Many of us will experience different degrees of knee pain at least once in our lifetime. Factors that can affect the level of knee pain include: faulty movement patterns, muscle force and/or length, posture/alignment and physical activity (occupational, recreational, self-care activities). Many health practitioners choose to treat just the symptoms of knee pain; using modalities such as kineseotape, medication, ultrasound, and inconsistent massage which offer short term relief. To treat the underlying mechanisms of knee dysfunction it is prudent to include: therapeutic exercises to strengthen the glute maximus/medius muscles; self myofascial release with foam roller of quadriceps, hip flexors and gastrocnemius/soleus complex; corrective exercise to improve faulty movement patterns; and manual therapy such as joint mobilization.
After taking a continuing education course on Functional Biomechanics of the Lower Quarter taught by Christopher Powers, PhD, PT and Co-Director of Musculoskeletal Biomechanics Laboratory at U.S.C., I realized the relationship between hip/glute weakness and knee pain. Hip motions that can influence the knee are femoral internal rotation and adduction. These motions if unchecked by strong glute maximus/medius muscles will cause a Genu Valgus (knocked knee) stress on the knee complex. This hip extensor/abductor weakness combined with quadriceps overuse will cause increased patella-femoral joint reaction forces and thus knee pain.
Many personal trainers and even physical therapist would incorrectly treat knee pain with numerous quadriceps strengthening exercises, but this inherently leads to more quadriceps overuse and thus no significant improvement in knee symptoms. Therapeutic exercises to strengthen glute maximus/medius include: bridging, sidelying hip abduction with external rot/extension, quadruped hip motions, single leg stance activities with progression to functional/dynamic movements that require hip/knee stability.