Med 13(1): 103-114.
Meardon, S. A., et al. (2012). "Step width alters iliotibial band strain during running." Sports Biomech 11(4): 464-472.
Meardon, S. A. and T. R. Derrick (2014). "Effect of step width manipulation on tibial stress during running." Journal of biomechanics.
Nakagawa, T. H., et al. (2012). "Frontal plane biomechanics in males and females with and without patellofemoral pain." Med Sci Sports Exerc 44(9): 1747-1755.
Neal, B. S., et al. (2016). "Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: A systematic review and meta-analysis." Gait Posture 45: 69-82.
Noehren, B., et al. (2013). "Prospective evidence for a hip etiology in patellofemoral pain." Med Sci Sports Exerc 45(6): 1120-1124.
Stefanyshyn, D. J., et al. (2006). "Knee angular impulse as a predictor of patellofemoral pain in runners." Am J Sports Med 34(11): 1844-1851.