Our bodies are intricate. Each bone, muscle, nerve, cell, and piece of tissue plays a vital role in even the most basic of functions. When an area is weak or lacking in some way, it often sparks a chain reaction that affects other parts of the body. It can then easily turn into a vicious cycle and leave you wondering where the pain actually originated, and how to correct it. Let’s take the knee for example. When experiencing pain in the knee, it can absolutely be the result of an injury or conditions such as arthritis or repetitive strain. However, sometimes the pain in your knee isn’t caused by the knee itself, but rather some long line of connection and compensation patterns. While there are numerous reasons your knee may be painful, a common culprit is the hips, specifically the glute muscles.
Your hip bears a lot of weight in several different planes of movement, and because of this, requires numerous ligaments and muscles to support and stabilize throughout. One of the most important for this stabilization is the gluteus medius. This muscle aids in pulling your leg out to the side and back (abduction and extension) as well as rotating outward (external rotation). The gluteus medius is also one of the muscles in charge of keeping your pelvis level when you’re walking or standing.
Now, when your gluteus medius isn’t strong enough to support and stabilize as it should, the TFL (tensor fascia lata) has to take over. The TFL is a fairly small muscle located on the side of the hip and upper thigh, that is acts in a small way to stabilize the pelvis during certain phases of walking. While that may not seem like such a big problem when the TFL is forced to compensate for the weak gluteus medius, it easily becomes too tense, pulling on the IT (iliotibial) band; that long, tight piece of tissue that runs straight down the side of your thigh and to your knee. As the TFL pulls, the entire band can become tense and pull upward. Because it wraps around the knee, that upward movement pulls on the kneecap (patella), causing an abnormal tracking of the patella during flexion and extension of the knee, often resulting in pain.
You may think your glutes are strong because you do squats, lunges, or other exercises meant to target that area, but this particular muscle isn’t fully activated during those activities. Instead, it requires a bit more focused effort; more specifically, hip abduction and external rotation exercises are best. If you lay on your side with your entire body in a straight line, then lift your top leg up, back, and slightly rotate it outward so your knee faces toward the ceiling, you might notice that you need to compensate in some way to hold that position; either stabilizing yourself to the floor with your hand or pulling your bottom leg forward to prevent rolling onto your back. This is a clear indication of a weak gluteus medius. It’s also the perfect exercise to strengthen it.
As you can see, it’s vital to pay special attention to the gluteus medius and other stabilizers and secondary muscle groups, as they play an important role in ensuring stability, strength, and proper movement down the chain of structures.
If your knee has been painful, make an appointment with us, and let’s work together to determine what the real cause is, how to rehabilitate your injury, and how to prevent any further damage.