Your Knee Pain Can Be Coming From Your Hips | Total Performance Physical Therapy

Your Knee Pain Can Be Coming From Your Hips

June 6, 2019

Have you experienced knee pain while running? If you have and work with a physical therapist, you may have noticed that they use exercises focusing on your hips. Why is this?

While there may be an issue with the knee, a good place to look for the cause of pain is in the hip region. One of the muscles on your hip is the gluteus medius, and it could be the main culprit of your knee pain. 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 further injuries.

Let’s look at why your gluteus medius is causing knee pain and how you can strengthen your hip muscles with specific exercises.

What Is the Gluteus Medius, and What Does It Have to Do With My Hip?

Several muscles are 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 the movement of the hip and thigh. You use this muscle to stand up from a chair, go up the stairs, stand up, and walk around. While this is the largest and most well-known buttocks muscle, two other gluteal muscles are very important to the hip region, especially while running — the 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 gluteus medius muscle is vital for your ability to walk around day-to-day and to run. 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.

Running Injuries from 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 cannot properly control your thigh bone or femur. When this bone falls too far towards the midline of your body, it can cause stress on the knee in different areas. A weak gluteus medius causing knee pain can impede a runner’s ability to train. It can slow you down and may be all you can think about.
  2. Low back pain: If your gluteus medius muscle is weak and not working correctly, 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 a weakness of the gluteus medius, 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 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?

Because weak hips cause knee pain, you’ll want to focus on your gluteus medius during your strength training. Many exercises can be performed to target this essential muscle of your hip. First, you should see a physical therapist to have the strength of your gluteus medius and other gluteal muscles assessed. 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.

Common gluteus medius exercises for knee pain include:

  1. Pistol (or one-legged) squat: This type of squat targets your hip structure and helps you regain strength in these muscles.
  2. Pelvic drop exercise: This exercise strengthens your weak gluteus medius.
  3. Lateral hip raises: With an exercise band around your ankles, perform these raises while lying on your side to target your hips.
  4. Gait retraining: Often, weak hip muscles can cause your gait to be thrown off, which may cause knee pain. A physical therapist can run through exercises with you to improve your gait.

Check out this video to learn more about exercises for knee pain:

How Do I Avoid Putting Stress on My Knees and Hips?

If you’re recovering from an injury because of your weak hips, be sure to follow the strengthening exercises your physical therapist gave you. You may feel like you want to immediately get back up to exercising the way you were before the injury, but give your knees and hips time to heal. Exercise lightly on a regular basis with floor exercises, hand weights, gentle yoga, or swimming.

Are My Weak Hips Causing My Knee Pain?

Continual knee pain is not a good sign, especially for runners still wanting to train and improve their skills. If you’re struggling with painful knees, a physical therapist can perform an assessment of your hip mobility and strength to determine if your gluteus medius muscle is weak. They’ll be able to relieve the stress on your knees by strengthening your hips.

For more information on physical therapy services or gluteus medius testing, contact us today!