Basketball Knee Pain, Jumping Technique, Hip/Glute Activation

[il prescelto]

I've been reading a bit about how knee pain in basketball is caused by being too quad-dominant, and not using the glutes and hips enough, as well as not having enough ankle and calf mobility/flexibility. I also came across articles and stuff online saying that correct jumping technique relies on the glutes and hips a lot, and that most people don't use them enough.
does anyone have any more info on this? tips/excercises/drills/stretches that can help?

 

[dipsetgeneral]

Yeah, i've starting to have an ache in my left knee after hooping for a couple hours. Came outta nowhere, no injury or anythin'.

 

[rashi]

Knee pain with jumping has a lot to do with the tracking of the patella. Most likely enough you have weakness Vastus Medialis which causes the patella to track laterally (towards the outside) causing the pain. This is the most common type. We call this Patellofemoral Syndrome. When I have young men as patients with these complaints I also look at the position of the ankle and hip. A misaligned ankle can cause imbalances as well.


When you jump playing basketball, you use more of hip flexors and knee extensors to initiate the jump, and when you land you eccentrically use the glutes, hip muscles, and hamstrings.


Explain the pain. Is it dull? Behind the knee cap? Below the knee cap?

 

[jesusshuttlesworth34]

I think I am just getting old....playing 4 nights a week now, by Friday morning my knees and feet are sore like no other. 10 years ago I had infinite energy and recovery.....now

 

[lastchance21]

I think having a good strength and conditioning program might help with the chronic pain you experience when you play a lot every week..

 

[il prescelto]

Knee pain with jumping has a lot to do with the tracking of the patella. Most likely enough you have weakness Vastus Medialis which causes the patella to track laterally (towards the outside) causing the pain. This is the most common type. We call this Patellofemoral Syndrome. When I have young men as patients with these complaints I also look at the position of the ankle and hip. A misaligned ankle can cause imbalances as well.
When you jump playing basketball, you use more of hip flexors and knee extensors to initiate the jump, and when you land you eccentrically use the glutes, hip muscles, and hamstrings.
Explain the pain. Is it dull? Behind the knee cap? Below the knee cap?

I'd say the pain is below the knee cap, and maybe slightly towards the outer portion of the knee, facing away from the other leg. I'm not sure what you mean by dull, but it's not a piercing or stinging pain, if that's what you meant by that.
Thanks a lot for the informative reply though, I googled Vastus Medialis and a bunch of stuff about knee pain came up, so I'll read up on that as well.

As far as using more glutes and hips when jumping, is that a matter of consciously adopting a proper technique, or just training to make those groups stronger (in the case of the glutes) or more flexible (in the case of the hips)?

 

[willzway26]

One thing I've always done is work on the hamstrings, b.c a lot of the time the quads are overworked when jumping and the hamstrings are undercompensated....remember the hammys end right behind the knees...

 

[rashi]

I'd say the pain is below the knee cap, and maybe slightly towards the outer portion of the knee, facing away from the other leg. I'm not sure what you mean by dull, but it's not a piercing or stinging pain, if that's what you meant by that.
Thanks a lot for the informative reply though, I googled Vastus Medialis and a bunch of stuff about knee pain came up, so I'll read up on that as well.
As far as using more glutes and hips when jumping, is that a matter of consciously adopting a proper technique, or just training to make those groups stronger (in the case of the glutes) or more flexible (in the case of the hips)?

From what you are telling me, it sounds like the tracking issue I mentioned. What I would recommend is something called McConnell Taping. I'm not recommending you do this, because it takes a skilled clinician to do this properly, but if you want to take a shot, you can go on to YouTube. You would need to buy HypaFix tape and KinisioTape (both at a medical supply store). HypaFix goes on first, then the Kinisio Tape. You want to tape the outside of the knee cap and pull it towards the inside part of the knee. Like I said, there are videos on YouTube. Also, any legs workout of jumping activities should be done with this tape so it can reeducate the muscle to engage properly and pull the knee cap into proper tracking.


