Knee pain is one of the most common complaints seen in active individuals’ at all different levels. There are numerous knee-related injuries that can occur directly to specific structures, like ligaments or tendons, in the knee. But what many people are unaware of are the effects of the hip musculature, specifically the glutes (glut max, glut med, glut min), on forces occurring at the knee.
Bio-mechanically speaking, the glutes are responsible for controlling hip extension, as well as rotation and lateral movements occurring in the femur. Often times the glutes will become weak or inhibited by over-activation of muscles like the hamstrings and TFL/IT-band, causing decreased pelvic stability and inappropriate forces to occur in the knee. Research is now focusing on the entire kinetic chain of the hip, knee, and ankle when looking at lower limb injuries. In a recent study published in the North American Journal of Sports Physical Therapy, it was found that active individuals complaining of unilateral knee pain had significantly decreased gluteal strength on their affected leg vs. their non-painful leg. This study demonstrates the importance of taking a closer look at hip musculature, specifically the glutes, when knee pain in present.
So, what are some effective ways to strengthen the glutes if you do have weakness present? Here are some exercises that have been shown to specifically target these muscles and may reduce your knee pain:
- Bridging: While lying on your back with knees bent, slowly raise your hips off the floor, squeezing your glutes. Make sure your pelvis stays neutral and abdominals are engaged. Slowly lower back down. Progression– advance to single limb bridging keeping one leg lifted off the floor.
- Clam Series: Lay on your side with heels in line with your glutes, knees bent, and hips flexed to about 45 degrees. Keeping your heels together, slowly open your knees without letting your pelvis rotate backward. Progression: You can add in resistance with a thera-band.
- Sideplank: while lying on your side with your upper body propped on elbow and forearm, lift your pelvis off the floor while maintaining straight alignment. Hold 15-30 sec. Progression: while maintaining plank position, raise and lower top leg.
- Side Stepping: maintain tight core, toes pointed straight ahead, with a slight bend in your knee. Take small lateral steps. Progression: add thera-band for resistance at the ankles or toes.
- Squatting: maintain feet shoulder width apart, core engaged, and trunk upright. Slowly lower body, keeping knees in line with 2nd toe and not going past your toes. Progression: advance to single limb squat making sure knee does not fall inward.
For more advanced exercises, or for more information specifically about where your knee pain may be coming from, contact a therapist at ProActive Physical Therapy and Sports Medicine.
Reference:
Rowe J, Shafer L, Kelley K, et al. Hip Strength and Knee Pain in Females. North American Journal of Sports Physical Therapy. 2007. 2(3): 164-169.