Women’s hips are designed with what is called the Q Angle. If you are a woman over 40 and having knee pain may be thinking it is just “old age”? But it might be because of your Q Angle.
Q Angle May Be Affecting Your Fitness Workouts
We all (pretty much) have the same amount of bones, muscles, and organs inside but we are all put together differently. As you look around you will see women with wider hips and smaller hips, longer legs etc.
There are many different reasons you may be having knee pain (click here to read my blog post on preventing running injuries ) one of the reasons might be coming from the Q Angle of your hip and knee.
The Quadriceps Angle (a.k.a. Q angle) describes the angle from the hip down toward the knee cap. Knowing your Q angle will give you an idea on how the thigh muscle functions in conjunction with the knee cap. A normal knee cap moves up and down in the groove as you bend and extend your knee. When your Q angle is at a wider position, the knee cap does not track properly which can cause damage over time.
What is a normal Q Angle?
The Q Angle is measured using a goniometer (similar to a protractor). This is the angle formed by a line from the pelvis to the knee cap and second line from under the pelvis to the knee cap (depicted by orange angle in picture). A normal Q angle is between 13-18 degrees. If you measure over 15 degrees, you are more inclined to be at a greater risk of knee injuries. Typically, women have a wider Q angle due to the size of their pelvis compared to males. Having a wider pelvis comes in handy for child birth.
How the Q Angle Affects Exercises
The biomechanics of certain exercises involving the knee joint may put you at a disadvantage if you have a larger Q angle. When landing in jumps, squats and/ or pivoting, women tend to roll their knees inward and pronate their feet. This does not allow your knee joint to properly absorb the shock of a jump or track correctly as you squat.
Problems That May Occur With Wider Q Angles
- Muscle Imbalances
A wider Q angle tends to pull the knee cap towards the outside on the knee. This can be from having tight quads (especially the lateral quadricep) and tight iliotibial band (IT band). When the knee cap is constantly pulled off to the outside, the knee cap will not track properly in the knee grove which can lead to wear and tear and possible degeneration behind the knee cap. This condition can be common in dancers and runners.
- Over Compensation
“The knee bone is connected to the thigh bone” we all have heard this song…well it is so true! If one thing is off in the body another body part will jump in a try to help out (team work!) But sometimes, it does not benefit the body in the long run. If you have an excessive Q angle, it can alter the placement of your foot. With an excessive Q angle, the knees tend to look “knock-kneed” which makes the foot roll inwards or pronate. Runners are susceptible to number of injures from over pronating the foot.
- Joint Instability
When the knee cap faces inward, the ligaments become over stretched and lax, which compromises the stability of the knee joint. The ACL (anterior cruciate ligament) takes the brunt of the work in this position. Females with wider Q angles are at a higher risk of having an ACL injury due to this instability.
What To Do If You Have A Q Angle Wider Than 15 Degrees
- Stabilizing the Joint
- Add balance exercises to increase proprioception and stability in the knee joint.
- Getting orthotics isn’t just for grandma. Having custom orthotics made for you may help to control excessive pronation in the feet and can reduce the stress placed on the knee cap.
- Balance muscles and ligaments out with strength and flexibility exercises.
- Strengthen the muscles surrounding the knee joint.
- How to Strength Quadriceps
Sticking with closed-chain exercises like squats preformed at 30 degrees of flexion will engage the quadriceps without adding additional shearing to the knee cap.
- How to Strength Quadriceps
- Making sure you stretch out the IT band before and after your workouts. Using a foam roller is a great way to loosen up your IT band. Check out video below to see how it’s done.
- Strengthen the thighs (quadriceps) – making sure you hit all the angles of the each quadricep.
- Strengthening the gluteus medius to enable proper knee cap tracking.
- Stretch your hamstrings and calves (check out the video below for stretches for runners).
Common Injuries Include:
- Patellofemoral pain – pain under or around the knee cap
- Chondromalacia of knee – degeneration from wear and tear on the underside of the patella (knee cap).
- ACL injures