As far as the Glutes and Hips are concerned. You are not going to be able to isolate the Glutes and hips. There are 3 Glute muscles, maximus, medius, and minimus. The work together, but also the 3 do different things, so you can't really consciously use them more when jumping because to play basketball you are jumping more with the ball of the foot, not exploding from flat feet. The mechanics of jumping off of one foot is different than exploding off of two feet.

If you are going to do plyometrics and squats make sure you look for a few things.

1. Make sure your knees are shoulder width apart, not flaring out.
2. Make sure your knees are not past your toes when squatting down


Some stretches for the pain I would definitely recommend are as follows

and another way is this

Do these throughout the day, anf hold for 1 minute each.


The previous poster is right when working on the hamstrings. I work with a lot of athletes and a lot of poor Quad to Hamstring ratios which lead to ACL injuries. I actually pitched something like this to the Miami Heat and now myself, their physicians, and some physical therapists do what is called Isokinetic Testing to test the ratios, if the ratios are too wide, then they need to be put on a conditioning program that decreases the ratio, and therefore decreasing their risk of ACL injuries.

 

[ag 47]

Knee pain with jumping has a lot to do with the tracking of the patella. Most likely enough you have weakness Vastus Medialis which causes the patella to track laterally (towards the outside) causing the pain. This is the most common type. We call this Patellofemoral Syndrome. When I have young men as patients with these complaints I also look at the position of the ankle and hip. A misaligned ankle can cause imbalances as well.
When you jump playing basketball, you use more of hip flexors and knee extensors to initiate the jump, and when you land you eccentrically use the glutes, hip muscles, and hamstrings.
Explain the pain. Is it dull? Behind the knee cap? Below the knee cap?

I suffer from this everyday. Went to physical therapy and everything for it. It's a long, frustrating process trying to eliminate that ache.

The previous poster is right when working on the hamstrings. I work with a lot of athletes and a lot of poor Quad to Hamstring ratios which lead to ACL injuries. I actually pitched something like this to the Miami Heat and now myself, their physicians, and some physical therapists do what is called Isokinetic Testing to test the ratios, if the ratios are too wide, then they need to be put on a conditioning program that decreases the ratio, and therefore decreasing their risk of ACL injuries.

You have anymore info you can share about the Isokinetic Testing?

 

[il prescelto]

From what you are telling me, it sounds like the tracking issue I mentioned. What I would recommend is something called McConnell Taping. I'm not recommending you do this, because it takes a skilled clinician to do this properly, but if you want to take a shot, you can go on to YouTube. You would need to buy HypaFix tape and KinisioTape (both at a medical supply store). HypaFix goes on first, then the Kinisio Tape. You want to tape the outside of the knee cap and pull it towards the inside part of the knee. Like I said, there are videos on YouTube. Also, any legs workout of jumping activities should be done with this tape so it can reeducate the muscle to engage properly and pull the knee cap into proper tracking.

Hmm don't think I want to try that myself, I definitely don't want to mess up and make things worse. I'll try going to a physical therapist though and see if they can do the procedure. Is there anything else I can do in the meantime?

If you are going to do plyometrics and squats make sure you look for a few things.
1. Make sure your knees are shoulder width apart, not flaring out.
2. Make sure your knees are not past your toes when squatting down
Some stretches for the pain I would definitely recommend are as follows

and another way is this

Where am I supposed to feel the first stretch? I tried it but I'm not really feeling it anywhere, and I'm not sure what to search for to get more info or vids on it.
Thanks

 

[dipsetgeneral]

Knee pain with jumping has a lot to do with the tracking of the patella. Most likely enough you have weakness Vastus Medialis which causes the patella to track laterally (towards the outside) causing the pain. This is the most common type. We call this Patellofemoral Syndrome. When I have young men as patients with these complaints I also look at the position of the ankle and hip. A misaligned ankle can cause imbalances as well.
When you jump playing basketball, you use more of hip flexors and knee extensors to initiate the jump, and when you land you eccentrically use the glutes, hip muscles, and hamstrings.
Explain the pain. Is it dull? Behind the knee cap? Below the knee cap?

Below the knee cap. I don't if it's dull though.

