Sore Knees? You Have a Wimpy Butt!
Knee pain is one of the most common reasons that we see people for in physical therapy. The vast majority of the time, if there wasn’t an injury, the problem can be traced back to weak muscles in the hip/buttock region, specifically the gluteus medius muscle.
“..but… but… but I exercise! How can I have weak hip muscles?” Good question! Most people that exercise, unless they specifically target these muscles – may still be weak in the gluteus medius. The reason is that it is much easier to use bigger stronger muscles to compensate so the weak muscles just stay that way.
Why do weak butt muscles make your knees hurt? Without getting too technical – it is all about shock absorption. Your body is built in such a way that when you walk certain muscles are supposed to “absorb” the forces that come from each step you take. This happens at the ankles, knees, and hips and the forces are distributed so that one area isn’t overworked. A weak link in that chain causes other muscles to have to work harder – in this case often times weak hip muscles lead to your thigh muscles (your quadriceps) overworking, which in turn causes tendon irritation and sometimes joint problems.
Luckily, prevention is fairly easy. There are a couple of simple exercises that you can add to your daily routine that will target your gluteus medius and help prevent knee pain. They are:
1) Hip Abduction: If you go to the gym you’ve probably seen this machine and walked right past it (picture below). This directly targets the gluteus medius muscle along with other muscles that work at the hip. I suggest starting out with a weight that you can do 15 repetitions with and doing 3 sets. The goal here is to stick with higher repetitions because you want a bit more endurance in this muscle – but be sure to increase the weights as it gets easier to complete the 3 sets of 15. You can also do this exercise with a theraband – just tie it around your thighs and pull your knees apart.
2) Hip Extension: You can find a few different machines at most gyms that will allow you to do this – the most common is the Multihip Machine (see picture below). The key with this is to make sure you aren’t swinging your body and you are actually using your glutes to push the weight back. On these I like to also pick a weight where you can do 15 repetitions, but the catch is you want to hold it for 3-5 seconds at the “squeeze” portion of each rep – then return SLOWLY to the start position. 2-3 sets on this.
3) Lateral Step-Up: For this you will need a step – as the name implies. The idea here is that you are working everything in your legs because of the stepup portion, your glute medius will work extra hard to keep you stable as you lift yourself up. At first you want to start out with a low step if you are having knee pain – one of those Reebok steps is a good starting point. You want to work up to larger boxes as you get stronger as long as you can maintain good form. See the picture below for an advanced version using a barbell for extra fun. For this you are just stepping up onto the step – shoot for 3 sets of 10-20 reps.
Those simple exercises will make a big difference for you if you are a “knee pain sufferer” that doesn’t know why your knees hurt, even if you do know why they hurt these exercises will help get you back on track.
As always – be sure to see a doctor to get yourself checked out if your pain is severe or it doesn’t go away after a week or 2.