Your knee pain can be coming from your hips | Total Performance Physical Therapy

Your knee pain can be coming from your hips

October 1, 2014

Have you experienced knee pain while running?  While there may be an issue with the knee, a good place to look for the cause of pain is in the hip region.  If the muscles surrounding your hips and pelvis are weak, there may be increased stress placed on your knee or other areas of your legs.  This can result in increased pain and can result in further injuries.

There are many muscles surrounding your pelvis and hips.  Many of us have heard of the gluteus maximus muscle, also known as the buttocks muscle.  This muscle is the strongest and largest muscle in the human body.  It is responsible for movement of the hip and thigh.  You use this muscle to stand up from a chair, go up stairs, and while standing up and walking around. While this is the largest and most well known buttocks muscle, there are two other gluteal muscles that are very important to the hip region, especially while running – gluteus medius and gluteus minimus.

The gluteus medius and minimus sit more on the side of each hip and start right underneath your gluteus maximus.  They function to pull your thigh directly out to the side, also known as hip abduction. This is the motion of your leg while performing a jumping jack. It also functions to rotate the thigh inward.

The muscles surrounding the hip need to be kept strong to help limit pain.
The muscles surrounding the hip need to be kept strong to help limit pain.

The gluteus medius muscle is very important while you are walking around day to day and during running.  During these activities, you are often standing on one leg as the other leg advances forward.  For example, when you are standing on your right leg and holding the left leg up in the air, your right gluteus medius is active and functions to keep your hips level. If this muscle is weak, your hips will become uneven and higher stress will be placed on certain parts of your legs.  Over time, this can lead to injury.

Gluteus Medius Weakness

Weakness of your gluteus medius muscle has been shown to contribute to many common running injuries. Some examples of injuries associated with this weakness are:

1)                  Knee pain on the inner or outer knee: When your gluteus medius is weak, you are unable to properly control your thigh bone, or femur.  When this bone falls in too far towards the midline of your body, it can cause stress on the knee in different areas.

2)                  Low back pain: If your gluteus medius muscle is weak and not working properly, more stress is placed on the muscles of your lower back to compensate for the weakness.  This causes increased low back pain.

3)                  Iliotibial band syndrome: When there is weakness of the gluteus medius, the thigh bone falls inward while standing on that leg, and there is more stress placed on the IT band that runs down the outside of your thigh. This causes increased inflammation of the IT band and increased pain as a result.

There are many other leg and foot injuries associated with weakness of the gluteus medius.  Trigger points, or muscle knots, are also commonly formed throughout the leg muscles when the gluteus medius is weak.  These can be treated with a foam roll program or manual therapy from a physical therapist.

How can I tell if my gluteus medius is weak?

There are many quick tests to tell if you have weak gluteus medius muscles.  First, you can stand in front of a mirror and on one leg.  For example, stand on your right leg.  Perform a single leg squat.  If your left hip drops during the squat or if your right knee rotates inward, this can be a sign of gluteus medius weakness.

What do I do if my gluteus medius is weak?

There are many exercises that can be performed to target this very important muscle of your hip. First, you should see a physical therapist to assess the strength of your gluteus medius and other gluteal muscles.  Next, you should begin a hip and core strengthening program to target these muscles in order to treat or prevent hip, knee, and other lower extremity injuries.

For more information on physical therapy services or for gluteus medius testing, please visit or email us at