The Cooper Institute

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH


Prevent Knee Injuries with Hip Abduction

Written by
Michael Harper, MEd
Posted in
Fit Tips

Saturday, Feb 01, 2014

Common knee issues for runners, such as patellofemoral pain syndrome or iliotibial band syndrome, may be alleviated or prevented by strengthening hip abductors. Studies have shown that adding hip abduction exercises provide strength improvements of 33-51% in as little as 3-5 weeks.

The knee is the most common injured joint for runners (2002, Taunten, et al.). Common injuries for runners include issues such as patellofemoral pain syndrome or iliotibial band syndrome. Patellofemoral pain syndrome is often characterized by pain under and around the kneecap. Iliotibial band syndrome is often characterized by pain on the outside of the knee.

Finding one solution to the aforementioned injuries may be difficult as there could be a number of factors causing the injury, but research has shown possible links to the muscles on the lateral side of the hips (2010, Ferber, et al; 2011, Ferber, et al; 2009, Beazell, et al; 2012, Van der Worp, et al). If the muscles on the lateral hip (hip abductors), are weak, it may cause the knees to cave inward. Strengthening the hip abductors may alleviate and/or help prevent injury; as the hip muscles help stabilize the leg during running.


  • If working out at a gym, look for a Hip Abductor machine and begin adding this exercise to your routine.
  • If bands are available, place a band around the feet or ankle and move laterally by side stepping. Move one leg, and then follow with the other leg. Finish by returning to the starting position by moving in the opposite direction.

If no equipment is available, hip abduction in a side lying position can be done instead. To perform this exercise, lay on your side with the legs stacked on top of one another. Keeping the knees extended, lift the top ankle upward to the sky as far as comfortable, but under control. Then lower to the starting position slowly and repeat.

A 2011 study lasting only three weeks  that included hip abductor strengthening exercises, reported a 32.69% increase in strength among individuals with patellofemoral pain syndrome (Ferber). The study also reported decreased pain levels. A case study by Beazell (2009) showed similar results over a three week period. As reported in a previous study by Ferber (2010), significant strength improvements of the hip abductors among individuals with iliotibial band syndrome pain were seen in five weeks. After five weeks, 22 of the 24 patients in the study demonstrated a 34.9% to 51.4% increase in muscle strength and reported to be free of pain while running.

After a long run, the last thing many runners think about is hitting the gym for a lower body weight routine. However, in light of this research, it may be worth rethinking. Most of the time, the benefits of running and other forms of exercise outweigh the risks.  "Active individuals had a 17%-19% lower chance of injury during non-sport or non-leisure time activities than those who were inactive," but injury risk still exists during physical activity (Howard, 2011).


Beazell, J.R., Grindstaff, T.L., Magrum, E.M., Wilder, R. Treatment of lateral knee pain by addressing tibiofibular hypomobility in a recreational runner. N Am J Sports Phys Ther. 2009 Feb;4(1):21-8.

Ferber, R., Noehren, B., Hamill, J., Davis, I. Competitive Female Runners with a History of Iliotibial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics. J of Orthopaedic & Sports Phys Ther. 2010; 40(2):52-58.

Ferber, R., Kendall, K.D., Farr, L. Changes in Knee Biomechanics After a Hip-Abductor Strengthening Protocol for Runners With Patellofemoral Pain Syndrome. J of Athletic Training. 2011; 46(2):142-149.

Howard, E. (2011, May 30). Exercise: why risk the injury?

Taunton J.E., Ryan M.B., Clement D.B., et al. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002; 36:95-101.

Van der Worp, M.P., Van der Horst, N., de Wijer, A., et al. Iliotibial Band Syndrome in Runners: a Systematic Review. Sports Med. 2012 Nov 1;42(11):969-92.