 

[rashi]

Hmm don't think I want to try that myself, I definitely don't want to mess up and make things worse. I'll try going to a physical therapist though and see if they can do the procedure. Is there anything else I can do in the meantime?
Where am I supposed to feel the first stretch? I tried it but I'm not really feeling it anywhere, and I'm not sure what to search for to get more info or vids on it.
Thanks

You should start to feel the stretch where the guy on the picture has his hand placed. You are going to feel the stretch more in that are rather than the knee because IT Band starts. Make sure the toes are pointing forward. YouTube has videos of modifications of this stretch.

Below the knee cap. I don't if it's dull though.

What do you do that increases the pain? You could have the same issue as the OP, which is very common. Men don't tend to stretch a whole lot, which contributes to the issue.

In addition to the stretches I posted.

 

[qtnettles]

I know a lot about knee pain. Torn my meniscus smh. Ended my college basketball career and now i can only play for fun. I use to be able to dunk now i can barely grab the rim, doc told me it was the worst he had ever seen, I shouldn't even be playing now but i love the game and competition to much

 

[BIG LEEMELONE]

I fractured my left patella twice and messed up my right knee pretty bad. The doc wouldn't even tell me what happened but he told my pops that I "pulverized" it . I'm guessing it was my acl/mcl. With that said there is a way to jump where you don't really feel any pressure on the knee whatsoever. I think it's like rashi said, using the hips and glutes but I don't really feel anything there either. Personally I focus on jumping with my calves. despite my injuries I can still get about halfway up the square (5'10 with shoes). all I do is touch and hold my toes for a count of 100 followed by bending at the hip and punching the floor (explosive movement) with both hands about 50 times before and after I play and I feel great.

you also might want to try the supplement super cissus which is supposed to work miracles for joint pain. I just got on it today and already the placebo effect has me jumping like crazy.

question for Dr. rashi - with my injuries are you saying I can do squats without any discomfort in the knees at all? I feel like my technique is pretty good but my knees still get stiff so I avoid the squat rack and thus my thighs are skinny as hell any other exercises to build up the quads? also any kind of kneeling down is a mother.... what can I do to remedy this?

 

[rashi]

question for Dr. rashi - with my injuries are you saying I can do squats without any discomfort in the knees at all? I feel like my technique is pretty good but my knees still get stiff so I avoid the squat rack and thus my thighs are skinny as hell laugh.gif any other exercises to build up the quads? also any kind of kneeling down is a mother.... what can I do to remedy this?

Fracture you patella twice? Yikes! You probably developed what we call Chondromalacia of that patella. Which means the cartilage behind the patella that allows it to track smoothly has degenerated, which will happen when immobilize for long periods of time. Assuming they didn't do surgery, they probably had that knee immobilized in long leg brace for 8-12 weeks. And that will do it.

I would say you are better off doing "half squats", try this without weights first. To build up quad strength, you could do the knee extension machine, but angle it at 45deg. Reason being is that at 90deg. is too much force on the patella and the femur (thigh bone) behind it, at 45deg it is less. Start off light and build up.

Kneeling down is going to to suck and really hurt, I would try to avoid that as much as possible. My recommendation is to really focus of getting the strength supporting the knee, because if you are having problems now, just wait when you are 40. So the best way to counter that is to strengthen the muscles to support the joint.

You could this:

but add a folded pillow between the knee, as you get to the apex (the position the girl is in) squeeze the pillow with your knee. 3 sets of 10 or 15 or to your tolerance. It isn't as easy as it looks.


Also, doing exercise in the pool would be great for the knee. It would take gravity (pressure) off the joint while strengthening at the same time. Win-win.

 

[frankbink5]

After dealing with the patella pain for close to two years, I had tibial tuberosity osteotomy, lateral release and scope done 2 weeks ago. From what I hear the recovery for this is not fun

 

[rashi]

After dealing with the patella pain for close to two years, I had tibial tuberosity osteotomy, lateral release and scope done 2 weeks ago. From what I hear the recovery for this is not fun

Sounds like Osgood Schlatter's disease, which is also very common. No, the recovery isn't fun, but there is a very good prognosis with the advancement of physical therapy.

