If you’re dealing with hip arthritis — and now your knee has started aching too — you’re not imagining things.
There’s a growing body of research confirming what we see all the time: hip arthritis and knee arthritis are closely connected, and problems in one joint can directly impact the other.
Let’s unpack why this happens, what the research shows, and how you can stop the cycle of joint breakdown before it gets worse.
How the Hip and Knee Work Together
Your hip and knee aren’t isolated joints — they’re part of a kinetic chain that includes your pelvis, low back, and ankle. These structures work together to support stability, absorb force, and coordinate movement during everyday tasks like walking, squatting, or climbing stairs.
But when arthritis limits motion in the hip, your body adapts to avoid pain. Hip muscles stop firing effectively, especially those responsible for controlling rotation and stabilizing the pelvis. This compensation shifts stress to the knee, forcing it to handle forces it was never built for — especially in the medial (inner) compartment.
Over time, this repeated strain leads to irritation, breakdown, and often knee osteoarthritis — even before the hip pain feels like the main problem.
Here’s the kicker: most people (and many healthcare providers) don’t think to assess the hip or low back when knee pain shows up. But it’s all connected — and research backs it up.
What the Research Tells Us
- A 2020 study in Osteoarthritis and Cartilage found that hip osteoarthritis changes how forces are distributed through the knee, especially increasing stress on the medial (inner) side of the knee.
- Research from the Journal of Biomechanics confirmed that patients with hip OA had altered walking mechanics, increasing force through the knees.
- A Mayo Clinic review found that patients who had a hip replacement were at increased risk of developing knee arthritis, even if they weren’t experiencing significant knee symptoms beforehand.
The bottom line? When the hip stops working well, the knee suffers.
How Hip Arthritis Leads to Knee Arthritis: The Biomechanics
Here’s a deeper look at how exactly this breakdown occurs:
1. Decreased Hip Mobility → Increased Knee Stress
When the hip joint becomes stiff or painful, your movement patterns change — whether you realize it or not. You lose natural range of motion, and your hip muscles stop activating efficiently. The result? Excess strain is pushed to the knee, especially in everyday movements like stairs or getting out of a chair.
2. Weak Glutes → Poor Knee Alignment
Your glute muscles, especially the glute medius, help stabilize your pelvis and guide proper knee alignment. But with hip arthritis, glute strength often declines. This causes the knee to collapse inward during movement — a condition called dynamic valgus — which increases joint stress and speeds up cartilage breakdown.
3. Impaired Gait → Asymmetrical Load on the Knee
To avoid hip pain, people often shift their weight away from the affected side when walking. This creates uneven loading through the knees, leading to more wear and tear on one side. It’s not just inefficient — it’s damaging.
“But My Knee Hurts More Than My Hip…”
This is one of the most common things we hear — and it makes perfect sense.
The hip often starts compensating silently long before any pain kicks in. You might not feel anything wrong with the hip until months or even years later, but all the while, the knee has been bearing the brunt of those inefficient movement patterns.
In fact, studies show that patients who undergo total hip replacement often experience relief of knee pain afterward, even if the knee was never treated directly.
This strongly supports the hip-to-knee causation pattern we see in real-world practice.
The Vicious Cycle of Compensation
Here’s how the breakdown usually unfolds:
- Hip joint stiffness develops from arthritis or degeneration.
- Pain reduces hip muscle activation — especially the stabilizers.
- Your body compensates, placing more load and strain on the knee.
- The knee joint undergoes repetitive stress, which leads to irritation, inflammation, and — eventually — osteoarthritis.
- Your movement becomes even more limited, restarting the cycle.
So What Can You Do?
If your knee hurts and your hip feels stiff, the solution isn’t another round of ice or anti-inflammatories. You need to treat the source, not just the symptoms — and that starts with understanding how your whole body moves.
At mPower Physical Therapy in Dallas, TX, we specialize in uncovering the hidden movement issues that lead to chronic joint pain. We don’t chase pain — we correct what’s causing it.
We Can Help You Break the Cycle
Whether your knee pain is new or has been creeping up for years, we help you:
- Restore proper hip and knee mobility
- Re-activate weak stabilizing muscles (especially the glutes)
- Rebuild healthy movement patterns
- Prevent further joint damage
- Move and live with confidence again
Ready to finally understand the real cause of your knee pain?
Let’s take a closer look at how your hips, spine, and knees are working together — and fix what’s really going on.
Book a Discovery Visit with mPower Physical Therapy in Dallas, TX today and start moving pain-free, with strength and confidence.
