Experiencing pain in both the hip and knee while walking often signals a problem in the way the entire lower limb is moving. These two large, weight-bearing joints are intimately connected, meaning dysfunction in one joint frequently transfers stress and pain to the other. The act of walking is a repetitive motion that demands coordinated function from the entire leg. When this coordination breaks down, the resulting pain can significantly limit daily activity.
Understanding the Biomechanical Link
The lower body operates as a linked system known as the kinetic chain, where the hip, knee, and ankle work together to manage and transfer forces during movement. During the stance phase of walking, the hip provides stability and controls the alignment of the leg. If the muscles surrounding the hip, particularly the gluteus medius, are weak, the pelvis may drop slightly on the unsupported side, leading to a compensatory movement.
This instability causes the femur—the thigh bone—to rotate slightly inward, forcing the knee to collapse toward the midline of the body, a pattern known as dynamic knee valgus. This misalignment increases stress on the knee joint and its supporting structures, such as the patella and certain ligaments. The knee is then forced to absorb excessive rotational forces that the hip should have controlled, leading to pain that originates higher up the leg.
The way a person walks, or their gait, changes significantly when one joint is painful. A person experiencing pain often adopts a shorter, slower stride to minimize the load on the affected area, which alters the forces traveling through the joints. This protective walking pattern can lead to an exaggerated motion in the lower back or cause other muscles, like the quadriceps, to overwork, resulting in strain and discomfort in the previously unaffected joint.
Specific Sources of Hip and Knee Pain
One of the most frequent causes of combined hip and knee pain is osteoarthritis (OA), a degenerative condition where the protective cartilage within the joint wears down. OA in the hip can cause pain that radiates down to the knee, while OA in the knee can alter gait mechanics, placing undue strain on the hip joint. Patients with OA often exhibit a reduced range of motion and a slower walking speed as they attempt to minimize joint loading.
Iliotibial Band (IT Band) Syndrome is a common overuse injury that causes pain on the outside of both the hip and the knee. The IT band is a thick band of tissue running along the outside of the thigh from the pelvis to just below the knee. When this band becomes tight or irritated due to repetitive friction from walking or running, it can cause sharp pain on the lateral side of the knee and the hip.
A tight IT band is frequently linked to Greater Trochanteric Bursitis, which involves inflammation of the fluid-filled sac (bursa) located over the prominent bony part of the outer hip. This condition causes pain on the side of the hip, often worsening when lying on that side or with prolonged walking. The pain and altered mechanics from bursitis can cause a compensatory limp, putting abnormal stress on the knee joint.
Non-Invasive Management Strategies
Simple modifications to daily life can help manage the symptoms of combined hip and knee pain. Maintaining a healthy weight is one of the most impactful strategies, as every pound of excess body weight dramatically increases the load and stress placed on both the hip and knee joints during walking. Even a modest reduction in weight can significantly lessen joint pain.
Selecting appropriate footwear is important, as shoes with shock-absorbing soles can help to cushion the impact and distribute forces more evenly across the lower limbs. Gentle, low-impact exercise, such as walking on level ground, cycling, or swimming, can help to maintain flexibility and strength without excessive joint strain. The goal is to keep the joints mobile and the surrounding muscles active.
Targeted strengthening of the hip muscles, particularly the hip abductors and gluteal muscles, can help restore proper alignment and reduce the rotational stress on the knee. Simple stretches for the hip flexors and quadriceps can also improve muscle balance and joint function. For temporary relief of localized pain and swelling, applying ice or cold packs to the joints after activity can help reduce inflammation.
Knowing When to Consult a Specialist
It is advisable to seek professional medical evaluation when certain signs, known as “red flags,” are present. Pain that is persistent and does not improve after one to two weeks of self-management, such as rest and over-the-counter pain relievers, warrants a consultation. Pain that is severe enough to disrupt sleep is an indicator of a more serious underlying issue, such as advanced joint degeneration or significant inflammation.
Other concerning signs include sudden or significant joint swelling, a feeling of instability or the joint “giving way,” or an inability to bear weight on the leg. If the pain causes a noticeable change in your walking pattern or if you experience numbness or tingling, a specialist should be consulted promptly. A primary care physician can offer an initial assessment and may refer you to a physical therapist or an orthopedic specialist for a detailed diagnosis and treatment plan.