 

[flipnlu]

Around November I turned towards my right shoulder without lifting my feet. Immediately felt a pain in my inner left knee near my meniscus I believe. Also I've had severe left hip pain possibly from sitting alot at work.I went to see a family doctor due to no insurance and he said I may have damage/strained a ligament. I wore a knee brace as he recommended for months and this is the first month I've had no pain. I've strengthen my knee slowly and still aittle scared. Any diagnosis or help will be greatly appreciated. Thanks in advance

 

[True Blues]

After dealing with the patella pain for close to two years, I had tibial tuberosity osteotomy, lateral release and scope done 2 weeks ago. From what I hear the recovery for this is not fun

Sounds like Osgood Schlatter's disease, which is also very common. No, the recovery isn't fun, but there is a very good prognosis with the advancement of physical therapy.

I would recommend wearing a patella strap during physical activity from now on. I, too, suffered from Osgood Schlatter's, but was able to manage the pain through wearing the brace when I played basketball and occasional PT. Eventually, the symptoms went away.

I liked the McDavid and Cho-Pat straps best.

 

[rashi]

Around November I turned towards my right shoulder without lifting my feet. Immediately felt a pain in my inner left knee near my meniscus I believe. Also I've had severe left hip pain possibly from sitting alot at work.I went to see a family doctor due to no insurance and he said I may have damage/strained a ligament. I wore a knee brace as he recommended for months and this is the first month I've had no pain. I've strengthen my knee slowly and still aittle scared. Any diagnosis or help will be greatly appreciated. Thanks in advance

From the information you are telling me, you may of injured the meniscus. But that doesn't mean you won't be able to do things you use to do. The inflammation that comes with an injury like that basically "shuts off" part of the quadriceps for ever how long the inflammation is present, which will then lead to atrophy of the quadriceps.

Since you are no longer having pain, I would recommend not wearing the brace anymore. I am totally against wearing braces unless not wearing one has an effect on what ever it is you are doing. The reason is that wearing braces don't allow the joint to move as it should normally. Braces take away the natural proprioception of the joint during daily life and sport activities. Continue strengthening you quadriceps and hamstrings. Also, if you want to start doing squats, start off with light or no weight to get your body accustomed to doing that movement again. Progress per your toleration.


For the hip issue, sitting down for long period could be a contributing factor, but may not be the reason. Every time I see a patient with a hip issue, I always look inside the shoe to see what kind of support they have 95% of the time it is a basic support with the shoe. The way the walk, and what kind of shoe they are using. Obviously, this is over a computer so I can't make any objective decision, but with hip patients I always recommend an insole like a Dr. Scholls which will also help out with the forces on the knee and ankle.

 

[flipnlu]

Thank you Dr.Rashi! I did have swelling at first I appreciate your time and input. I was at the gym today and realize I had no brace on and no pain. I will condition slowly as you recommend. I believe you are on the right path with my hip. I've been a sneaker head since 99 and wearing 60 different shoes I believe had a negative effect on my body and feet. I will look into better shoes certainly. Would you recommend vibram? Where are you located I would live to visit someone as knowledgable as yourself. Thanks in advance rep is a must. OneLove

 

[orsrt8]

Good info in here....

I hurt my knee on sat playing ball jumping for a rebound. Went up and when I came down it felt weak (scared the hell outta me since it was non contact). I had what they call Jumpers knee years ago as a kid and this seems like the same thing. The area underneath my right kneecap always was a little bigger since then. So after that game i stopped playing and was talking to this trainer who was playing with us and he thinks it was the patella. Pain is underneath the kneecap,directy on the front of it, swelled a little bit and I felt pain when I bent the knee all the way back. Still had over strength and lateral.jumping movement with no problem. But still this scared the hell outta me since my biggest fear in life is tearing an acl Been icing it twice a day since and most of the pain has gone away and I can move it more and go down the stairs easier but still aint %100. Like i say the area under my knee has always been a little bigger since the first injury, but it still seems a lil swollen.

