Knee Pain and Hip Pain after using Elliptical Machine:

After reviewing a few articles I had found that the issue with elliptical trainers in general are they were supposed to be designed to reduce the amount of force distributed from ground reaction forces (the point where the foot comes into contact into the ground). Upon further reading I found due to the fixed pedals which don’t allow for dorsiflexion at the ankle joint, it puts more stress on the knee and hip. Many elliptical machines have a fixed gait and don’t allow for any mobility in the ankle joint. It is essentially a vertical cycling machine when it comes to this, and the individual is to some degree forced to move in a certain type of direction. It has been found that the knee remains flexed throughout most of the gait cycle on an elliptical. If the stride length is too short then the greater the knee flexion that occurs and thus the great anterior force placed at the knee joint. This can lead to patellofemoral knee pain, and for individuals with any type of knee issue this can possibly lead to re-injury of the joint.
Depending on which type of elliptical you decide to purchase the studies to show a significant drop in the about of anterior force at the knee and hip when the pedal is not in a fixed position and the swinging arms are able to move in both abduction and adduction based on an individual’s own gait cycle. The arc trainer allows this to occur. In fact it was the only one to produce lower impact forces at the joints than walking. The elliptical trainers depending on the overall path the pedals produce on average the amount of force through the joints as climbing stairs, squatting and lunging.
In my professional opinion if your clientele is older and a population that will have more chances of being injured the arc trainer would be the best way to go as it has the lowest impact on all joints throughout the gait cycle. If the arc trainer is not available then it may be better to prescribe walking on a treadmill or on flat ground to reduce the stress on the ankle, knee and hip joints.
If anyone else has experienced this issue with elliptical machines and their knees or hip I would love to hear your thoughts on this.
References:
1. Patellofemoral Joint Forces Between Two Non-Impact Cardio Machines. Department of Physical Therapy, University of Wisconsin- La Crosse. Cybex Research Institute
2. Tung-Wu Lu; Hui-Lien Chien, Hao-Ling Chen. Joint Loading in the Lower Extremities During Elliptical Exercise. Med Sci Sports Exerc. 2007; 39(9): 1651-1658
3. Knutzen KM, McLaughlin WL, Lawson AJ, et al. Influence of Ramp Position on Joint Biomechanics During Elliptical Trainer Exercise. The Open Sports Sciences Journal, 2010; 3: 165-177.

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