 

[jigga boi]

True Blues recommendation of the McDavid patella strap is on point. I've gotten older the past few years and have had knee pain/ Osgood Schlatter's and the patella strap actually minimizes pain and helps a lot. I wear them on both knees whenever I play basketball.

 

[rashi]

Good info in here....
I hurt my knee on sat playing ball jumping for a rebound. Went up and when I came down it felt weak (scared the hell outta me since it was non contact). I had what they call Jumpers knee years ago as a kid and this seems like the same thing. The area underneath my right kneecap always was a little bigger since then. So after that game i stopped playing and was talking to this trainer who was playing with us and he thinks it was the patella. Pain is underneath the kneecap,directy on the front of it, swelled a little bit and I felt pain when I bent the knee all the way back. Still had over strength and lateral.jumping movement with no problem. But still this scared the hell outta me since my biggest fear in life is tearing an acl Been icing it twice a day since and most of the pain has gone away and I can move it more and go down the stairs easier but still aint %100. Like i say the area under my knee has always been a little bigger since the first injury, but it still seems a lil swollen.

This could be a few different things. Majority of ACL injuries are a result of non-contact. If you tore it, you wouldn't of been able to walk on that knee. Worst case scenario if it was the ACL, it is probably what we call a Grade I sprain. If you feel the knee is "giving way", I would recommend to get it checked out by an orthopaedist.

I tore my ACL a few years back playing flag football. I didn't have surgery because I was still in school and couldn't take the down time. Did some PT, and rehabbed it. I still to this day do Plyometrics, boxes, agility ladder, hurdles, ect and play basketball (with a brace).


One thing I always tell people who play basketball or football. Please, please, please DO NOT neglect your hamstrings!

Thank you Dr.Rashi! I did have swelling at first I appreciate your time and input. I was at the gym today and realize I had no brace on and no pain. I will condition slowly as you recommend. I believe you are on the right path with my hip. I've been a sneaker head since 99 and wearing 60 different shoes I believe had a negative effect on my body and feet. I will look into better shoes certainly. Would you recommend vibram? Where are you located I would live to visit someone as knowledgable as yourself. Thanks in advance rep is a must. OneLove

I'm currently practicing in So. FL, but I might be relocating to Scottsadale,AZ, San Diego, L.A., or San Fran soon.

I like minimalist shoes like Vibram. I think it is healthy to walk bare foot because we're so use to wearing sneakers, which is great, but it makes them muscles of the bottom of the feet weak. So they closest thing to being bare foot.

I wear minimalist shoes myself.

For training I wear Asics or NB
For basketball I wear Kobe System lows


I think the Kobe System lows are probably the best basketball shoes I ever wore.

 

[airblaster503]

Good info in here....
I hurt my knee on sat playing ball jumping for a rebound. Went up and when I came down it felt weak (scared the hell outta me since it was non contact). I had what they call Jumpers knee years ago as a kid and this seems like the same thing. The area underneath my right kneecap always was a little bigger since then. So after that game i stopped playing and was talking to this trainer who was playing with us and he thinks it was the patella. Pain is underneath the kneecap,directy on the front of it, swelled a little bit and I felt pain when I bent the knee all the way back. Still had over strength and lateral.jumping movement with no problem. But still this scared the hell outta me since my biggest fear in life is tearing an acl Been icing it twice a day since and most of the pain has gone away and I can move it more and go down the stairs easier but still aint %100. Like i say the area under my knee has always been a little bigger since the first injury, but it still seems a lil swollen.

Sounds like you need to use a Patella strap which reduces pain by taking pressure off the patellar tendon. I get the same thing when running lately and it is a tracking problem with my patella.

I would recommend wearing a patella strap during physical activity from now on. I, too, suffered from Osgood Schlatter's, but was able to manage the pain through wearing the brace when I played basketball and occasional PT. Eventually, the symptoms went away.
I liked the McDavid and Cho-Pat straps best.

Good recommendation but I think by far the best strap is the Pro-Tec Patella Strap. It is way more comfortable than any others I have tried and has different sizes instead of a one size fits all.